Clinical Parkinsonism Related Disorders最新文献_第3页

Delirium-onset prodromal Lewy body disease: A series of 5 cases 谵妄前兆路易体病：5 例系列病例

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100289

Daiki Taomoto , Yoshiyuki Nishio , Yousuke Hidaka , Hideki Kanemoto , Shun Takahashi , Manabu Ikeda

Background

Delirium-onset prodromal Lewy body disease (LBD) has been proposed as one of the primary phenotypes of prodromal stages of LBD. The detailed clinical features and biomarker profiles of delirium-onset prodromal LBD have not been well characterized.

Methods

Five consecutive cases of delirium-onset prodromal LBD were documented. The diagnosis of prodromal LBD was made based on neuroimaging biomarkers, including dopamine transporter single-photon emission computed tomography (SPECT), cardiac ¹²³I-metaiodobenzylguanidine scintigraphy, and/or brain perfusion SPECT, as well as clinical findings in the post-delirium follow-up periods.

Results

In all cases, one or more of the core or supportive clinical features of dementia with Lewy bodies, including rapid eye movement sleep behavior disorder, minor hallucinations, hyposmia, or autonomic dysfunction, were present prior to the onset of delirium. The precipitating factors for delirium were diverse, including surgery, radiation therapy, chemotherapy, and infection. The duration of delirium was prolonged for several months in two cases, whereas it was resolved within a few weeks in the other cases. In most cases, persistent mild cognitive or behavioral symptoms were observed, which were improved with donepezil.

Conclusions

Our observations suggest that delirium-onset prodromal LBD may represent the later stages of the prodromal LBD rather than its initial stages. It is possible that delirium in the prodromal stages of LBD may represent subthreshold cognitive fluctuations that are transformed into clinically detectable states by a variety of precipitating factors.

背景谵妄前驱路易体病（LBD）被认为是LBD前驱期的主要表型之一。谵妄前驱型路易体病的详细临床特征和生物标记物谱系尚未得到很好的描述。方法连续记录了5例谵妄前驱型路易体病病例。根据神经影像学生物标记物（包括多巴胺转运体单光子发射计算机断层扫描（SPECT）、心脏123I-甲碘苄胍闪烁扫描和/或脑灌注SPECT）以及谵妄后随访期间的临床发现，做出枸杞多糖症前驱的诊断。结果在所有病例中，一个或多个路易体痴呆的核心或辅助临床特征，包括眼球快速运动睡眠行为障碍、轻微幻觉、嗅觉减退或自主神经功能障碍，在谵妄发生前均已存在。谵妄的诱发因素多种多样，包括手术、放疗、化疗和感染。有两个病例的谵妄持续时间长达数月，而其他病例的谵妄则在数周内缓解。结论我们的观察结果表明，由谵妄引发的前驱性枸杞多糖症可能是前驱性枸杞多糖症的晚期阶段，而非初期阶段。枸杞多糖症前驱期的谵妄可能是阈值以下的认知波动，在各种诱发因素的作用下转变为临床上可检测到的状态。

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引用次数: 0

Determination of optimal vibration dose to treat Parkinson's disease gait symptoms: A clinical trial 确定治疗帕金森病步态症状的最佳振动剂量：临床试验

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100248

Ingrid Pretzer-Aboff , R.K. Elswick , Arnaud Gouelle , Noah Helm , GinaMari Blackwell , Leslie Cloud

Introduction

Most people with Parkinson's disease (PD) will experience gait problems. Previous studies demonstrated improved gait and balance after vibration stimulation was applied to the feet of PD patients. However, not all study participants showed improvement, perhaps due to sub-optimal vibration stimulus. Thus far, the optimal frequency and amplitude of vibration for mitigating gait dysfunction in PD have yet to be systematically explored. This study aimed to deliver vibration to the feet of 26 people with PD gait disturbances. We hypothesized that a global frequency, amplitude, and minimum duration of vibration therapy are required to improve PD gait issues.

Methods

This was a phase Ib trial to identify optimal vibration parameters. Thirteen participants were recruited at Hoehn & Yahr (H&Y) stage II and 13 participants at stage III. Each group was randomly assigned to different frequency and amplitude settings prescribed by the central composite design methodology. Each participant received vibration for 18 min per walking session, for eight sessions spread over one week.

