JAMA Neurol:帕金森病患者冻结步态与生活质量的研究

2014-06-03 佚名 丁香园

近期,法国图卢兹大学的Olivier Rascol教授等开展了一项关于帕金森病(PD)患者冻结步态(freezing of gait, FOG)发生率、影响因素以对患者生活质量影响的研究,该研究的结果发表于2014年5月的JAMA neurology杂志。冻结步态是帕金森病药物治疗时较为常见的一种不良反应,表现为行走过程中(特别是起始和转身时)突然发生的步态停滞,在症状波动的缓解期(“开”期)和(

近期,法国图卢兹大学的Olivier Rascol教授等开展了一项关于帕金森病(PD)患者冻结步态(freezing of gait, FOG)发生率、影响因素以对患者生活质量影响的研究,该研究的结果发表于2014年5月的JAMA neurology杂志。【原文下载】

冻结步态是帕金森病药物治疗时较为常见的一种不良反应,表现为行走过程中(特别是起始和转身时)突然发生的步态停滞,在症状波动的缓解期(“开”期)和(“关”期)加重期均可出现。FOG的存在可明显影响PD患者的生活质量。关于FOG和一些相关因素及生活质量、药物治疗策略等目前报道较少。



该研究以UPDRS量表条目14得分≥1分为界筛选出672名存在FOG的患者,并对其生活质量、PD症状特征以及用药情况等进行分析,以探索FOG与上述因素的潜在关系。

结果显示,治疗“开”期FOG的发生率为38.2%.FOG与较低的生活质量、PD病程长、日常功能和运动功能差、情感淡漠、左旋多巴用量大以及更为频繁使用抗胆碱能药有关。在出现症状波动的患者中,有85.2%的患者FOG症状随“关”期向“开”期的转换而得到改善,并且,年轻患者症状的改善更为明显。



该研究的新意在于分别对处于症状波动“开”期和“关”期患者的冻结步态情况进行了研究。此外,研究进一步强调了冻结步态对生活质量产生影响,而通过多巴胺治疗并避免使用抗胆碱能药可能减少发生冻结步态的风险,这为今后进一步优化PD的药物治疗策略提供了重要的依据。

原始出处:

Perez-Lloret S1, Negre-Pages L2, Damier P3, Delval A4, Derkinderen P3, Destée A5, Meissner WG6, Schelosky L7, Tison F8, Rascol O1.Prevalence, Determinants, and Effect on Quality of Life of Freezing of Gait in Parkinson Disease.JAMA Neurol. 2014 May 19. doi: 10.1001/jamaneurol.2014.753.【原文下载】

