New insights into Parkinson's disease through statistical analysis of standard clinical scales quantifying symptom severity.
New insights into Parkinson's disease through statistical analysis of standard clinical scales quantifying symptom severity.
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通过对量化症状严重程度的标准临床量表进行统计分析，对帕金森病有了新的认识。
DOI：
10.1109/embc.2019.8856559
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Tsanas,Athanasios
中科院分区：
文献类型：
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作者：
Tsanas,Athanasios
帕金森病（PD）的临床研究侧重于症状评估，通常依赖于在统一帕金森病评定量表（Unified Parkinson's Disease Rating Scale，简称CAFRS）等临床量表上量化的彻底耗时的体格检查。虽然广泛用于临床研究，但现实的时间限制使其无法在日常临床实践中使用。Hoehn和Yahr（H&Y）分期是一种替代量表，更容易管理，并提供了整体PD严重程度的简洁描述。在神经科医生中，对于他们需要评估的特定PD症状没有普遍的一致意见，以便为其患者开出治疗方案并优化症状管理，实际上在日常临床实践中没有记录临床量表。在这项研究中，我们系统地评估了不同的症状（如44个HRS项目所表示的），并旨在使用等级相关和互信息度量提供HRS和H&Y的统计关联。此外，我们研究了一个二维图上映射到H&Y上的CNORS项目子集的投影。我们报告了一些统计学上的强相关性，PD症状对BRAS和H&Y（|R| ≥ 0.3），并提供直观吸引人的可视化映射到H&Y。这些发现可能是有用的神经科医生在他们的日常临床工作的实际指导。
Clinical research studies in Parkinson's Disease (PD) focusing on symptom assessment often rely on thorough time-consuming physical examinations quantified on clinical scales such as the Unified Parkinson's Disease Rating Scale (UPDRS). Although widely used in clinical research, realistic time constraints preclude its use in daily clinical practice. The Hoehn and Yahr (H&Y) staging is an alternative scale which is easier to administer and provides a succinct descriptor of overall PD severity. There is no universal agreement amongst neurologists on the specific PD symptoms they need to be assessing in order to prescribe treatments and optimize symptom management for their patients, and practically there are no clinical scales which are recorded in daily clinical practice. In this study, we systematically evaluate diverse symptoms (as expressed in 44 UPDRS items) and aim to provide a statistical association with UPDRS and H&Y using rank correlation and mutual information metrics. Moreover, we investigate the projection of a UPDRS item subset on a 2D plot to map onto H&Y. We report some statistically strong correlations of PD symptoms against UPDRS and H&Y (|R| ≥ 0.3), and provide an intuitively appealing visualization mapping onto H&Y. These findings may be useful to neurologists as practical guidance in their daily clinical routine.