Parkinsonism & related disorders最新文献_第4页

Comparative pharmacokinetics of levodopa–carbidopa intestinal gel infusion and foslevodopa–foscarbidopa continuous subcutaneous infusion therapies in advanced Parkinson's disease 左旋多巴-卡比多巴肠凝胶输注与左旋多巴-卡比多巴持续皮下输注治疗晚期帕金森病的比较药代动力学

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-20 DOI: 10.1016/j.parkreldis.2026.108197

Yohei Mukai , Junko Takei , Juri Nomoto , Motohiro Okumura , Shinji Oda , Tasuku Ishihara , Yuka Hama , Hotake Takizawa , Toru Yamakawa , Fumiko Furukawa , Jun Shinmi , Shoya Inagawa , Shuho Namatame , Yuji Takahashi

Introduction

Levodopa–carbidopa intestinal gel therapy (LCIG) and foslevodopa–foscarbidopa continuous subcutaneous infusion therapy (FOCS) are device-aided therapies for advanced Parkinson's disease. Comparative real-world pharmacokinetic (PK) data remain limited. This study aimed to compare overall plasma levodopa exposure between LCIG and FOCS.

Methods

Patients who initiated LCIG or FOCS, completed dose optimization, and underwent a standardized levodopa challenge were evaluated. Plasma levodopa concentrations and motor states were assessed repeatedly over 420 min. Overall concentrations were compared using a linear mixed-effects model. Steady-state concentration (SSConc; 300–420 min) and its relationship with body-surface-area–adjusted infusion rate were examined. Time to On and the plasma concentration at On transition (On-Conc) were analyzed.

Results

Mean plasma levodopa concentrations tended to be higher with FOCS, although the group effect was not significant (geometric mean ratio: 1.38; p = 0.060). SSConc was higher with FOCS (12.85 ± 2.78 vs. 9.23 ± 1.61 nmol/mL). Both therapies showed linear SSConc–dose relationships, with a steeper slope for FOCS. LCIG produced a faster transition to the On state (median 45 vs. 150 min), whereas On-Conc was similar between groups (approximately 10 nmol/mL). In the FOCS group, baseline Off occurred only when nighttime infusion rates were ≤74 % of daytime rates.

Conclusion

LCIG and FOCS show distinct PK profiles despite similar overall concentrations. LCIG provides a rapid rise in levodopa levels and earlier On onset, whereas FOCS yields higher SSConc values and greater dose–concentration efficiency, informing titration approaches, nighttime infusion settings, and individualized selection of continuous infusion-based dopaminergic therapy.

左旋多巴-卡比多巴肠凝胶疗法（LCIG）和foslevodopa-foscarbidopa持续皮下输注疗法（FOCS）是晚期帕金森病的器械辅助疗法。比较真实世界的药代动力学（PK）数据仍然有限。本研究旨在比较LCIG和fos的左旋多巴总血浆暴露情况。方法对启动LCIG或FOCS、完成剂量优化并接受标准化左旋多巴刺激的患者进行评估。在420分钟内反复评估血浆左旋多巴浓度和运动状态。使用线性混合效应模型比较总浓度。研究稳态浓度（SSConc; 300-420 min）及其与体表调节输注速率的关系。分析了到On的时间和On跃迁时的血浆浓度。结果fos组左旋多巴平均血浆浓度有升高趋势，但组效应不显著（几何平均比值：1.38;p = 0.060）。SSConc随FOCS升高（12.85±2.78 vs. 9.23±1.61 nmol/mL）。两种疗法均显示sscc与剂量的线性关系，其中FOCS的斜率更陡。LCIG可以更快地过渡到On状态（中位数45 vs 150分钟），而On- conc在两组之间相似（约10 nmol/mL）。在FOCS组中，基线Off仅在夜间输注率≤白天输注率的74%时发生。结论lcig和fos在总浓度相近的情况下表现出不同的PK谱。LCIG使左旋多巴水平迅速上升，发作时间更早，而FOCS产生更高的SSConc值和更高的剂量-浓度效率，这为滴定方法、夜间输注设置和个性化选择持续输注的多巴胺能治疗提供了信息。

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引用次数: 0

Automated assessment of susceptibility map-weighted imaging in patients with clinically uncertain parkinsonism 临床不确定帕金森患者易感图加权成像的自动评估

