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Objective:To explore the epidemiology, pathogenesis, risk factors, screening and evaluation, diagnostic strategies and treatment of impulse control disorder after Parkinson's disease (PD). Methods:Studies related to Parkinson's disease complicated with impulse control disorder were retrieved using subject search from PubMed, Medline, Embase, Cochrane Library, CNKI, VIP and Wanfang Data, until December, 2020, and supplemented by reference backtracking and manual retrieval. Results:A total of 2355 studies were returned first, and 30 were included, from ten countries, mainly published in journals about medicine, neurology, psychiatry, sleep medicine and movement disorders, etc., between 2010 and 2020. The researches mainly involved the pathogenesis, risk factors, screening and evaluation, diagnostic strategies and treatment. Conclusion:There are many risk factors for impulse control disorder in PD patients, mostly the dopaminergic drugs, especially dopamine receptor agonists. Interventions for impulse control disorders emphasize prevention and early identification. Individualized and symptomatic treatments based on adjustment of dopamine receptor agonists are needed.
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Objective To study the pain prevalence and clinical characteristics in Parkinson disease (PD) for better understanding its pathophysiology and improving nursing care and treatment. Methods A cross-sectional controlled study was conducted at Department of Neurology, West China Hospital of Sichuan University from November 2015 to November 2016. A total of 316 subjects with mini-mental state examination scores ≥ 24 were enrolled, including 162 PD patients and 154 controls. Pain was assessed using the medical outcomes study 36-item short-form health survey (SF-36v2) bodily pain scale, and a body illustration including 45 anatomical areas for subjects to indicate the prevalence, severity and location of pain. Results Pain prevalence and severity in the PD group were significantly higher than those in the control group (P<0.001). Pain distribution was similar between groups, predominantly in the lower back, followed by the gluteal region, lower legs, thighs, posterior neck, and shoulders, but the prevalence of pain location in each between groups was with statistical significance (all P<0.05). Conclusions Pain prevalence in the PD group is significantly higher than that of normal people as well as its severity, but both groups are not similar in pain location. Pain is a significant problem in daily life of PD patients. Recognition of this has the potential to aid the better clinical management of and improved quality of life for PD patients.
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Objective To analyze the clinical features of Parkinson's disease (PD) combined with chronic pain in the elderly.Methods A total of 366 idiopathic PD patients experiencing pain were enrolled and divided into two groups:the elderly group (n=289) and the young group (n=77).Rating scales including Visual Analogue Scale (VAS),Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn Yahr (H-Y) Scale,Self-rating Anxiety Scale (SAS),Self rating Depression Scale (SDS) and Brief Pain Inventory (BPI) were evaluated.Results Compared with the young group,the elderly group had evidently higher scores of UPDRSⅡ,Ⅱ,Ⅳ,H-Y Scale,VAS as well as five sub-items of BPI including daily living,working,sleeping,walking ability and social communication [(13.7±5.3) vs.(12.3±6.3),(27.3±12.9)vs.(23.3±9.6),(2.3±2.2)vs.(1.7±1.3),(2.4± 1.0)vs.(2.1±0.9),(63.3±25.6)vs.(56.6±25.0),(5.3±2.7)vs.(4.6±2.7),(5.9±3.2)vs.(5.1±2.8),(6.3±2.5)vs.(5.6±2.6),(4.7±3.1)vs.(3.8±2.0),(3.2±2.1)vs.(2.6±2.5),t=1.976,2.539,2.287,2.381,2.050,2.021,1.997,2.165,2.420,2.134,respectively,all P＜0.05].No significant differences were found in SAS,SDS or other sub-items of BPI such as life pleasure and mood scores between the two groups (all P＞0.05).Compared with the young group,patients in the elderly group had a higher ratio of two or more pain types associated with PD[41.2％ (119/299)vs.23.4％ (18/77),x2=8.190,P＜0.05],but a lower ratio of pain-related treatment [29.76％ (86/299)vs.51.95％ (40/77),x2=13.260,P＜0.05].Conclusions Pain in elderlyPD patients is more severe,shows more diverse types,and significantly aftects the quality of life.Enhanced intervention is needed.
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Objective To describe the prevalence and neuropsychological character of mild cognitive impairment (MCI) associated with Parkinson' s disease(PD-MCI). Methods One hundred and three PD patients and a control group of 32 healthy old subjects were chosen. Psychometric assessment included the Mini Mental State Examination, the Dementia Rating Scale and a series of neuropsychol ogicaltests. The Hamilton Rating Scale of Depression was used to assess depression in PD patients. Results (1)Twenty-one (20.4%) PD patients was diagnosed with dementia, 45 (43.7%) had a MCI and only 37(35.9%) had no cognitive impairment; (2) Subjects with PD-MCI were older, had a later onset of the PD,and displayed more severe motor symptoms compared with those without cognitive impairment; (3) The prevalence and neuropsychological profile of PD-MCI were thought to correlate with the dominating side and subtype of Parkinsonian symptoms, for patients with left-sided dominant symptoms had a significantly higher chance of suffering MCI than those with right-sided dominant symptoms, the ratio being 74.2% vs 42.2%,χ<'2 =7. 589,P <0.05; The tremor-dominant group took less time than the mixed group for Stroop word test measurement ((80.8±39.9) s vs (94.4±30.0) s,t=3.332,P<0.01). Conclusion Identification of MCI is of important clinical significance, which helps to treat patients differently and thus predict the prognosis.
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Objective To investigate the distribution of TCM Syndromes of Parkinson's disease(PD).Methods The 125 PD patients were graded according to Hoehn-Yahr(H&Y) criteria for assessment.The assigned TCM physician investigated TCM syndromes of these patients with the structured questionnaire which was based on literature and experience of experts.Results Of 125 cases,96 ones(76.8%) presented a single syndrome,and 29 ones(23.2%) presented complex syndrome.The positive rate of main syndrome was in an order of deficiency of both the Spleen and Kidney(22.4%),yin deficiency of the Liver and Kidney(18.4%),yang deficiency of the Spleen and Kidney(16%),qi deficiency of both qi and yin(15.2%),phlegm-heat stirring up the wind(12.8%),qi deficiency with blood stasis(4.8%),deficiency of both yin and yang(4%),damp abundance due to the Spleen deficiency(3.2%),endoretention of damp heat(1.6%),stagnation of the Liver qi with deficiency of the Spleen and Liver fire flaring(0.8%).There existed a significant difference in the distribution of TCM syndromes in H&Y 1.0~1.5 and H&Y 2.0~3.0(P