Results

Results showed an optimal response to treatment for frequency (Hz) and amplitude (mm) of vibration based on the Functional Ambulation Performance score for stages II and III. In the H&Y stage II group, stabilization of outcomes occurred after the 4th treatment. This stabilization was not seen in stage III participants.

Conclusions

A global frequency and vibration amplitude have been identified for treating PD gait disorders. Patients with more advanced disease may require a longer duration of therapy.

导言：大多数帕金森病（PD）患者都会出现步态问题。以前的研究表明，对帕金森病患者的脚部进行振动刺激后，他们的步态和平衡能力会得到改善。然而，并非所有研究参与者的情况都有所改善，这可能是由于振动刺激不够理想所致。到目前为止，人们还没有系统地探索出振动的最佳频率和振幅，以缓解帕金森氏症患者的步态功能障碍。本研究旨在为 26 名步态障碍患者的脚部提供振动。我们假设，要改善帕金森病步态问题，需要振动治疗的总体频率、振幅和最短持续时间。我们招募了 13 名处于 Hoehn & Yahr (H&Y) II 期的患者和 13 名处于 III 期的患者。根据中心复合设计方法，每组被随机分配到不同的频率和振幅设置。结果表明，根据 II 期和 III 期的功能性行走表现评分，振动频率（赫兹）和振幅（毫米）对治疗有最佳响应。在 H&Y II 阶段组中，第四次治疗后疗效趋于稳定。结论已确定了治疗帕金森病步态障碍的整体频率和振动幅度。晚期患者可能需要更长的治疗时间。

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引用次数: 0

The value of consciousness coaching in Parkinson’s disease: Experiences and possible impact of holistic coaching 意识辅导在帕金森病中的价值：整体辅导的经验和可能影响

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100261

Lousanne E.J. Tangelder, Ana L. Silva de Lima, Arjonne Laar, Nienke M. de Vries

Background

People with a chronic condition such as Parkinson’s disease (PD) struggle with acceptance and finding meaning in life. Consciousness coaching could be a valuable addition in addressing these issues.

Objective

We aim to evaluate the user experiences and potential effectiveness of consciousness coaching for people with PD (PwPD).

Methods

We performed a pilot randomized controlled trial including PwPD in Hoehn & Yahr stage 1–3. People with cognitive impairments, severe psychiatric disorders, or those who did not have a clear issue to address with consciousness coaching, were excluded. PwPD were randomly allocated to either receiving 6 months of consciousness coaching in addition to usual care or to usual care alone. To explore experiences we performed semi-structured qualitative interviews with all PwPD in the intervention group. Potential effects were explored using questionnaires on quality of life, activities of daily life, self-management and non-motor symptoms at baseline and after 6 months.

Results

We included 39 PwPD, 19 participants in the intervention group and 20 in the control group. Based on the interviews, we identified a number of themes and codes. In general PwPD experienced consciousness coaching as confronting but supportive in reaching their goals and in taking more responsibility for their lives. Quantitatively, we did not find a difference between groups for any of the outcomes.

Conclusions

Consciousness coaching was considered valuable by most participants in this study and may be an interesting addition to PD treatment. We did not find any effects of the intervention on PD symptoms or quality of life.

背景帕金森病（PD）等慢性病患者在接受和寻找生活意义方面挣扎不已。我们的目标是评估帕金森病患者（PwPD）的用户体验和意识辅导的潜在效果。方法我们进行了一项试验性随机对照试验，其中包括处于 Hoehn & Yahr 阶段 1-3 的帕金森病患者。有认知障碍、严重精神障碍或没有明确问题需要通过意识辅导来解决的患者被排除在外。患者被随机分配到接受为期6个月的意识辅导，同时接受常规护理或仅接受常规护理。为了探索经验，我们对干预组的所有残疾人进行了半结构化定性访谈。在基线期和 6 个月后，我们使用生活质量、日常生活活动、自我管理和非运动症状调查问卷对潜在影响进行了探讨。根据访谈，我们确定了一些主题和代码。总的来说，残疾人认为意识辅导具有对抗性，但对他们实现目标和为自己的生活承担更多责任具有支持作用。从数量上看，我们没有发现不同组别之间在任何结果上存在差异。我们没有发现干预对帕金森病症状或生活质量有任何影响。