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-20 DOI: 10.1016/j.parkreldis.2026.108198

Elon D. Wallert , Elsmarieke van de Giessen , Martijn Beudel , Tom van Mierlo , Jeroen Blankevoort , Henk W. Berendse , Rob M.A. de Bie , Jan Booij

Background and objectives

In patients with a clinically uncertain parkinsonian syndrome (CUPS), the novel MRI sequence susceptibility map-weighted imaging (SMWI) may be a diagnostic alternative to dopamine transporter (DAT) imaging with the advantage of greater accessibility. This study aimed to assess the diagnostic accuracy of software analyzing SMWI in differentiating dopaminergic neurodegenerative from non-neurodegenerative parkinsonism in CUPS patients.

Methods

A diagnostic accuracy study was conducted, including patients presenting with CUPS who underwent DAT SPECT imaging. The index test was the result of AI-driven software (Heuron IPD version 1.0.1.9, Heuron Co., Ltd, Seoul, Korea), designed to classify the nigrosome-1 on SMWI acquired at 3T as normal or abnormal. The reference test was the final clinical diagnosis, incorporating findings from DAT SPECT imaging.

Results

A total of 176 patients were included in the final analysis; 82 received a final diagnosis of dopaminergic neurodegenerative parkinsonism, and 94 with non-neurodegenerative parkinsonism. The AI-driven SMWI software demonstrated a diagnostic accuracy of 86.9 % distinguishing neurodegenerative from non-neurodegenerative parkinsonism, with sensitivity of 92.7 % and specificity of 81.9 %.

Discussion

This study is the first to evaluate the diagnostic accuracy of software analyzing SMWI in patients presenting with CUPS. The findings highlight the promising diagnostic utility of SMWI in clinical practice for CUPS patients. Future studies are warranted as SMWI might be able to reduce the need for DAT-imaging in the future by offering a more accessible and cost-effective alternative.

背景与目的在临床不确定的帕金森综合征（CUPS）患者中，新型MRI序列易感图加权成像（SMWI）可能是多巴胺转运体（DAT）成像的一种替代诊断方法，具有更大的可及性。本研究旨在评估SMWI分析软件在鉴别CUPS患者多巴胺能性神经退行性与非神经退行性帕金森病中的诊断准确性。方法对行数据SPECT显像的CUPS患者进行诊断准确性研究。指标检验采用ai驱动软件（Heuron IPD version 1.0.1.9, Heuron Co., Ltd, Seoul, Korea），将3T时获得的SMWI上的黑体-1分为正常或异常。参考测试是最终的临床诊断，结合数据SPECT成像的结果。结果共纳入176例患者；82人最终诊断为多巴胺能性神经退行性帕金森病，94人诊断为非神经退行性帕金森病。人工智能驱动的SMWI软件对神经退行性和非神经退行性帕金森病的诊断准确率为86.9%，敏感性为92.7%，特异性为81.9%。本研究首次评估了软件分析SMWI对CUPS患者的诊断准确性。研究结果强调了SMWI在临床实践中对CUPS患者的诊断价值。未来的研究是有必要的，因为SMWI可能能够通过提供更容易获得和成本效益的替代方案来减少未来对dat成像的需求。

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引用次数: 0

Introducing a workflow algorithm for adaptive DBS programming in Parkinson's disease. 介绍了一种帕金森病自适应DBS编程的工作流算法。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-19 DOI: 10.1016/j.parkreldis.2026.108199

Saar Anis, Patricia A Clark, Shannon Shaffer, Emma Hartwig, Laurie Moser, Jenera Scott, Erica Hennigs, Ellen Walter, Tatiana Lopez Gonzalez, David Escobar, Benjamin L Walter

Background: Adaptive deep brain stimulation (aDBS) utilizing BrainSense™ technology by Medtronic Percept™ stimulator, is a recent advancement that dynamically adjusts stimulation in real-time based on the power of frequency-specific neural signals. Although clinical trials have shown the feasibility of aDBS, real-world implementation remains underreported. We describe the development and implementation of a structured workflow for aDBS activation and programming at a tertiary movement disorders center.

