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Objective:To investigate the relationship between plasma phosphorylated α-synuclein (ps129-α-syn) and cognitive function in Parkinson disease (PD).Methods:This study recruited 90 PD patients who were hospitalized in the Department of Neurology, Henan province people's hospital from March 2019 to June 2020.Forty healthy middle-aged and elderly people with normal cognitive function who came to the hospital for physical examination were selected during the same period.Clinical characteristics and blood samples were collected.Patients with PD were classified into those with normally cognitive (PD-NC), mild cognitive impairment (PD-MCI), and dementia (PDD). The enzyme-linked immunosorbent assay was used to measure the plasma ps129-α-syn.Correlations between plasma ps129-α-syn and clinical characteristics such as disease duration, Hoehn-Yahr stage (H-Y), unified Parkinson's disease rating scale (UPDRS), Montreal cognitive assessment (MoCA), 14-item Hamilton anxiety rating scale (HAMA-14), the 24-item Hamilton depression rating scale (HAMD-24), levodopa equivalent daily dosage (LEDD), the scale of outcomes in Parkinson's disease for autonomic symptoms, SCOPA-AUT) were analyzed using Pearson or Spearman correlation analysis.Multiple linear regression analysis was used to evaluate the factors affecting the cognitive function of PD.Results:Plasma ps129-α-syn in PD patients was higher than that in healthy controls((19.44±8.93)μg/L, (10.78±5.87)μg/L, ( t=5.615, P<0.01). Plasma ps129-α-syn was higher in PD-MCI group((19.64±7.77)μg/L)and PDD group((23.79±9.47)μg/L) compared with that in PD-NC group((13.37±5.40)μg/L)( P<0.05). Plasma ps129-α-syn was positively correlated with H-Y ( r=0.404, P<0.01), UPDRS-Ⅲ( r=0.275, P=0.009), UPDRS-total ( r=0.211, P=0.046) and SCOPA-AUT( r=0.335, P=0.001). Plasma ps129-α-syn was negatively associated with MoCA ( r=-0.459, P<0.01). Multiple linear regression analysis suggested disease duration ( t=-4.618, P<0.01), ps129-α-syn( t=-3.792, P<0.01) and UPDRS-total ( t=-2.826, P=0.006) were independently associated with cognitive function.Plasma ps129-α-syn could discriminate between PD-NC and PD cognitive function impairment with an AUC of 0.7797 (95% CI: 0.686 3-0.873 2, P<0.01). Conclusions:Plasma ps129-α-syn is correlated with cognitive function and the severity of motor symptoms in PD patients, and have high sensitivity and specificity in diagnosing PD cognitive dysfunction.Therefore, plasma ps129-α-syn can serve as a biomarker to assess cognitive function in PD.
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Objective:To evaluate the sleep disorders in patients with Parkinson′s disease (PD) with different onset sides, and to analyze the correlation between PD kinesia-onset side and sleep disorders.Methods:A total of 658 patients with primary PD admitted to the Special Outpatient Department of Parkinson′s disease in Fujian Medical University Union Hospital from January 2015 to March 2021 were collected. According to the onset side of motor symptoms, they were divided into the left group (313 cases) and the right group (345 cases). The medical history collection and physical examination were conducted to evaluate the motor symptoms, non-motor symptoms [Non-Motor Symptom Scale (NMSS)], depression state and cognitive function of the patients. Parkinson′s Disease Sleep Sclale-2 (PDSS-2) and the Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ) were used to evaluate and analyze their sleep status, and comparisons were made between groups. Binary multivariate Logistic regression analysis was used to access the risk factors associated with sleep disorders in Parkinson′s disease.Results:The scores of daytime fatigue [2.00(0, 4.00)] and unexplained limb pain [4.00(0, 4.00)] in NMSS assessment of PD patients in the left onset group were significantly higher than those in the right onset group [1.00(0, 3.00), Z=-2.545, P=0.001; 2.00(0, 4.00), Z=-2.797, P=0.005]. There was no significant difference in the total score of PDSS-2 between the two groups, but there were significant differences in limb restlessness, periodic limb activity, muscle spasm and early drowsiness between the two groups. In the evaluation of rapid eye movement sleep behavior disorder (RBD), the total score of RBDSQ in the left onset group [2.00(0, 4.00)] was significantly higher than that in the right onset group [1.00(0, 3.00), Z=-4.363, P<0.001]. The incidence of dream content, nocturnal behavior, nocturnal exercise, self-injury and bed partner in dream, abnormal behavior at night, nighttime awakening, dream memory and sleep disorder in the left onset group was also higher than that in the right onset group. In addition, binary multivariate Logistic regression showed that PD-related sleep disorders were associated with onset of advanced age ( OR=1.037, 95% CI 1.018-1.057, P<0.001), course of disease ( OR=1.014, 95% CI 1.010-1.018, P<0.001) and onset of abnormal postural gait ( OR=1.505,95% CI 1.058-2.141, P=0.023). RBD in patients with PD was associated with left onset ( OR=2.215,95% CI 1.395-3.515, P=0.001), advanced age onset ( OR=1.045,95% CI 1.019-1.072, P=0.001) and course of disease ( OR=1.014,95% CI 1.009-1.019, P<0.001). Conclusions:PD patients with left onset are more likely to have sleep disorders such as limb restlessness, periodic limb activity, muscle spasm and early drowsiness. At the same time, the incidence and severity of RBD in patients with left onset of PD are significantly higher than those of patients with right onset of PD. The onset side of motor symptoms of PD is an important factor affecting sleep disorders, and the onset of left side may be a risk factor for PD patients with RBD.