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引用次数: 0

Hand-foot synkinesis in a patient with phenytoin intoxication 苯妥英中毒患者的手足徐动症

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100237

Gohei Yamada , Takanari Toyoda , Eiichi Katada , Noriyuki Matsukawa

Here we report the first case of phenytoin intoxication that was closely associated with hand-foot synkinesis. This case suggests a close association between cerebellar dysfunction and hand-foot synkinesis. In patients with hand-foot synkinesis, lesions of not only the secondary motor areas but also the cerebellum should be considered.

我们在此报告了首例苯妥英中毒与手足徐动症密切相关的病例。该病例表明，小脑功能障碍与手足徐动症密切相关。对于手足徐动症患者，不仅应考虑次级运动区的病变，还应考虑小脑的病变。

引用次数: 0

Self-treatment of freezing of gait in Parkinson’s disease patients using silicone pads to apply Thai acupressure to plantar acupoints: A randomised, controlled trial 使用硅胶垫对足底穴位进行泰式穴位按摩，对帕金森病患者的步态冻结进行自我治疗：随机对照试验

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100254

Yuka Miyahara , Pattamon Panyakaew , Jiradon Tinuan , Onanong Phokaewvarangkul , Chanawat Anan , Haruki Toriumi , Roongroj Bhidayasiri

Introduction

Freezing of gait (FOG) involves dysfunction of the motor and sensory systems. Peripheral sensory stimuli, including Thai acupressure, can improve proprioceptive function and decrease FOG episodes. Here, we sought to determine the efficacy of acupressure as a self-treatment to alleviate FOG in patients with Parkinson’s disease (PD).

Methods

We conducted an open-label, controlled trial of 60 PD patients with FOG while medicated, randomised into two groups: an active-treatment group using silicone pads to apply pressure to plantar acupoints on the head of the big toe and the base of the first metatarsal bone on each foot for 6 s using patient body weight while seated, repeated four times for each acupoint bilaterally, and a sham-treatment group using a similar protocol without the silicone pads. The primary outcome was stride length. Secondary outcomes included FOG episodes, FOG duration, percent duration of FOG to total gait time (%FOG), and gait parameters. A baseline-adjusted analysis of covariance was used to compare outcomes between the two groups.

Results

Compared with the sham treatment, the active treatment increased stride length, gait velocity, and cadence (all p < 0.001), and decreased FOG episodes and duration (both p < 0.001), %FOG (p = 0.011), and double-support time (p < 0.001). No adverse effects were noted.

Conclusions

Acupressure using silicone pads to stimulate plantar acupoints for self-treatment is a noninvasive, simple, safe way to improve gait and alleviate FOG in patients with PD.

Clinical Trial Registration

We registered the study prospectively in the Thai Clinical Trial Registry No. TCTR20200317001.

导言步态冻结（FOG）涉及运动和感觉系统的功能障碍。包括泰式穴位按摩在内的外周感觉刺激可以改善本体感觉功能，减少冻结步态的发生。在此，我们试图确定穴位按摩作为一种自我治疗方法对缓解帕金森病（PD）患者 FOG 的疗效。方法我们进行了一项开放标签对照试验，60 名帕金森病患者在服药期间出现 FOG，随机分为两组：积极治疗组使用硅胶垫，在坐位时利用患者体重对每只脚的大拇趾头和第一跖骨基部的足底穴位施压 6 秒钟，对每个穴位重复四次；假治疗组使用类似方案，不使用硅胶垫。主要结果是步长。次要结果包括FOG发作次数、FOG持续时间、FOG持续时间占总步态时间的百分比（%FOG）以及步态参数。结果与假治疗相比，积极治疗增加了步长、步速和步调（均为 p < 0.001），减少了 FOG 发作和持续时间（均为 p < 0.001）、FOG 百分比（p = 0.011）和双支撑时间（p < 0.001）。结论使用硅胶垫刺激足底穴位进行自我治疗是一种无创、简单、安全的方法，可改善步态并缓解帕金森病患者的 FOG。

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引用次数: 0

CRPD frontiers in movement disorders Therapeutics: From evidence to treatment and applications CRPD 运动障碍治疗学前沿：从证据到治疗和应用

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100255

Susan L. Perlman

The genetic ataxias have no cures and no proven ways to delay progression (no disease-modifying therapies). The acquired ataxias may have treatments that address the underlying cause and may slow or stop progression, but will not reverse damage already sustained. The idiopathic ataxias (of unknown genetic or acquired cause) also have no proven disease-modifying therapies. However, for all patients with ataxia of any cause, there is always something that can be done to improve quality of life—treat associated symptoms, provide information and resources, counsel patient and family, help with insurance and disability concerns, be available to listen and answer the many questions they will have.

