Parkinsonism & related disorders最新文献_第6页

Upper-thoracic predominance and non-vertebral fracture burden in Parkinson's disease: A matched Case–Control study 帕金森病的上胸优势和非椎体骨折负担：一项匹配的病例-对照研究

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-26 DOI: 10.1016/j.parkreldis.2025.108172

Min Soo Kang , Yoon Tae Jung , Seonok Kim , Won Kim

Introduction

We investigated whether Parkinson's disease (PD) alters the topographical distribution of vertebral fractures and the burden of concomitant non-vertebral fractures in patients with osteoporotic vertebral fractures (OVFs).

Methods

Among 1627 OVF patients, 116 with PD were matched (up to 1:4) to 349 controls by age, sex, and duration of radiographic surveillance. Group differences were analyzed using generalized linear mixed models, adjusting for femoral neck bone mineral density (BMD).

Results

PD Patients exhibited higher adjusted risks of total (risk ratio [RR] 2.35, p < 0.001) and vertebral fractures (RR 1.46, p < 0.001). Upper-thoracic (T1–T10) fracture counts were nearly threefold higher in PD (RR 2.97, p < 0.001), with increased prevalence (odds ratio [OR] 1.90, p = 0.010). Although the adjusted within-person proportion of upper-thoracic fractures was not significant (p = 0.125), level-specific mapping showed increased prevalence across T4–T10 in patients with PD. Non-vertebral fractures were markedly more common in PD, particularly at the hip (OR 11.71), distal radius/ulna (OR 20.98), and ribs (OR 8.44) (all p < 0.001). Femoral neck T-scores were significantly lower in PD (p = 0.009).

Conclusion

In patients with prevalent OVFs, PD is associated with a higher fracture burden and a distinct upper-thoracic pattern, even after adjustment for femoral neck BMD. The frequent concomitant non-vertebral fractures underscore fall-related biomechanical risks, highlighting the need for osteoporosis management that includes thoracic imaging and PD-specific interventions.

前言：我们研究帕金森病（PD）是否会改变骨质疏松性椎体骨折（OVFs）患者椎体骨折的地形分布和伴随的非椎体骨折的负担。方法：在1627例OVF患者中，116例PD患者按年龄、性别和放射监测时间匹配（1:4）至349例对照。采用广义线性混合模型分析组间差异，调整股骨颈骨密度（BMD）。结果：PD患者表现出更高的总风险（风险比[RR] 2.35, p）。结论：在ovf患者中，PD与更高的骨折负担和明显的上胸椎模式相关，即使在股骨颈骨密度调整后也是如此。经常发生的非椎体骨折强调了与跌倒相关的生物力学风险，强调了骨质疏松症管理的必要性，包括胸部成像和pd特异性干预。

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引用次数: 0

Incretin-based therapy and Parkinson's disease risk among patients with type 2 diabetes: Retrospective cohort study and meta-analysis 2型糖尿病患者肠促胰岛素治疗与帕金森病风险：回顾性队列研究和荟萃分析

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-25 DOI: 10.1016/j.parkreldis.2025.108171

Yael Barer , Tal Ast , Gabriel Chodick , Gilad Twig , Nir Giladi

Introduction

Despite the widespread adoption of incretin-based therapy (IBT) for type 2 diabetes (T2D) and weight management, its potential neuroprotective effects remain inadequately characterized. Given emerging evidence of IBT's effects on neurodegenerative pathways, determining its association with Parkinson's disease (PD) incidence could have major clinical implications. We investigated the association between IBT and PD incidence in patients with T2D.

Methods

This retrospective cohort study identified patients with T2D between January 2008 and December 2021 who were classified as users or non-users of IBT based on time-dependent exposure and were followed for incident PD until December 2022. Additionally, a systematic literature review and meta-analysis were conducted.