Methods: This quality improvement project included the first 50 patients with Parkinson's disease who initiated aDBS between March and September 2025 at the Cleveland Clinic. Data were abstracted from clinical records and programming logs as part of routine process evaluation. Findings were discussed with programming clinicians to identify variability and troubleshooting steps, leading to iterative refinement and consensus on a standardized workflow for aDBS activation and programming.

Results: The primary reasons for converting to aDBS were dyskinesias, motor fluctuations, and limited therapeutic windows on continuous DBS. Programming emphasized individualized threshold strategies (single vs. dual), ensuring each was fully optimized before transition. Successful implementation depended on three key factors: clearly defined therapeutic goals, validation of the frequency of interest, and confirmation of appropriate system adaptation through Timeline plots review and real-time signal streaming. A structured flowchart summarizing the programming and troubleshooting sequence is provided.

Conclusions: Implementation of aDBS in routine clinical practice is feasible with a structured, team-based workflow. Standardizing programming steps and incorporating iterative feedback support safety, consistency, and broader adoption across centers.

背景：利用美敦力感知刺激器的BrainSense™技术的自适应深部脑刺激（aDBS）是一项最新进展，它可以根据特定频率的神经信号的功率实时动态调整刺激。尽管临床试验已经表明aDBS的可行性，但现实世界的实施仍然被低估。我们描述了在三级运动障碍中心aDBS激活和编程的结构化工作流程的开发和实施。方法：该质量改善项目纳入了2025年3月至9月期间在克利夫兰诊所开始aDBS治疗的首批50名帕金森病患者。数据从临床记录和编程日志中提取，作为常规过程评估的一部分。研究结果与编程临床医生进行了讨论，以确定可变性和故障排除步骤，从而导致aDBS激活和编程的标准化工作流程的迭代改进和共识。结果：转化为aDBS的主要原因是运动障碍、运动波动和持续DBS治疗窗口有限。编程强调个性化的阈值策略（单阈值vs双阈值），确保每个阈值在转换前都得到充分优化。成功的实施取决于三个关键因素：明确定义的治疗目标，验证感兴趣的频率，并通过时间轴图回顾和实时信号流确认适当的系统适应。给出了总结编程和故障排除顺序的结构化流程图。结论：通过结构化的团队工作流程，在常规临床实践中实施aDBS是可行的。标准化编程步骤和合并迭代反馈支持安全性、一致性和跨中心的更广泛采用。

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引用次数: 0

Oculogyric crisis induced by high-dose apomorphine in a patient with advanced Parkinson's disease 大剂量阿波啡致晚期帕金森病患者眼危象1例

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-17 DOI: 10.1016/j.parkreldis.2026.108186

Negin Eissazade , Elizabeth Slow , Anthony E. Lang , Mohammad Rohani

引用次数: 0

Motor-planning cerebello-cerebral network alterations in PRRT2-related paroxysmal kinesigenic dyskinesia prrt2相关的阵发性运动性运动障碍的运动规划小脑-大脑网络改变。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-16 DOI: 10.1016/j.parkreldis.2026.108195

Weihao Liao , Yingying Zhang , Jiechuan Ren , Xiang Huang , Qiuxing Lin , Kailing Huang , Yuming Li , Peiwen Liu , Danyang Cao , Wenhao Li , Xiuli Li , Tianhua Yang , Qiyong Gong , Dongmei An , Dong Zhou

Background and objectives

Emerging preclinical evidence suggests that the cerebellum plays a critical role in paroxysmal kinesigenic dyskinesia (PKD) associated with proline-rich transmembrane protein 2 (PRRT2) mutations. This study aimed to investigate the role of cerebello-cerebral network in PKD patients with PRRT2 mutations (PKD-M) and PKD patients with no PRRT2 mutations (PKD-N).

Methods

Resting-state functional magnetic resonance imaging scan was performed on 105 PKD patients (47 PKD-M and 58 PKD-N) and 62 healthy controls (HC). For seed-based functional connectivity (FC) analysis, the cerebellum was parcellated into 10 function-related regions through a functional atlas of the human cerebellum obtained by a multi-domain task battery. The cerebello-cerebral FC and regional homogeneity (ReHo) were examined using one-way analysis of covariance and two-sample t-test in PKD-M, PKD-N and HC.