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Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26％),constipation 53 cases (49.07％) and taste abnormalities 40 cases (37.04％),followed by loss of appetite 35 cases (32.41％) and early satiety 26 cases (24.07％),swallowing disorders 20 cases (18.52％),nausea 11 cases (10.19％),salivation 10 cases (9.26％),oral pain seven cases (6.48％),vomiting four cases (3.70％),loose stools one case (0.87％).In 76 controls,taste abnormalities accounted for 13 cases (17.11％),early satiety six cases (7.89％),loss of appetite six cases (7.89％),nausea five cases (6.58％),salivation three cases (3.95％),oral pain one case (1.32％),and the rest zero.The incidence of constipation (x2=52.390,P＜0.01),dry mouth (x2=69.050,P＜0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P＜0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P＜0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95％CI 1.371-7.495,OR=3.205),early satiety (95％CI 4.227-282.913,OR=34.582),taste abnormalities (95％CI 6.620-88.942,OR=24.260) and swallowing disorders (95％CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.
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Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant degenerative disease. The main clinical manifestation of SCA2 is progressive cerebellar syndrome, but a wide range of extracerebellar and non-motor symptoms can be observed clinically. The non-motor symptoms and extra-cerebellar signs in SCA2 patients are reviewed to provide a better understanding in cognition, diagnosis and treatment of the disease.
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One hundred ten patients with Parkinson′s disease(PD)and 110 age-matched healthy controls were enrolled in the study.The non-motor symptoms(NMS)were assessed with Non-motor symptoms of Parkinson′s disease questionnaire(PDNMSQ30).The PD patients were classified as gait abnormality posture type(PIGD, n=73)and tremor type(TD, n=37).The non-motor symptoms were compared between two groups.Results showed that the NMS in PD patients was higher than that in healthy controls[(35.2 ±3.0)vs.(6.0 ±2.0)symptoms, t=6.43, P=0.01].The NMS score of PIGD group was higher than that of TD group[(28.9 ±1.1)vs.(6.2 ±0.7)symptoms, t=2.73, P<0.01]; Mini-mental state examination(MMSE)and Montreal cognitive assessment scale(MoCA)scores of TD group were significantly higher than those of PIGD group(t=11.52,P<0.01; t=8.79,P<0.01).The results indicate that for PD patients with different motor types,their NMS are different,and PD patients with PIGD have more axial involvement,and more NMS.
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Objective To investigate whether sex,age-of-onset,education and asymmetry affect non-motor symptoms (NMS)in Parkinson disease,and to analyze the relationship between motor symptoms and NMS in Parkinson's disease.Methods The detailed clinical information of 157 patients with idiopathic Parkinson's disease(PD)was recorded and followed up.The data was calculated with SPSS statistic software.Sex had an impact on sleeping disorder (P＜ 0.05).Sleep disorder in female was more prominent.Cognitive disorder was affected by age-of-onset and education duration.The pain and sensory disorder were affected by age-of-onset (P ＜ 0.05).Differences in the effects of asymmetry on NMS were not statistically significant (P＞ 0.05).The higher the scores of postural instability and gait difficulty (PIGD)were,the lower the Mini-Mental State Examination (MMSE)score was(β=-1.837,P =0.004).The higher the tremor score was,the higher the Hamilton Depression Scale(HAMD) score was(β=3.460,P =0.001).The higher the rigidity akinesia score was,the higher the autonomic dysfunction score was(β=0.104,P=0.006).Conclusions The non-motor symptoms of Parkinson's disease are affected by the age,sex and cultural level.Symmetryor-not does not affect Parkinson's disease.Non-motor symptoms and motor symptoms are closely linked.The encountered posture and gait abnormalities of patients should trigger physician alerts to focus on patients' cognitive function.The encountered tremor of patients should trigger physician alerts to focus on their emotional changes.Facing to the patient with rigidity and less moving,physician should alert to the occurrence of autonomic symptoms.
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Objective To analyze the correlation between non-motor symptoms (NMS) and the quality of life in the mild Parkinson's disease (PD) patients of different genders.Methods 85 mild PD patients (H-Y stage 1～2) were investigated.The PD NMS Quest was used to assess NMS.The quality of life was assessed with SF-36 questionnaire.Results Stepwise linear regression analysis showed that nocturia,restless legs,depression,daytime sleepiness,decreased interest,smell taste problems were positively correlated with the score of life quality of male and pain,increased sweating,taste smell problems,sleep problems,changes in libido,decreased memory,diplopia influenced life quality score of female.The scores of SF-36 questionnaire of the male with PD were lower than that of female patients.Conclusions The nonmotor symptom (NMS) There was a gender difference about the influence that NMS has made on PD patients.The male's life quality were lower than that of female patients about mild PD patients.
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Objective To survey the prevalence,distribution of non-motor symptoms(NMS)in different H-Y stage of Parkinson diseases(PD)and some correlative factors of NMS.Methods 169 patients with PD and 102 controls were involved in the survey.Parkinson diseases rating scale Ⅲ(UPDRS-Ⅲ)and Ⅴ(UPDRS-Ⅴ),Non-Motor Symptoms Questionnaire for Parkinson's disease(NMSQuest),Hamilton depression scale(HAMD),Hamilton Anxiety Scale(HAMA),Parkinson's Disease Sleep Scale(PDSS)and Mini-Mental State Examination (MMSE)were used to assess motor and non-motor symptoms.Results Most patients had non-motor symptoms (99.41%),including depressive symptoms(76.33%)and anxious symptoms(80.47%).The scores of HAMA,HAMD,PDSS and NMSQuest of patients were significant different from those of the controls.There were significant different between the different H-Y stages on the distribution and severity of NMS.The HAMA,the H-Y stage,PDSS,gender and MMSE had entered the regression equation.Conclusion NMS in PD are common and frequent.There are different clinical characteristics on the distribution and severity of NMS between the different H-Y stages.