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1999427, encodeId=d77b199942eb3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Feb 21 08:11:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647500, encodeId=155d164e50084, content=<a href='/topic/show?id=39d63118248' target=_blank style='color:#2F92EE;'>#冻结步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31182, encryptionId=39d63118248, topicName=冻结步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5bc723440462, createdName=chg129, createdTime=Tue Jul 22 16:11:00 CST 2014, time=2014-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741955, encodeId=13c11e4195517, content=<a href='/topic/show?id=5681632e84e' target=_blank style='color:#2F92EE;'>#步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63278, encryptionId=5681632e84e, topicName=步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76f034999566, createdName=xxxx1061, createdTime=Fri Oct 03 09:11:00 CST 2014, time=2014-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757402, encodeId=98d21e574026d, content=<a href='/topic/show?id=058e4852e63' target=_blank style='color:#2F92EE;'>#帕金森病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48527, encryptionId=058e4852e63, topicName=帕金森病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a17f37322741, createdName=ms6832696159214430, createdTime=Thu Oct 23 10:11:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573915, encodeId=e92115e391520, content=<a href='/topic/show?id=6b3348526a0' target=_blank style='color:#2F92EE;'>#帕金森病患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48526, encryptionId=6b3348526a0, topicName=帕金森病患)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73fe15977481, createdName=saikp, createdTime=Thu Jun 05 00:11:00 CST 2014, time=2014-06-05, status=1, ipAttribution=)]
    2015-02-21 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=1999427, encodeId=d77b199942eb3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Feb 21 08:11:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647500, encodeId=155d164e50084, content=<a href='/topic/show?id=39d63118248' target=_blank style='color:#2F92EE;'>#冻结步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31182, encryptionId=39d63118248, topicName=冻结步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5bc723440462, createdName=chg129, createdTime=Tue Jul 22 16:11:00 CST 2014, time=2014-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741955, encodeId=13c11e4195517, content=<a href='/topic/show?id=5681632e84e' target=_blank style='color:#2F92EE;'>#步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63278, encryptionId=5681632e84e, topicName=步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76f034999566, createdName=xxxx1061, createdTime=Fri Oct 03 09:11:00 CST 2014, time=2014-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757402, encodeId=98d21e574026d, content=<a href='/topic/show?id=058e4852e63' target=_blank style='color:#2F92EE;'>#帕金森病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48527, encryptionId=058e4852e63, topicName=帕金森病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a17f37322741, createdName=ms6832696159214430, createdTime=Thu Oct 23 10:11:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573915, encodeId=e92115e391520, content=<a href='/topic/show?id=6b3348526a0' target=_blank style='color:#2F92EE;'>#帕金森病患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48526, encryptionId=6b3348526a0, topicName=帕金森病患)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73fe15977481, createdName=saikp, createdTime=Thu Jun 05 00:11:00 CST 2014, time=2014-06-05, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1999427, encodeId=d77b199942eb3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Feb 21 08:11:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647500, encodeId=155d164e50084, content=<a href='/topic/show?id=39d63118248' target=_blank style='color:#2F92EE;'>#冻结步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31182, encryptionId=39d63118248, topicName=冻结步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5bc723440462, createdName=chg129, createdTime=Tue Jul 22 16:11:00 CST 2014, time=2014-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741955, encodeId=13c11e4195517, content=<a href='/topic/show?id=5681632e84e' target=_blank style='color:#2F92EE;'>#步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63278, encryptionId=5681632e84e, topicName=步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76f034999566, createdName=xxxx1061, createdTime=Fri Oct 03 09:11:00 CST 2014, time=2014-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757402, encodeId=98d21e574026d, content=<a href='/topic/show?id=058e4852e63' target=_blank style='color:#2F92EE;'>#帕金森病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48527, encryptionId=058e4852e63, topicName=帕金森病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a17f37322741, createdName=ms6832696159214430, createdTime=Thu Oct 23 10:11:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573915, encodeId=e92115e391520, content=<a href='/topic/show?id=6b3348526a0' target=_blank style='color:#2F92EE;'>#帕金森病患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48526, encryptionId=6b3348526a0, topicName=帕金森病患)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73fe15977481, createdName=saikp, createdTime=Thu Jun 05 00:11:00 CST 2014, time=2014-06-05, status=1, ipAttribution=)]
    2014-10-03 xxxx1061
  4. [GetPortalCommentsPageByObjectIdResponse(id=1999427, encodeId=d77b199942eb3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Feb 21 08:11:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647500, encodeId=155d164e50084, content=<a href='/topic/show?id=39d63118248' target=_blank style='color:#2F92EE;'>#冻结步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31182, encryptionId=39d63118248, topicName=冻结步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5bc723440462, createdName=chg129, createdTime=Tue Jul 22 16:11:00 CST 2014, time=2014-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741955, encodeId=13c11e4195517, content=<a href='/topic/show?id=5681632e84e' target=_blank style='color:#2F92EE;'>#步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63278, encryptionId=5681632e84e, topicName=步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76f034999566, createdName=xxxx1061, createdTime=Fri Oct 03 09:11:00 CST 2014, time=2014-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757402, encodeId=98d21e574026d, content=<a href='/topic/show?id=058e4852e63' target=_blank style='color:#2F92EE;'>#帕金森病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48527, encryptionId=058e4852e63, topicName=帕金森病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a17f37322741, createdName=ms6832696159214430, createdTime=Thu Oct 23 10:11:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573915, encodeId=e92115e391520, content=<a href='/topic/show?id=6b3348526a0' target=_blank style='color:#2F92EE;'>#帕金森病患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48526, encryptionId=6b3348526a0, topicName=帕金森病患)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73fe15977481, createdName=saikp, createdTime=Thu Jun 05 00:11:00 CST 2014, time=2014-06-05, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1999427, encodeId=d77b199942eb3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Feb 21 08:11:00 CST 2015, time=2015-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647500, encodeId=155d164e50084, content=<a href='/topic/show?id=39d63118248' target=_blank style='color:#2F92EE;'>#冻结步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31182, encryptionId=39d63118248, topicName=冻结步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5bc723440462, createdName=chg129, createdTime=Tue Jul 22 16:11:00 CST 2014, time=2014-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1741955, encodeId=13c11e4195517, content=<a href='/topic/show?id=5681632e84e' target=_blank style='color:#2F92EE;'>#步态#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63278, encryptionId=5681632e84e, topicName=步态)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76f034999566, createdName=xxxx1061, createdTime=Fri Oct 03 09:11:00 CST 2014, time=2014-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757402, encodeId=98d21e574026d, content=<a href='/topic/show?id=058e4852e63' target=_blank style='color:#2F92EE;'>#帕金森病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48527, encryptionId=058e4852e63, topicName=帕金森病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a17f37322741, createdName=ms6832696159214430, createdTime=Thu Oct 23 10:11:00 CST 2014, time=2014-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573915, encodeId=e92115e391520, content=<a href='/topic/show?id=6b3348526a0' target=_blank style='color:#2F92EE;'>#帕金森病患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48526, encryptionId=6b3348526a0, topicName=帕金森病患)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73fe15977481, createdName=saikp, createdTime=Thu Jun 05 00:11:00 CST 2014, time=2014-06-05, status=1, ipAttribution=)]