Results

We identified 86,105 patients with T2D, of those, 347 patients developed PD. IBT use was associated with a decreased risk of PD (Hazard Ratio [HR] = 0.76, 95 % Confidence Interval [CI]:0.59–0.98), but this effect did not remain significant after confounders control (HR = 0.87, 95 % CI:0.65–1.15). The meta-analysis, comprising 12 studies and 964,446 patients, including our current cohort, revealed that IBT use was associated with a 30 % lower risk of PD (RR = 0.70, 95 % CI:0.56–0.87). This effect was more pronounced in studies including younger subjects and those with shorter T2D duration at baseline.

Conclusions

The current findings suggest a negative relationship between IBT and risk of PD among patients with T2D, particularly in younger age group with short duration of the disease.

导论：尽管以肠促胰岛素为基础的治疗（IBT）广泛用于2型糖尿病（T2D）和体重控制，但其潜在的神经保护作用仍未得到充分的描述。鉴于IBT对神经退行性通路影响的新证据，确定其与帕金森病（PD）发病率的关系可能具有重要的临床意义。我们调查了T2D患者IBT和PD发病率之间的关系。方法：这项回顾性队列研究确定了2008年1月至2021年12月期间的T2D患者，这些患者根据时间依赖性暴露被分类为使用IBT或非使用IBT，并随访到2022年12月。此外，我们还进行了系统的文献综述和荟萃分析。结果：我们确定了86105例T2D患者，其中347例发展为PD。IBT使用与PD风险降低相关（风险比[HR] = 0.76, 95%可信区间[CI]:0.59-0.98），但在混杂因素控制后，这种影响并不显著（HR = 0.87, 95% CI:0.65-1.15）。荟萃分析，包括12项研究和964,446例患者，包括我们当前的队列，显示IBT使用与PD风险降低30%相关（RR = 0.70, 95% CI:0.56-0.87）。在包括年轻受试者和基线时T2D持续时间较短的受试者的研究中，这种效果更为明显。结论：目前的研究结果表明，在T2D患者中，IBT与PD风险呈负相关，特别是在病程较短的年轻人群中。

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引用次数: 0

White matter hyperintensities in the deep cerebral venous territory differ between subcortical and cortical 4-repeat tauopathies 脑深部静脉区域白质高信号在皮层下和皮层4-重复病变中有所不同

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-22 DOI: 10.1016/j.parkreldis.2025.108170

Mu-Hui Fu , Ryota Satoh , Farwa Ali , Heather M. Clark , Julie Stierwalt , Yehkyoung C. Stephens , Hossam Youssef , Jerusha G. Bhaskaran , Dennis W. Dickson , Keith A. Josephs , Jennifer L. Whitwell

Background

Progressive supranuclear palsy (PSP) syndromes and corticobasal syndrome (CBS) are atypical parkinsonian disorders resulting from 4-repeat (4R) tauopathies. They target a common network of brain regions, although relative involvement of cortical and subcortical regions differs. White matter hyperintensities (WMHs) are explicit in neurodegenerative disorders, however, little is known about their distribution in 4R-tauopathies.

Objectives

To evaluate the distribution of WMHs in the cortical and subcortical predominant 4R-tauopathies using venous territory-based and the derivative layer designed atlases.

Methods

Ninety-five participants with clinical variants of PSP or CBS were recruited by the Neurodegenerative Research Group, Mayo Clinic, and were classified as cortical (n = 64) or subcortical (n = 31) predominant. WMH volume was calculated for superficial, deep cerebral venous territory, and the periventricular (PV) region. Additionally, a layered atlas was created to assess WMH volume from the lateral ventricles (LV) to the brain surface. WMH volumes, clinical tests, and vascular-relevant histories were compared across groups and to 50 age-matched controls.

Results

Compared to the cortical group, the subcortical group had greater WMHs in the deep venous territory (p = 0.04). The major WMHs in the subcortical group distributed in layers 5–10 (12–30 mm from the LV) (p ≤ 0.01). The subcortical group had more histories of old strokes, chronic kidney disease, and headache.

Conclusions

The distribution of WMHs in the deep cerebral venous territory and the presumed watershed zone suggests that dysfunction of the venous system may play a role in the pathomechanism of 4R-tauopathies, particularly subcortical variants.