Results

PKD-M had increased FC between a motor-planning related cerebellar region (region 4) and the middle cingulate gyrus, compared to HC. While PKD-M had decreased FC between this region and the lingual gyrus, compared to HC. PKD-M had increased FC between another cerebellar region (region 8) and the right inferior temporal gyrus/right superior frontal gyrus, compared to PKD-N. Additionally, PKD-M had decreased ReHo in the pons and the cerebellum anterior lobe and increased ReHo in the right inferior temporal gyrus, compared to HC.

Conclusions

PRRT2 mutations may cause abnormalities in a motor-planning cerebello-cerebral network, which likely play a major role in the pathogenesis of PKD-M.

背景和目的：越来越多的临床前证据表明，小脑在与富含脯氨酸的跨膜蛋白2 （PRRT2）突变相关的阵发性运动障碍（PKD）中起着关键作用。本研究旨在探讨小脑-脑网络在PRRT2突变PKD患者（PKD- m）和无PRRT2突变PKD患者（PKD- n）中的作用。方法：对105例PKD患者（PKD- m型47例，PKD- n型58例）和62例健康对照（HC）进行静息状态功能磁共振成像扫描。为了进行基于种子的功能连接（FC）分析，通过多域任务电池获得的人类小脑功能图谱，将小脑划分为10个功能相关区域。采用单因素协方差分析和双样本t检验PKD-M、PKD-N和HC的小脑-大脑FC和区域均匀性（ReHo）。结果：与HC相比，PKD-M在运动计划相关的小脑区（第4区）和中扣带回之间增加了FC。而与HC相比，PKD-M在该区域和舌回之间的FC减少。与PKD-N相比，PKD-M与另一个小脑区域（8区）和右侧颞下回/右侧额上回之间的FC增加。此外，与HC相比，PKD-M降低了脑桥和小脑前叶的ReHo，增加了右侧颞下回的ReHo。结论：PRRT2突变可能导致运动规划小脑-大脑网络异常，这可能在PKD-M的发病机制中起重要作用。

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引用次数: 0

Influence of hypokinetic dysarthria severity level on the long-term outcome of repetitive transcranial magnetic stimulation therapy 低运动构音障碍严重程度对反复经颅磁刺激治疗远期疗效的影响

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-10 DOI: 10.1016/j.parkreldis.2026.108175

Krystof Novotny , Lubos Brabenec , Jiri Mekyska , Andrea Moravska , Pedro Gómez-Vilda , Andrés Gómez-Rodellar , Irena Rektorova

Introduction

Hypokinetic dysarthria (HD) is a common and disabling symptom of Parkinson's disease (PD) for which established pharmacological and surgical treatments bring only limited, often short-term improvement in speech. The aim of this study was to investigate whether the long-term acoustic effects of repetitive transcranial magnetic stimulation (rTMS) over the right superior temporal gyrus (STG) depend on the baseline severity of HD.

Methods

26 PD patients were randomized to active STG-targeted rTMS (n = 15) or sham stimulation (n = 11) and followed across five recording sessions over 14 weeks, alongside one session of matched healthy controls. HD

severity at baseline was quantified using 3F test subscores and used to stratify patients into milder (0) and more severe (1) subgroups. The STG 1 subgroup combined greater motor and speech impairment with shorter disease duration. Multiple acoustic features from sustained phonation and free monologue were extracted, normalized to controls, adjusted for sex, and analyzed using non-parametric statistics and descriptive visualisations.

Results

Patients with more severe HD receiving active stimulation (STG 1) showed consistent, long-lasting improvements in phonation-related parameters, whereas milder HD (STG 0) and sham groups (SHAM 0, SHAM 1) exhibited only limited or transient changes.

Conclusion

Given this observation, STG-targeted rTMS appears particularly beneficial for PD patients with more advanced HD, supporting auditory–motor network modulation as a therapeutic strategy and motivating larger, multi-centre trials to confirm these stratified effects and their clinical impact.

