Clinical features of 35 patients with Parkinson's disease displaying REM behavior disorder
Clinical features of 35 patients with Parkinson's disease displaying REM behavior disorder
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DOI：
10.1016/j.clineuro.2004.09.021
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发表时间：
2005-06-01
影响因子：
1.9
通讯作者：
Kiliç, E
中科院分区：
文献类型：
--
作者：
Özekmekçi, S;Apaydin, H;Kiliç, E
目的：评价和比较帕金森病(PD)伴与不伴REM陡峭行为障碍(RBD)患者的病情严重程度、治疗特点及运动并发症的发生率。评估RBD存在的标准问卷已经发给了这些患者和他们的告密者。符合临床诊断标准的35例患者(RBD组)的平均发病年龄为61.8岁。其中77%是男性。PD患者Hoehn-Yahr分期的临床特点。根据统一帕金森病评定量表(UPDRS)评定帕金森病的严重程度。左旋多巴(LD)治疗的平均剂量和持续时间。结果：PD病程、Hoehn-Yahr分期和UPDRS评分的平均值，RBD组明显长于NRBD组(分别为6.2年和3.05年，P<；0.005)，平均实际剂量也较高(分别为460.3 mg/d和320.3 mg/d)。P<；0.02)。多巴胺激动剂的剂量和持续时间在不同组之间没有差异。在RBD组，疲劳现象非常普遍(P<；0.01)。其病程较长(P<；0.005)，与LD相关的运动障碍发生率较高(P<；0.01)。结论：与正常对照组相比，RBD患者在PD早期需要较高剂量的LD治疗，最终导致运动并发症。在这些病人身上。多巴胺能治疗恢复了UPDRS评分，但不能阻止RBD的发生。(C)2004爱思唯尔B.V.保留所有权利。
Objective: To assess and compare the disease severity, the treatment properties and the frequency of motor complications in the patients with Parkinson's disease (PD) having and not having REM steep behavior disorder (RBD).Patients and methods: Based on chart review, patients with Parkinson's disease whose bed partners have reported prominent motor activity while dreaming were identified. Standard questionnaires assessing the presence of RBD have been addresed to these patients and their informants. Obtained data fulfilled clinical diagnostic criteria of probable RBD in 35 patients (RBD group) with the mean age at symptom onset was 61.8 years. Of them 77% were men. Clinical features of these patients concerning Hoehn-Yahr stage of PD. the severity of PD according to the Unified Parkinson's disease rating scale (UPDRS). the mean dose and duration of levodopa (LD) therapy. the presence of motor complications were compared with those of gender and age at PD-onset matched 35 PD patients without RBD (NRBD group).Results: The mean values of PD duration, Hoehn-Yahr stage and UPDRS scores did not differ between groups, The duration of LD therapy was significantly longer in RBD group in comparison to NRBD group (6.2 years versus 3.05 years, respectively, P < 0.005) and also mean actual dose of LD was higher (460.3 mg/day versus 320.3 mg/day respectively. P < 0.02). The dose and duration of dopamine agonists did not differ between groups. In RBD group, wearing-off phenomenon was significantly common (P < 0.01). its duration was longer (P < 0.005), and LD-related dyskinesias were more frequent (P < 0.01).Conclusion: In the current study, when compared with NRBD group, the patients with RBD required higher doses of LD treatment at an earlier stage of PD which eventually led to motor complications. In these patients. dopaminergic treatment restored UPDRS scores, but did not prevent the occurrence of RBD. (c) 2004 Elsevier B.V. All rights reserved.