进行性核上性麻痹（PSP）综合征和皮质基底综合征（CBS）是由4-重复（4R） tau病变引起的非典型帕金森病。它们的目标是一个共同的大脑区域网络，尽管皮层和皮层下区域的相对参与程度不同。白质高强度（wmh）在神经退行性疾病中是明确的，然而，对其在4r -tau病变中的分布知之甚少。目的应用基于静脉领域和衍生层设计的地图集，评价wmh在皮质和皮质下主要4r -tau病变中的分布。方法Mayo诊所神经退行性研究小组招募了95例PSP或CBS临床变异体患者，分为皮质型（n = 64）和皮质下型（n = 31）。计算脑浅、脑深静脉区域和脑室周围（PV）区域的WMH体积。此外，创建分层图谱以评估从侧脑室（LV）到脑表面的WMH体积。比较各组和50名年龄匹配的对照组的WMH体积、临床试验和血管相关病史。结果与皮质组相比，皮质下组深静脉区WMHs显著高于皮质组（p = 0.04）。皮层下组主要whs分布在5 ~ 10层（距左室12 ~ 30 mm）（p≤0.01）。皮质下组有更多的老年中风、慢性肾病和头痛病史。结论wmh分布在脑深部静脉区域和假定的分水岭区，表明静脉系统功能障碍可能在4r -tau病变的病理机制中发挥作用，特别是皮质下变异。

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引用次数: 0

Inflammation and oligoclonal bands in cerebrospinal fluid in neurodegeneration associated with C19orf12 mutations 与C19orf12突变相关的神经变性患者脑脊液中的炎症和寡克隆带

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-19 DOI: 10.1016/j.parkreldis.2025.108169

Marta Skowrońska , Agnieszka Cudna , Zbigniew Grad , Iwona Kurkowska-Jastrzębska

Introduction

Analysis of cerebrospinal fluid examination can provide valuable information about the ongoing pathological processes in the central nervous system. To demonstrate chronic inflammation, oligoclonal bands (OCB) are detected and are typical of chronic demyelinating disease—multiple sclerosis (MS). This study aimed to detect OCB and white matter hyperintensities in patients with C19orf12 mutations.

Methods

Thirteen patients with C19orf12 mutations causing mitochondrial membrane protein-associated neurodegeneration (MPAN) were examined.

Results

Eight patients exhibited oligoclonal bands, with 6 having type 3 and 2 having type 2. All patients with OCB and 3 without OCB showed myelin loss.

Conclusions

Our findings, which reveal chronic inflammation in NBIA-MPAN alongside myelin loss, provide new insights into disease pathology and promote discussion of anti-inflammatory treatments in C19orf12 carriers.

脑脊液检查分析可以提供中枢神经系统正在进行的病理过程的有价值的信息。为了证明慢性炎症，检测到寡克隆带（OCB），这是慢性脱髓鞘疾病-多发性硬化症（MS）的典型特征。本研究旨在检测C19orf12突变患者的OCB和白质高信号。方法对13例C19orf12基因突变致线粒体膜蛋白相关神经变性（MPAN）患者进行检测。结果寡克隆带8例，3型6例，2型2例。所有OCB患者和3例无OCB患者均表现髓磷脂丢失。结论我们的研究结果揭示了NBIA-MPAN的慢性炎症伴髓磷脂损失，为C19orf12携带者的疾病病理提供了新的见解，并促进了抗炎治疗的讨论。

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引用次数: 0

Yawning-related tremor in patients with Parkinson's disease 帕金森病患者的哈欠相关震颤

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-18 DOI: 10.1016/j.parkreldis.2025.108162

Peyman Petramfar , Joseph Jankovic

Yawning-related tremor (YRT), tremor triggered by or exacerbated during yawning, has been described anecdotally in Parkinson's disease (PD), but never systematically studied. We aimed to determine the prevalence and clinical associations of YRT in PD. In this cross-sectional study, 119 PD patients and 74 controls completed a structured questionnaire. YRT was significantly more common in PD patients (18.5 %) than in controls (2.7 %) (p = 0.001). YRT prevalence was especially high in PD patients with co-existent essential tremor (41.2 %) and in those with probable REM sleep behavior disorder (68.2 %). In 31.8 % of cases, YRT preceded the onset of motor symptoms by an average of 21 months, suggesting a possible prodromal feature. Upper limbs were most frequently affected. These findings support the concept that YRT may reflect shared brainstem pathophysiology with RBD and essential tremor, and could serve as a clinical marker of early neurodegeneration in PD.