低运动构音障碍（HD）是帕金森病（PD）的一种常见致残症状，现有的药物和手术治疗只能带来有限的，通常是短期的语言改善。本研究的目的是研究重复经颅磁刺激（rTMS）对右侧颞上回（STG）的长期声学效应是否依赖于HD的基线严重程度。方法26名PD患者被随机分配到主动stg靶向rTMS （n = 15）或假刺激（n = 11），并在14周内进行5次记录，同时进行1次匹配的健康对照。基线时HDseverity使用3F测试亚评分进行量化，并将患者分为较轻(0)和较严重(1)亚组。stg1亚组运动和语言障碍更严重，病程更短。从持续发声和自由独白中提取多个声学特征，归一化为对照，根据性别进行调整，并使用非参数统计和描述性可视化进行分析。结果接受主动刺激（STG 1）的重度HD患者在发音相关参数方面表现出一致的、持久的改善，而轻度HD （STG 0）和假手术组（sham 0、sham 1）仅表现出有限或短暂的改变。鉴于这一观察结果，stg靶向的rTMS似乎对晚期HD PD患者特别有益，支持将听觉-运动网络调节作为一种治疗策略，并推动更大规模的多中心试验来证实这些分层效应及其临床影响。

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引用次数: 0

Hydrocephalus should not be a mandatory exclusion criterion in PSP: Emerging pathologic and clinical evidence urges reconsideration 脑积水不应成为PSP的强制性排除标准：新出现的病理和临床证据敦促重新考虑

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-08 DOI: 10.1016/j.parkreldis.2026.108183

Halil Onder

引用次数: 0

Imaging biomarkers for early prediction of the transition from idiopathic late-onset cerebellar ataxia to multiple system atrophy 早期预测特发性晚发性小脑共济失调向多系统萎缩转变的成像生物标志物。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.parkreldis.2026.108176

Jun Seok Lee , Junmo Kwon , Jongmok Ha , Ji Hye Won , Jinyoung Youn , Hirohisa Watanabe , Hee Tae Kim , Hyunjin Park , Jin Whan Cho

Introduction

Idiopathic late-onset cerebellar ataxia (ILOCA) is a degenerative, non-hereditary form of adult-onset cerebellar ataxia. A subset of patients with ILOCA eventually develop multiple system atrophy of the cerebellar type (MSA-C), but imaging biomarkers that predict this transition remain unidentified. This study aimed to identify imaging biomarkers that may predict phenoconversion from ILOCA to MSA-C.

Methods

A retrospective cohort of patients diagnosed with ILOCA who underwent baseline T1-weighted and diffusion-weighted magnetic resonance imaging (MRI) was analyzed. Patients were followed longitudinally and reclassified as ‘phenoconverters’ if they met diagnostic criteria for MSA-C, or as ‘non-phenoconverters’ otherwise. Clinical characteristics were compared between groups, and infratentorial volumetric and microstructural changes were assessed using diffusion tensor imaging (DTI).

Results

Over a mean follow-up of 5.7 years, 13 of 45 patients (28.9 %) transitioned to a diagnosis of MSA-C. Phenoconverters exhibited more severe baseline ataxia compared to non-phenoconverters. While cerebellar volumes were similar between groups, phenoconverters had significantly reduced volumes in the pons and superior and middle cerebellar peduncles. Additionally, they demonstrated lower mean fractional anisotropy in the middle and inferior cerebellar peduncles.

Conclusions

Patients with ILOCA who later develop MSA-C show early microstructural changes and volume loss in the pons and cerebellar peduncles. Combining infratentorial volumetry with DTI may offer complementary imaging biomarkers for predicting phenoconversion to MSA-C.

特发性晚发性小脑性共济失调（ILOCA）是一种退行性、非遗传性的成人型小脑性共济失调。一小部分ILOCA患者最终发展为小脑型多系统萎缩（MSA-C），但预测这种转变的成像生物标志物仍未确定。本研究旨在鉴定可能预测从ILOCA到MSA-C表型转化的成像生物标志物。方法：回顾性分析诊断为ILOCA并接受基线t1加权和弥散加权磁共振成像（MRI）检查的患者。对患者进行纵向随访，如果他们符合MSA-C的诊断标准，则将其重新分类为“表型转化者”，否则将其重新分类为“非表型转化者”。比较两组患者的临床特征，并利用弥散张量成像（DTI）评估幕下体积和显微结构变化。结果：在平均5.7年的随访中，45例患者中有13例（28.9%）转变为MSA-C诊断。与非表型转化者相比，表型转化者表现出更严重的基线共济失调。虽然各组之间的小脑体积相似，但表型转换者的脑桥和小脑上、中小脑蒂的体积显著减少。此外，他们在小脑中、下端表现出较低的平均分数各向异性。结论：后发为MSA-C的ILOCA患者在脑桥和小脑蒂表现出早期微结构改变和体积损失。幕下体积法与DTI相结合可能为预测向MSA-C的表型转化提供补充的成像生物标志物。

