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Parkinson's disease (PD) is the fastest-growing neurological disease and the main cause of disability.
In 2016, 6 million people were affected worldwide, while only 2.
5 million people were affected in 1990, which brought a heavy burden to patients, families and society.
Burden
.
The apparent heterogeneity of clinical phenotypes and disease progression rates observed in PD brings considerable uncertainty to individual patients at the time of diagnosis
.
Although recent data-driven cluster analysis reveals important insights into broader disease subtypes, the characteristics of disease progression mostly focus only on motion-related diseases
diagnosis
Non-motor features vary greatly in morbidity and severity, and may have a greater impact on quality of life than motor features, especially in the early stages
.
The ability to predict how these characteristics will appear and change over time will enable clinicians to predict individualized care needs
The ability to predict how these characteristics will appear and change over time will enable clinicians to predict individualized care needs
However, whether the co-existing RBD in patients with early Parkinson's disease affects the rate of progression of other phenotypic features has not been fully described
.
In this way, Yaping Liu, et al.
of the University of Cambridge tried to explore the influence of combined RBD on the longitudinal changes of motor and non-motor symptoms in patients with early Parkinson's disease
In the discovery cohort of the Oxford University Parkinson's Disease Center, patients with early Parkinson's disease (diagnosed within 3.
5 years) recruited from 2010 to 2019 were followed up every 18 months
.
At each visit, they used standard questionnaires and measurements to assess demographic characteristics and motor and non-motor symptoms (including RBD, daytime sleepiness, mood, autonomic symptoms, cognition, and smell)
They recruited a total of 923 patients (mean age: 67.
1±9.
59 years; 35.
9% were women), and 788 were followed up for evaluation (mean: 4.
8±1.
98 years, range: 1.
3-8.
3)
.
Among them, 33.
3% were confirmed as pRBD (PD + pRBD)
.
PD + pRBD patients have more severe baseline symptoms and show faster progress in the first and third parts of the Dyskinesia Association-Unified Parkinson's Disease Rating Scale, Purdue Pegboard Test, and Beck Depression Scale scores
In addition, Parkinson’s disease + pRBD and mild cognitive impairment (hazard ratio [HR]=1.
36, 95% confidence interval [CI]: 1.
01-1.
83), gait freezing (HR=1.
42, 95%CI: 1.
10-1.
86) ) Is related to the increased risk of frequent falls (HR=1.
62, 95%CI: 1.
02-2.
60)
.
The important significance of this study is the discovery: Parkinson’s disease + pRBD patients progress faster in motor, mood, and cognitive symptoms , confirming a more aggressive subtype of Parkinson’s disease that can be identified at baseline, and It has great clinical significance
.
Original Source:
Liu Y, Lawton MA, Lo C, et al.
Longitudinal Changes in Parkinson's Disease Symptoms with and Without Rapid Eye Movement Sleep Behavior Disorder : The Oxford Discovery Cohort Study.
Longitudinal Changes in Parkinson's Disease Symptoms with and Without Rapid Eye Movement Sleep Behavior Disorder in this message