打哈欠相关震颤（YRT）是一种由打哈欠引发或加剧的震颤，在帕金森病（PD）中有轶事描述，但从未系统研究过。我们的目的是确定YRT在PD中的患病率和临床相关性。在这项横断面研究中，119名PD患者和74名对照者完成了一份结构化问卷。YRT在PD患者中的发生率（18.5%）明显高于对照组（2.7%）（p = 0.001）。伴有特发性震颤的PD患者（41.2%）和可能存在REM睡眠行为障碍的PD患者（68.2%）的YRT患病率尤其高。在31.8%的病例中，YRT在运动症状出现之前平均提前了21个月，这表明可能存在前驱症状。上肢最常受影响。这些发现支持了YRT可能与RBD和特发性震颤共同反映脑干病理生理的概念，并可作为PD早期神经退行性变的临床标志。

引用次数: 0

Biallelic CAG repeat expansion in the ATXN2 gene presenting with parkinsonism and spasticity ATXN2基因双等位CAG重复扩增表现为帕金森病和痉挛。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-17 DOI: 10.1016/j.parkreldis.2025.108168

Yosuke Osakada , Chika Matsuoka , Yumiko Nakano , Yuki Taira , Taijun Yunoki , Yusuke Fukui , Ryuta Morihara , Mami Takemoto , Yuko Kawahara , Yumiko Kutoku , Manabu Takaki , Osamu Yokota , Toru Yamashita , Hiroyuki Ishiura

引用次数: 0

Initiating foslevodopa infusion in Parkinson disease: a pragmatic study 启动左旋多巴输注治疗帕金森病：一项实用研究。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-17 DOI: 10.1016/j.parkreldis.2025.108142

Antoniangela Cocco , Roberta Zangaglia , Giorgio Belluscio , Micol Avenali , Francesca Valentino , Rosaria Calabrese , Tiziana De Santis , Paola Polverino , Alberto Albanese

Background

Subcutaneous foslevodopa (fLD) infusions are a new therapeutic option for treating complicated Parkinson's disease (PD).

Objectives

To assess the initial period of fLD infusion as replacement of oral medications in PD.

Methods

PD patients started infusion treatment according to recommended practice. Efficacy was assessed using the MDS-UPDRS motor examination and motor complications scores in the ON condition at baseline and after 20 weeks. Safety and fLD doses were assessed on a weekly basis. The 20-week observation period was compared to baseline.

Results

On week 20 the MDS-UPDRS motor examination score was unchanged, whereas the motor complications score was improved, indicating increased ON time without troublesome dyskinesias and reduced OFF time. The initial fLD dosage was gradually increased in all patients, by 37 % on week 20. Treatment optimization was achieved at a median of 12 weeks; patients with higher body mass index required a longer titration period. The levodopa equivalent daily dose of fLD on week 20 was 0.57mg. Adverse events occurred in 87 % of patients, primarily consisting of skin reactions at the infusion sites that occasionally required treatment.

Discussion

fLD infusion reduced motor fluctuations while maintaining stable ON motor performance. The infusion dose was progressively increased in the initial treatment period. The time needed for treatment stabilization was longer than previously reported and delayed in patients with higher body mass index. The treatment was generally well tolerated, neuropsychiatric effects were more common than previously reported.