遗传性共济失调没有治疗方法，也没有经过验证的延缓病情恶化的方法（没有疾病改变疗法）。后天性共济失调可能有针对潜在病因的治疗方法，可以延缓或阻止病情发展，但无法逆转已经造成的损害。特发性共济失调（遗传或获得性病因不明）也没有经证实的改变病情疗法。然而，对于任何原因导致的共济失调患者，我们总能做些什么来改善他们的生活质量--治疗相关症状、提供信息和资源、为患者和家属提供咨询、帮助解决保险和残疾问题、倾听并回答他们提出的许多问题。

引用次数: 0

Do sensorimotor insoles improve gait safety in patients with Parkinson’s disease on a short scale? 感觉运动鞋垫能否在短期内改善帕金森病患者的步态安全？

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100290

Lisa K. Maurer , Heiko Maurer , Manuel König , Marlena van Munster , Saskia Haen , David J. Pedrosa

Introduction

Parkinson’s disease (PD) often leads to gait abnormalities, increasing the risk of falls and affecting daily life. Sensorimotor insoles aim to enhance foot sensitivity, potentially improving gait stability.

Methods

This study examined whether there are short-term effects of sensorimotor insoles on neural activation (measured by EEG), kinematic gait parameters (speed, cadence, step length, and step-length variability), and subjective gait stability in PD patients. Sixteen individuals suffering from PD completed a gait task while wearing sensorimotor and placebo insoles, respectively.

Results

The results showed no significant changes in kinematic parameters with the sensorimotor insoles. Subjective ratings of gait stability and attentional control of gait improved on average with the sensorimotor insoles, but again did not reach statistical significance. There was no significant reduction in alpha-band activity, indicating no improvement in sensorimotor processing.

Conclusion

The immediate impact of sensorimotor insoles on sensorimotor processing and gait characteristics in PD patients remains inconclusive. The small sample size limited the statistical power, highlighting the need for larger studies to comprehensively assess efficacy. Further research should investigate the long-term effects and potential benefits on disability measures in PD patients.

帕金森病（PD）经常导致步态异常，增加跌倒的风险并影响日常生活。感觉运动鞋垫旨在提高足部灵敏度，潜在地改善步态稳定性。方法本研究考察了感觉运动鞋垫是否对PD患者的神经激活（通过EEG测量）、运动学步态参数（速度、节奏、步长和步长变异性）和主观步态稳定性有短期影响。16名PD患者分别穿着感觉运动鞋垫和安慰剂鞋垫完成了步态任务。结果感觉运动鞋垫对运动参数无明显影响。使用感觉运动鞋垫后，步态稳定性和步态注意力控制的主观评分平均有所改善，但同样没有达到统计学意义。α带活性没有明显降低，表明感觉运动加工没有改善。结论感觉运动鞋垫对PD患者感觉运动加工和步态特征的直接影响尚不明确。小样本量限制了统计效力，强调需要更大规模的研究来全面评估疗效。进一步的研究应该调查PD患者残疾措施的长期影响和潜在益处。

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引用次数: 0

Novel characteristics of the temporal transition to maximum tongue pressure in Parkinson’s disease: A pilot study 帕金森病患者舌压达到最大值的时间过渡的新特征：试点研究

Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100244

Sachi Hayasaka , Kozo Hatori , Shuko Nojiri , Taku Hatano , Takao Urabe , Akito Hayashi , Nobutaka Hattori , Toshiyuki Fujiwara

Introduction

The reason why maximum tongue pressure (MTP) decreases in patients with Parkinson’s disease (PD) remains unclear. Repeated measurements of isometric force and MTP may be useful for analyzing muscle wasting and force generation. The purpose of this pilot study was to evaluate the clinical characteristics and temporal transition of MTP in PD and normal control (NC) groups.

