The Motor Phenotype of Parkinson's Disease in Relation to Age at Onset
The Motor Phenotype of Parkinson's Disease in Relation to Age at Onset
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DOI：
10.1002/mds.23469
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发表时间：
2011-02-15
影响因子：
8.6
通讯作者：
Morris, Huw R.
中科院分区：
文献类型：
--
作者：
Wickremaratchi, Mirdhu M.;Knipe, M. Duleeka W.;Morris, Huw R.
背景：帕金森病（PD）是异质性的，发病年龄可能决定临床表型的变化。大多数以前的研究使用了不同的年龄截止值，并基于临床病例系列。方法：我们研究了358例社区和地区PD患者的临床特征和发病年龄之间的关系。结果如下：与45岁以下发病的患者相比，64岁以上发病的患者中震颤的发生率是45岁以下发病的患者的两倍（早发性PD -EOPD），并且随着发病年龄的增加而变得更常见（趋势p值< 0.004）。肌张力障碍影响60%的EOPD患者，与发病年龄呈曲线关系（立方与线性p=0.01），48岁之前发病的患者风险最高。在这项研究中，发病年龄是运动障碍发生的一个强有力的预测因素，年龄越小，运动障碍的风险越高。在多变量分析后，考虑到可能的混杂因素（疾病持续时间、左旋多巴剂量、左旋多巴治疗持续时间），发病时年龄较小（小于55岁）预测了左旋多巴诱导的运动障碍的发展（优势比
Background: Parkinson's disease (PD) is heterogeneous and age at onset may define variation in clinical phenotype. Most previous studies have used various age cut-offs and have been based on clinical case series. Methods: We have studied the association between clinical features and age of onset in 358 community-based and regional patients with PD. Results: Tremor at presentation is twice as common in those with onset over 64 years as compared to those with onset under 45 (early onset PD -EOPD) and becomes more common with increasing age at onset (p values for trend < 0.004). Dystonia affects 60% of those with EOPD, shows a curvilinear relationship with age at onset (cubic versus linear p=0.01) with highest risk in patients whose disease began before 48 years. In this study age at onset was a strong predictor of the development of dyskinesias, with younger age associated with a higher risk of dyskinesias. Following multivariable analysis, allowing for possibly confounding factors (disease duration, L-DOPA dosage, L-DOPA treatment duration) younger age at onset, (less than 55 years) predicted the development of L-DOPA induced dyskinesia (odds ratio