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引用次数: 0

On thin ice: sequence effect drifts toward freezing of gait. 薄冰上：序列效应向步态冻结方向漂移。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-07 DOI: 10.1016/j.parkreldis.2026.108182

Ihtsham U Haq

引用次数: 0

Impact of type 2 diabetes on the development of dementia and death in Parkinson's disease 2型糖尿病对帕金森病患者痴呆发展和死亡的影响

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-06 DOI: 10.1016/j.parkreldis.2026.108187

Seung Hyun Lee , Jooyoung Lee , Mina Kim , Da-woon Kim , Yun Su Hwang , Kye Won Park , Sungyang Jo , Ji-Hoon Kang , Richard J. Cook , Sun Ju Chung

Background

Increasing evidence suggests that type 2 diabetes (T2DM) can influence the progression of Parkinson's disease (PD). However, it remains unclear whether T2DM increases the risk of progression to dementia and death in PD.

Objective

This study aimed to investigate the impact of T2DM on the risk of developing dementia and death following a diagnosis of PD.

Methods

We examined 158,962 individuals (aged 60 years or older) without PD or dementia using the Korean National Health Insurance Service (NHIS)-senior cohort database. A multi-state model was used to estimate the hazard ratios characterizing the effect of T2DM on the risk of PD, dementia, and death while adjusting for potential confounding factors. Results were analyzed according to age and sex.

Results

T2DM increased the risk of development of PD (adjusted hazard ratio [aHR]: 1.26, 95 % confidence interval [CI]: 1.11–1.42), dementia (aHR: 1.31, 95 % CI: 1.24–1.39), or death (aHR: 1.58, 95 % CI: 1.52–1.65) compared to those without T2DM. However, after PD diagnosis, T2DM was not associated with progression to dementia (aHR: 1.09, 95 % CI: 0.96–1.48) and death (aHR: 1.10, 95 % CI: 0.85–1.42) although subgroup analysis showed an elevated risk for the progression from PD to dementia (aHR: 1.41 95 % CI: 1.06–1.89) in individuals under 70 years of age.

Conclusions

T2DM increases the risk of PD, dementia, and death in the elderly population. However, its effect on the progression to dementia and death may occur independently of the onset of PD, despite significant age-related heterogeneity.

越来越多的证据表明，2型糖尿病（T2DM）可以影响帕金森病（PD）的进展。然而，目前尚不清楚T2DM是否会增加PD患者进展为痴呆和死亡的风险。目的本研究旨在探讨T2DM对PD诊断后发生痴呆和死亡风险的影响。方法：我们使用韩国国民健康保险服务（NHIS）老年人队列数据库对158,962名（60岁及以上）无PD或痴呆的个体进行了检查。在校正潜在混杂因素的同时，采用多状态模型估计T2DM对PD、痴呆和死亡风险影响的风险比。结果按年龄和性别进行分析。结果与非T2DM患者相比，st2dm患者发生PD（校正危险比[aHR]: 1.26, 95%可信区间[CI]: 1.11-1.42）、痴呆（aHR: 1.31, 95% CI: 1.24-1.39）或死亡（aHR: 1.58, 95% CI: 1.52-1.65）的风险增加。然而，在PD诊断后，T2DM与进展为痴呆（aHR: 1.09, 95% CI: 0.96-1.48）和死亡（aHR: 1.10, 95% CI: 0.85-1.42）无关，尽管亚组分析显示70岁以下个体从PD进展为痴呆的风险升高（aHR: 1.41 95% CI: 1.06-1.89）。结论st2dm可增加老年人群PD、痴呆和死亡的风险。然而，尽管存在明显的年龄相关性异质性，但其对痴呆进展和死亡的影响可能与PD的发病无关。

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引用次数: 0