Methods

There were 18 participants in this study: 10 with PD and 8 NCs. The MTP was measured 20 times at regular intervals. The area under the curve of MTP temporal transitions, time to reach MTP, and total transition time of the tongue pressure (time to return to baseline) were compared between the groups.

Results

MTP decreased from baseline in PD subjects. Unlike NCs, PD subjects showed diverse and inconsistent temporal transitions. The decrease in MTP and delays in time to reach MTP and time to return to baseline were significantly greater in PD subjects (p < 0.05), while there was no group difference in area under the curve values. According to repeated-measures ANOVA, MTP was not different over time between PD subjects and NCs.

Conclusion

In this study, muscle fatigue did not affect the decrease in MTP seen in PD subjects, or the diversity and inconsistency of the temporal transition in MTP in that group. These findings indicate that the motor control needed for the repeated, identical movements associated with MTP generation may be impaired in PD patients.

导言：帕金森病（PD）患者最大舌压（MTP）下降的原因尚不清楚。重复测量等长力和 MTP 可能有助于分析肌肉萎缩和发力情况。本试验研究的目的是评估帕金森病组和正常对照组（NC）MTP 的临床特征和时间变化：本研究共有 18 名参与者：10 名 PD 患者和 8 名 NC 患者。研究人员对18名参与者（10名帕金森病患者和8名NC患者）进行了20次MTP测量。比较两组间 MTP 时间转换的曲线下面积、达到 MTP 的时间和舌压的总转换时间（恢复到基线的时间）。与 NCs 不同，PD 受试者表现出多样且不一致的时间过渡。帕金森氏症受试者的 MTP 下降幅度、达到 MTP 的时间延迟以及恢复基线的时间延迟均显著大于 NC 受试者（p < 0.05），而曲线下面积值没有组间差异。根据重复测量方差分析，PD 受试者和 NC 之间的 MTP 随时间变化没有差异。这些研究结果表明，与 MTP 生成相关的重复、相同动作所需的运动控制在帕金森病患者中可能受到了损害。

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引用次数: 0

Dysphagia is a risk factor of malnutrition in X-linked Dystonia-Parkinsonism 吞咽困难是 X 连锁肌张力障碍-帕金森病患者营养不良的风险因素之一

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100282

Tabitha H. Kao , Perman Gochyyev , Nutan Sharma , Jan K. de Guzman , Melanie Supnet Wells , Patrick Acuna , Shasha Li , Hannah P. Rowe , Bridget J. Perry

Introduction

Malnutrition is a leading cause of death for persons living with X-linked dystonia-parkinsonism (XDP), a degenerative disease endemic to the Philippines. Difficulty swallowing has been linked to malnutrition in other populations; however, knowledge of this relationship is limited in XDP. As such, the purpose of this study was to determine the association between dysphagia and malnutrition in this population.

Method(s)

21 individuals with XDP, 26 controls, and 18 genetic carriers were included in the final data analysis. Spearman’s rank order correlation coefficient was used to determine an association between baseline EAT-10 total scores and 12-month malnutrition status, and multiple linear regression to evaluate the predictive ability of the EAT-10. A baseline EAT-10 score cut-off point predicting 12-month malnutrition status was estimated.

Results

For the XDP group, the baseline EAT-10 total scores had a significant negative correlation (r = -0.68, p < 0.001) with and was a significant predictor (p = 0.001) of 12-month BMI. A baseline EAT-10 total score of ≥ 4 predicted malnutrition twelve months after administration (sensitivity = 0.93; specificity = 1; AUC = 0.95).

Discussion

Dysphagia, as measured using the EAT-10, was associated with BMI in the XDP population. Additionally, an EAT-10 total score ≥ 4 could predict malnutrition in twelve months after test administration. With these findings, healthcare providers could identify patients with XDP at high risk for malnutrition earlier and provide intervention sooner.

