Diabetes is associated with postural instability and gait difficulty in Parkinson disease.
Diabetes is associated with postural instability and gait difficulty in Parkinson disease.
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DOI：
10.1016/j.parkreldis.2013.01.016
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发表时间：
2013-05
影响因子：
4.1
通讯作者：
Bohnen NI
中科院分区：
文献类型：
--
作者：
Kotagal V;Albin RL;Müller ML;Koeppe RA;Frey KA;Bohnen NI
合并糖尿病可能与帕金森病更严重的运动障碍有关。在正常老年人中，糖尿病与帕金森病特征有关，包括步态困难和僵硬，但与震颤无关。糖尿病是否通过加剧黑质纹状体多巴胺能去神经或通过强化黑质外病理学来增加帕金森病的运动功能障碍尚不清楚。我们进行了一项病例对照研究 (n=39)，涉及 13 名患有糖尿病的帕金森病受试者（年龄 66.4 岁 ± 5.5 岁；病程 6.9 年 ± 4.4 年），以及 26 名年龄、性别和病程匹配的无糖尿病帕金森病对照者。所有受试者均接受[11C]二氢丁苯那嗪囊泡单胺转运蛋白2型正电子发射断层扫描成像，以评估纹状体二氢丁苯那嗪分布容积比，并进行统一帕金森病评定量表运动检查，以确定强直、运动迟缓、震颤、姿势不稳和步态困难子评分。分析磁共振成像扫描以评估脑白质疏松症负担。在控制黑质纹状体多巴胺能去神经后，患有糖尿病的帕金森病受试者表现出更大的姿势不稳定性和步态困难分项（t=3.81，p=0.0005）。病例和对照之间的运动迟缓、僵硬或震颤评分没有差异。在控制合并症高血压和体重指数后，糖尿病与姿势不稳和步态困难之间的关联仍然存在。病例和对照之间白细胞疏松、远端振动感和左旋多巴剂量当量没有显着差异。糖尿病可能通过黑质纹状体多巴胺能去神经以外的机制导致帕金森病的姿势不稳定和步态困难。
Comorbid diabetes may be associated with more severe motor impairment in Parkinson disease. In normal elderly individuals, diabetes is associated with parkinsonian features, including gait difficulty and rigidity, though not tremor. Whether diabetes contributes to increased motor dysfunction in Parkinson disease by exacerbating nigrostriatal dopaminergic denervation or through intensification of extranigral pathology is unknown. We performed a case-control study (n=39) involving 13 Parkinson disease subjects (age 66.4 yrs ± 5.5; duration of disease 6.9 yrs ± 4.4) with diabetes and 26 age, gender, and duration-of-disease-matched Parkinson disease controls without diabetes. All subjects underwent [11C]dihydrotetrabenazine vesicular monoamine transporter type-2 positron emission tomography imaging to assess striatal dihydrotetrabenazine distribution volume ratio and Unified Parkinson disease rating scale motor examination to determine rigidity, bradykinesia, tremor, and postural instability and gait difficulty subscores. Magnetic resonance imaging scans were analyzed to assess leukoaraiosis burden. After controlling for nigrostriatal dopaminergic denervation, Parkinson disease subjects with diabetes displayed greater postural instability and gait difficulty subscores (t=3.81, p=0.0005). There were no differences in bradykinesia, rigidity, or tremor subscores between cases and controls. The association between diabetes and postural instability and gait difficulty persisted after controlling for comorbid hypertension and body mass index. Leukoaraiosis, distal vibratory sense, and levodopa dose equivalents did not differ significantly between cases and controls. Diabetes may contribute to postural instability and gait difficulty in Parkinson disease through mechanisms other than nigrostriatal dopaminergic denervation.
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影响因子：
6.1
作者：
Tansey MG;Goldberg MS
通讯作者：
Goldberg MS
影响因子：
--
作者：
Craft, Suzanne;Baker, Laura D.;Montine, Thomas J.;Minoshima, Satoshi;Watson, G. Stennis;Claxton, Amy;Arbuckle, Matthew;Callaghan, Maureen;Tsai, Elaine;Plymate, Stephen R.;Green, Pattie S.;Leverenz, James;Cross, Donna;Gerton, Brooke
通讯作者：
Gerton, Brooke
影响因子：
11
作者：
HUGHES, AJ;DANIEL, SE;LEES, AJ
通讯作者：
LEES, AJ
影响因子：
9.9
作者：
Arvanitakis, Z;Wilson, RS;Bennett, DA
通讯作者：
Bennett, DA
影响因子：
12.7
作者：
Jellinger, KA
通讯作者：
Jellinger, KA