背景：foslevodopa （fLD）皮下注射是治疗复杂帕金森病（PD）的一种新的治疗选择。目的：评价fLD输注替代口服药物治疗PD的初期疗效。方法：PD患者按推荐做法开始输液治疗。在基线和20周后，使用MDS-UPDRS运动检查和运动并发症评分来评估疗效。每周评估安全性和ld剂量。20周观察期与基线比较。结果：第20周时，MDS-UPDRS运动检查评分无变化，而运动并发症评分有所提高，表明On时间增加，无麻烦的运动障碍，OFF时间减少。所有患者的初始fLD剂量逐渐增加，第20周增加37%。治疗优化中位数为12周；体重指数较高的患者需要较长的滴定周期。第20周fLD左旋多巴当量日剂量为0.57mg。87%的患者发生了不良事件，主要是输注部位的皮肤反应，偶尔需要治疗。讨论：fLD注入减少了运动波动，同时保持了稳定的ON运动性能。在初始治疗期间，输注剂量逐渐增加。治疗稳定所需的时间比先前报道的更长，并且在体重指数较高的患者中延迟。治疗总体耐受良好，神经精神效应比以前报道的更普遍。

{"title":"Initiating foslevodopa infusion in Parkinson disease: a pragmatic study","authors":"Antoniangela Cocco , Roberta Zangaglia , Giorgio Belluscio , Micol Avenali , Francesca Valentino , Rosaria Calabrese , Tiziana De Santis , Paola Polverino , Alberto Albanese","doi":"10.1016/j.parkreldis.2025.108142","DOIUrl":"10.1016/j.parkreldis.2025.108142","url":null,"abstract":"<div><h3>Background</h3><div>Subcutaneous foslevodopa (fLD) infusions are a new therapeutic option for treating complicated Parkinson's disease (PD).</div></div><div><h3>Objectives</h3><div>To assess the initial period of fLD infusion as replacement of oral medications in PD.</div></div><div><h3>Methods</h3><div>PD patients started infusion treatment according to recommended practice. Efficacy was assessed using the MDS-UPDRS motor examination and motor complications scores in the ON condition at baseline and after 20 weeks. Safety and fLD doses were assessed on a weekly basis. The 20-week observation period was compared to baseline.</div></div><div><h3>Results</h3><div>On week 20 the MDS-UPDRS motor examination score was unchanged, whereas the motor complications score was improved, indicating increased ON time without troublesome dyskinesias and reduced OFF time. The initial fLD dosage was gradually increased in all patients, by 37 % on week 20. Treatment optimization was achieved at a median of 12 weeks; patients with higher body mass index required a longer titration period. The levodopa equivalent daily dose of fLD on week 20 was 0.57mg. Adverse events occurred in 87 % of patients, primarily consisting of skin reactions at the infusion sites that occasionally required treatment.</div></div><div><h3>Discussion</h3><div>fLD infusion reduced motor fluctuations while maintaining stable ON motor performance. The infusion dose was progressively increased in the initial treatment period. The time needed for treatment stabilization was longer than previously reported and delayed in patients with higher body mass index. The treatment was generally well tolerated, neuropsychiatric effects were more common than previously reported.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"143 ","pages":"Article 108142"},"PeriodicalIF":3.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Altered subthalamic alpha-beta oscillations in PRKN-associated early onset Parkinson's disease in relation to off-dystonia prkn相关的早发性帕金森病与非肌张力障碍相关的丘脑下α - β振荡改变

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-17 DOI: 10.1016/j.parkreldis.2025.108165

Philip Pavlovsky , Anna Golik , Anna Gamaleya , Alexey Tomskiy , Marina Shulskaya , Alexey Sedov , Petr Slominsky , Elena Belova

Introduction

Electrophysiological features of monogenic early onset Parkinson's disease (EOPD) are poorly studied. This lack of knowledge hinders the development of personalized therapy for patients suffering from these PD forms. In this work, we aimed to investigate the differences in STN activity in patients with PRKN mutation and idiopathic EOPD (iEOPD).

Methods

All the patients underwent clinical evaluation assessing their disease phenotype. We utilized MLPA to test for the mutations in target genes and selected six patients with homozygous ex.8 deletion in PRKN gene. Seven patients without mutations were recruited to a control group. We recorded subthalamic activity intraoperatively, and analyzed single cell patterning and oscillations as well as LFPs.

