Defining the Parkinson's disease phenotype: initial symptoms and baseline characteristics in a clinical cohort
Defining the Parkinson's disease phenotype: initial symptoms and baseline characteristics in a clinical cohort
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DOI：
10.1016/j.parkreldis.2004.10.007
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发表时间：
2005-05-01
影响因子：
4.1
通讯作者：
Putzke, DJ
中科院分区：
文献类型：
--
作者：
Uitti, RJ;Baba, Y;Putzke, DJ
目的：研究大规模帕金森病(PD)临床队列的人口学和历史特征，并确定PD初始症状与首次专科门诊体检评分之间的模式和关系。方法：1244名连续诊断为PD的患者的临床系列。结果：总体样本以右撇子为主(92%)，男性(67%)，平均年龄70岁，症状性疾病持续时间约7年。约25%的样本报告有神经退行性疾病的阳性家族史。震颤(47%)和运动迟缓(29%)是帕金森病最常见的两种首发症状，主要发生在上肢(68%)。震颤、运动迟缓和姿势不稳在最初的自我报告症状和第一次检查时的临床体征之间显示出显著的一致性。结论：样本的人口学和临床特征被认为是典型帕金森病的典型代表，与其他临床和基于人群的队列相似。患者报告的初始症状，包括类型和身体位置，与帕金森症除僵硬之外的所有主要症状的初步检查结果密切相关。这一佐证可能证实在帕金森病纵向进展研究中包含这些数据。(C)2005爱思唯尔有限公司。保留所有权利。
Objectives: Examine the demographic and historical characteristics of a large Parkinson's disease (PD) clinical cohort and determine the pattern and relationship between initial symptoms of PD and physical examination ratings at the initial subspecialty clinic visit.Methods: A clinical series of 1244 consecutive individuals diagnosed with PD. Baseline characteristics were examined.Results: The overall sample was predominantly right-handed (92%) male (67%), with a mean age of 70 years and symptomatic disease duration of about 7 years. About 25% of the sample reported a positive family history of a neurodegenerative disorder. Tremor (47%) and bradykinesia (29%) were the two most common initial symptoms of PD and occurred primarily in the upper extremities (68%). Tremor, bradykinesia, and postural instability showed a significant correspondence between the initial self-reported symptom and clinical signs at the first exam p < 0.05. However, rigidity did not show a significant correspondence.Conclusion: The demographic and clinical characteristics of the sample are thought to be phenotypically representative of 'typical' PD and were comparable to other clinic- and population-based cohorts. Initial symptoms reported by patients, including type and body location correlate tightly with initial examination findings for all cardinal symptoms of parkinsonism except rigidity. This corroboration may substantiate inclusion of such data in studies of longitudinal progression in PD. (c) 2005 Elsevier Ltd. All rights reserved.