相关资讯

Neurology:下颌下腺穿刺活检可评估帕金森病

美国一项研究表明,在帕金森病患者中通过下颌下腺穿刺活检评估Lewy型α-突触蛋白病(LTS)具有可行性。论文于2月5日在线发表于《神经病学》(Neurology)。 此项研究共纳入15例病史≥5年的帕金森病患者,并在门诊条件下实施下颌下腺经皮穿刺活检(18G或16G)。通过下唇小切口切除小唾液腺。利用福尔马林固定组织,对石蜡切片行磷酸化α-突触蛋白免疫组化染色,并对LTS征象进行评估。 结果显

AAN 2014:帕金森病及运动障碍报道

帕金森病(Parkinson’s disease,PD)与其他诸多神经退行病相似,均为蛋白质异常沉积疾病。为此,本届大会专门安排了神经退行病蛋白异常沉积机制的研讨会。无论是帕金森病发病机制中的alpha-synuclein,还是阿尔兹海默病中的beta淀粉样蛋白、Tau蛋白,越来越多的研究结果显示:这些神经退行病相应特征性病理损害的时空贯序均可以应用Prion样的蛋白毒性传播机制解释。alph

JAMA Neurol:辅酶Q10治疗早期帕金森病无益?

3月24日在线发表于《美国医学会杂志·神经病学》JAMA Neurol的一项研究表明,辅酶Q10(CoQ10)治疗早期帕金森病(PD)患者安全且耐受性良好,但并未显示出临床获益证据。 CoQ10是一种有益于线粒体功能的抗氧化剂,既往研究证明它在临床前PD模式中可减少多巴胺能神经元的损失,并在人类研究的早期阶段中被证明是安全且能耐受性良好。之前的II期研究表明可能显示有临床获益。该研究是III期安

JAMA Neurol:高剂量辅酶Q10治疗早期帕金森病无效

帕金森病(Parkinson disease,PD)是中、老年人的常见神经退行性疾病。目前全球PD患者人数预计为430-460万。许多研究显示,PD存在明显的线粒体功能障碍以及氧化应激水平异常。辅酶Q10(CoQ10)作为线粒体电子传递链重要组份之一,在ATP生成以及减少自由基的产生方面发挥关键作用。因而,补充外源性CoQ10可能是PD治疗的策略之一。动物研究发现,CoQ10治疗能够对多种PD模型

Medscape:高剂量ω-3脂肪酸治疗帕金森病是否有效?

5月22日的Medscape神经学专栏发表了一篇关于帕金森病简单预防方法的文章;具体内容如下:尽管如今卒中死亡率下降,但其它神经系统疾病如阿尔茨海默病(AD)与帕金森病(PD)死亡率却正在上升。不同于阿尔茨海默病,导致PD的脑内异常可被精准确定,即黑质内多巴胺能神经元的损伤。当患者黑质内多巴胺能神经元损伤达50%——70%时,震颤、动作缓慢、肌强直及平衡与协调能力受损等PD相关症状则会表现明显。因

Lancet:慢病毒载体基因疗法治疗帕金森病安全有效

帕金森病为一种常见的神经退行性疾病,其主要特征为强直,运动迟缓,震颤和姿势步态异常。目前在全球范围内约有500万帕金森病患者,其主要采用口服多巴胺替代治疗;然而,长期的治疗会导致运动并发症,并偶发冲动控制障碍;这两者分别由多巴胺受体间歇性刺激以及脱靶效应所致。因此,提供持续和稳定的多巴胺能替代治疗的策略或能发挥长期的疗效,而不产生运动和行为并发症。转基因技术能够在体提供治疗药物的长期稳定表达。既往