Results

PRKN patients without off-dystonia demonstrated less prominent alpha and low beta oscillations but had more pause-burst cells compared to iEOPD. Pause-burst neurons were predominant in patients with dystonia regardless of the mutation, while the proportion of alpha-oscillating cells in PRKN patients with dystonia was drastically increased. STN activity in PRKN-PD and iEOPD did not differ significantly when compared without accounting for dystonia.

Conclusions

PRKN mutation alters subthalamic activity both in single cell patterns and oscillations. Future research may benefit from accounting for dystonia when studying EOPD.

单基因早发性帕金森病（EOPD）的电生理特征研究甚少。这种知识的缺乏阻碍了对这些PD形式患者进行个性化治疗的发展。在这项工作中，我们旨在研究PRKN突变和特发性EOPD （iEOPD）患者中STN活性的差异。方法对所有患者进行临床评估，评估其疾病表型。我们利用MLPA检测靶基因的突变，并选择6例PRKN基因纯合子ex8缺失的患者。7名没有突变的患者被招募为对照组。我们记录了术中丘脑底活动，并分析了单细胞模式和振荡以及lfp。结果与iEOPD相比，无肌张力失调的sprkn患者表现出较不突出的α和低β振荡，但有更多的暂停-爆发细胞。无论是否发生突变，肌张力障碍患者均以暂停-爆发神经元为主，而在肌张力障碍PRKN患者中α -振荡细胞的比例急剧增加。在不考虑肌张力障碍的情况下，PRKN-PD和iEOPD的STN活性没有显著差异。结论sprkn突变改变了丘脑下单细胞模式和振荡模式的活性。在研究EOPD时，考虑到肌张力障碍可能对未来的研究有益。

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引用次数: 0

Association of neurorehabilitation timing with Parkinson's disease development following moderate to severe traumatic brain injury: A retrospective cohort study 神经康复时机与中度至重度创伤性脑损伤后帕金森病发展的关系：一项回顾性队列研究

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-16 DOI: 10.1016/j.parkreldis.2025.108164

Zhenxiang Gao , Austin A. Kennemer , David C. Kaelber , Rong Xu

Background

Traumatic Brain Injury (TBI) is a major risk factor for Parkinson's Disease (PD), and while neurorehabilitation is essential in TBI care, the effect of its timing on PD risk is unclear.

Objective

This study aimed to evaluate whether early versus delayed initiation of neurorehabilitation following moderate to severe TBI is associated with a differential risk of developing PD.

Methods

This retrospective cohort study analyzed U.S. electronic health records from the TriNetX platform to compare the risk of PD among patients with documented moderate or severe TBI who received immediate treatment versus delayed treatment. The primary outcome was PD incidence, and PD-related medication prescriptions served as a secondary outcome. Cox proportional hazards models were used to estimate hazard ratios (HRs) for PD risk.

Results

The propensity score-matched cohorts demonstrated that patients who received immediate neurorehabilitation (within 1 week following TBI) compared with those received delayed neurorehabilitation (8 days–6 months following TBI) had significantly lower risk of developing PD at 3 years (HR: 0.66 (95 % CI: 0.48–0.91) and 5 years (HR: 0.69 (95 % CI: 0.52–0.91). Similar reductions were also observed for PD-related medication prescriptions. Sensitivity analyses using alternative time windows to define early versus delayed treatment, as well as analyses excluding patients with severe conditions or those who underwent craniotomy or craniectomy, yielded consistent findings.

Conclusions

Our findings suggest that early neurorehabilitation following moderate to severe TBI was associated with reduced long-term risk of PD. Future research is warranted to elucidate the underlying biological mechanisms, evaluate the optimal timing and intensity of rehabilitation.

