VARIABLE EXPRESSION OF PARKINSONS-DISEASE - A BASE-LINE ANALYSIS OF THE DATATOP COHORT
VARIABLE EXPRESSION OF PARKINSONS-DISEASE - A BASE-LINE ANALYSIS OF THE DATATOP COHORT
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DOI：
10.1212/wnl.40.10.1529
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发表时间：
1990-10-01
期刊：
影响因子：
9.9
通讯作者：
WEINER, W
中科院分区：
文献类型：
--
作者：
JANKOVIC, J;MCDERMOTT, M;WEINER, W
DATATOP数据库包含800例早期未治疗帕金森病（PD）患者的临床信息，非常适合用于探索帕金森病的临床异质性。早发型帕金森病患者（≤40岁，N = 33）达到与晚发型帕金森病患者（≥70岁，N = 85）相同的残疾水平所需时间明显更慢（2.9年对1.7年）。早发型帕金森病患者的认知功能优于晚发型患者。在疾病进展迅速（“恶性帕金森病”；症状持续时间≤4年，N = 65）的患者中，运动迟缓以及姿势不稳和步态困难（PIGD）在发病时更为常见。将震颤为主型帕金森病（平均震颤评分/平均PIGD评分≤1.5，N = 441）与PIGD为主型（平均震颤评分/平均PIGD评分≥1.0，N = 233）进行比较，为临床亚型的存在提供了支持。PIGD组报告的主观智力、运动和职业损害明显大于震颤组。II期患者的抑郁评分高于I期患者。在参与DATATOP研究的患者中，发病年龄较大且伴有运动迟缓，或为PIGD型帕金森病，与症状以震颤为主或发病年龄较小时相比，功能残疾更严重。
The DATATOP database, which includes clinical information on 800 patients with early untreated Parkinson''s disease (PD), is well suited to explore clinical heterogeneity in PD. Patients with early-onset PD (.ltoreq. 40 years, N = 33) reached the same level of disability as the late-onset PD (.gtoreq. 70 years, N = 85) group at a significantly slower rate (2.9 vs. 1.7 years). Early-onset PD patients functioned cognitively better than late-onset PD patients. Bradykinesia, and postural instability and gait difficulty (PIGD), were more common at onset in patients with a rapid rate of disease progression ("malignant PD"; duration of symptoms 4 years, N = 65). Comparisons of tremor-dominant PD (mean tremor score/mean PIGD score .ltoreq.1.5, N = 441) with the PIGD-dominant type (mean tremor score/mean PIGD score >EQ1.0, N = 233) provided support for the existence of clinical subtypes. The PIGD group reported significantly greater subjective intellectual, motor, and occupational impairment than the tremor group. Stage II patients had higher depression scores than stage I patients. Among the patients participating in the DATATOP, older age at onset with bradykinesia, or with the PIGD form of PD, is associated with more functional disability than when the symptoms are dominated by tremor or begin at a younger age.