背景：创伤性脑损伤（TBI）是帕金森病（PD）的主要危险因素，虽然神经康复在TBI护理中至关重要，但其时机对PD风险的影响尚不清楚。目的：本研究旨在评估中度至重度脑外伤后早期与延迟开始神经康复是否与发展为PD的不同风险相关。方法：这项回顾性队列研究分析了来自TriNetX平台的美国电子健康记录，比较了中度或重度TBI患者接受立即治疗和延迟治疗的PD风险。主要终点是PD发病率，PD相关药物处方作为次要终点。Cox比例风险模型用于估计PD风险的风险比（hr）。结果：倾向评分匹配的队列显示，与接受延迟神经康复（TBI后8天至6个月）的患者相比，立即接受神经康复（TBI后1周内）的患者在3年(HR: 0.66 （95% CI: 0.48-0.91）和5年(HR: 0.69 （95% CI: 0.52-0.91）时发生PD的风险显著降低。pd相关药物处方也观察到类似的减少。使用替代时间窗来定义早期治疗和延迟治疗的敏感性分析，以及排除病情严重或接受开颅手术或开颅手术的患者的分析，得出了一致的结果。结论：我们的研究结果表明，中度至重度脑外伤后的早期神经康复与降低PD的长期风险相关。未来的研究需要阐明潜在的生物学机制，评估最佳的康复时间和强度。

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引用次数: 0

Relationship between falls and physical activity in daily life of people with Parkinson's disease 帕金森病患者跌倒与日常体力活动的关系

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-16 DOI: 10.1016/j.parkreldis.2025.108166

Bart R. Maas , Gert-Jan de Vries , Giulio Valenti , Andreas Ejupi , Bastiaan R. Bloem , Sirwan K.L. Darweesh , Nienke M. de Vries

Background

The association between physical activity and falls among people with Parkinson's disease (PD) is unclear. Their interrelationship is likely complex: falling is typically most prominent among active people (i.e. those with less disease severity), but falling also worsens as balance becomes compromised (i.e. among more severely affected persons). Physical activity could therefore be related to both more and fewer falls in an inverted-U relationship.

Objective

To examine physical activity and falls among people with PD with a fall history, to study whether (change in) physical activity is different for fallers and non-fallers, and to determine whether physical activity levels are related to the number of falls.

Methods

Physical activity and falls were prospectively measured continuously over a 1-year period using a smartwatch and diaries in people with PD with a fall history.

Results

We analyzed data of 167 participants (mean age 69 years, 37 % females). The average daily step count was 4891 (SD = 2912) and median fall rate was 3 falls/person-year (Q1-Q3, 0–8.5), both stable during follow-up. Step count was similar for fallers (4866) and non-fallers (4960) (t(76) = 0.18, p = 0.86). Step count was not related to the number of falls in a linear relationship (Beta = −0.36, p = 0.97) nor in an inverted-U relationship (Beta = 0.14, p = 0.21).

Conclusion

We found no evidence that physical activity levels were different for fallers and non-fallers, or were related to the number of falls. This population with a fall history was quite sedentary and fell frequently, and these patterns were consistent during the relatively brief observation period of 1 year.

背景：体育活动与帕金森病（PD）患者跌倒之间的关系尚不清楚。它们之间的相互关系可能是复杂的：跌倒通常在活跃的人（即疾病严重程度较低的人）中最为突出，但随着平衡受到损害（即受影响较严重的人），跌倒也会恶化。因此，体育活动可能与跌倒的次数和次数都呈倒u型关系。目的：调查有跌倒史的PD患者的身体活动和跌倒情况，研究跌倒者和非跌倒者的身体活动（变化）是否不同，确定身体活动水平是否与跌倒次数有关。方法：在有跌倒史的PD患者中，使用智能手表和日记前瞻性地连续测量了1年的身体活动和跌倒情况。结果：我们分析了167名参与者的资料（平均年龄69岁，37%为女性）。平均每日步数为4891 (SD = 2912)，中位跌倒率为3次/人年（Q1-Q3, 0-8.5），随访期间均稳定。跌倒者（4866）和非跌倒者（4960）的步数相似（t(76) = 0.18, p = 0.86）。步数与跌倒次数之间不存在线性关系（Beta = -0.36, p = 0.97），也不存在倒u关系（Beta = 0.14, p = 0.21）。结论：我们没有发现证据表明跌倒者和非跌倒者的身体活动水平有差异，或与跌倒次数有关。有跌倒史的人群久坐不动，经常跌倒，这些模式在相对较短的1年观察期内是一致的。

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引用次数: 0