导言营养不良是X-连锁肌张力障碍-帕金森病（XDP）患者的主要死因，这是一种菲律宾特有的变性疾病。在其他人群中，吞咽困难与营养不良有关；但在 XDP 患者中，对这种关系的了解却很有限。因此，本研究旨在确定该人群中吞咽困难与营养不良之间的关系。斯皮尔曼秩相关系数用于确定基线 EAT-10 总分与 12 个月营养不良状况之间的关联，多元线性回归用于评估 EAT-10 的预测能力。结果在XDP组中，基线EAT-10总分与12个月体重指数呈显著负相关（r = -0.68，p <0.001），并且是12个月体重指数的重要预测指标（p = 0.001）。基线 EAT-10 总分≥ 4 分可预测 12 个月后的营养不良情况（灵敏度 = 0.93；特异性 = 1；AUC = 0.95）。此外，EAT-10 总分≥ 4 分可预测测试后 12 个月内的营养不良情况。有了这些发现，医疗服务提供者就能更早地发现XDP患者中营养不良的高危人群，并更快地进行干预。

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引用次数: 0

Comparison of MIBG uptake in the major salivary glands between Lewy body disease and progressive supranuclear palsy 路易体病与进行性核上性麻痹在主要唾液腺中的 MIBG 摄取比较

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2024-01-01 DOI: 10.1016/j.prdoa.2024.100287

Junya Ebina , Sunao Mizumura , Mari Shibukawa , Harumi Morioka , Junpei Nagasawa , Masaru Yanagihashi , Takehisa Hirayama , Nobutomo Ishii , Yukio Kobayashi , Akira Inaba , Satoshi Orimo , Osamu Kano

Introduction

Cardiac sympathetic denervation is specific to Lewy body disease (LBD). In Parkinson’s disease (PD), sympathetic denervation in the major salivary glands (parotid glands [PG] and submandibular glands [SMG]) has been demonstrated by ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy. We compared sympathetic denervation in the MSG between PD, dementia with Lewy bodies (DLB), and progressive supranuclear palsy (PSP).

Methods

We recruited 81 patients with PD, 12 with DLB, 13 with PSP and 25 with control subjects. We evaluated MIBG uptake in the major salivary glands and heart using a quantitative semi-automatic method. We compared MIBG uptake between PD, DLB, and PSP patients and controls, and we evaluated disease sensitivity and specificity. We compared olfactory function with MIBG uptake between PD and PSP patients.

Results

MIBG uptake in the PG and SMG in the delayed phase was significantly lower in PD and DLB patients than in PSP patients and controls. Conversely, MIBG uptake in the major salivary glands and heart was comparable between PD and DLB. Between LBD and non-LBD, MIBG uptake showed 56–100 % specificity in the PG, while it had 55.6–87.5 % sensitivity in the SMG. Between PD and PSP, MIBG uptake in the PG and SMG had higher disease specificity than olfactory function, while the sensitivity of SMG MIBG uptake was comparable to olfactory function.

Conclusion

PD and DLB patients showed lower MIBG uptake in the major salivary glands than PSP patients, especially in the delayed phase. MIBG uptake in the major salivary glands may differentiate PD from hyposmic PSP.

导言：心脏交感神经剥夺是路易体病（LBD）的特异性症状。在帕金森病（PD）中，主要唾液腺（腮腺[PG]和颌下腺[SMG]）的交感神经剥夺已被 123I-甲位十二烷基胍（MIBG）闪烁扫描所证实。我们比较了帕金森病、路易体痴呆（DLB）和进行性核上性麻痹（PSP）患者 MSG 的交感神经去神经化情况。我们使用半自动定量方法评估了主要唾液腺和心脏的 MIBG 摄取量。我们比较了 PD、DLB 和 PSP 患者与对照组的 MIBG 摄取量，并评估了疾病的敏感性和特异性。我们比较了PD和PSP患者的嗅觉功能和MIBG摄取量。结果MIBG在PG和SMG延迟阶段的摄取量在PD和DLB患者中明显低于PSP患者和对照组。相反，PD 和 DLB 患者主要唾液腺和心脏的 MIBG 摄取量相当。在 LBD 和非 LBD 之间，MIBG 摄取在 PG 中显示出 56-100 % 的特异性，而在 SMG 中显示出 55.6-87.5 % 的敏感性。在PD和PSP患者之间，PG和SMG的MIBG摄取的疾病特异性高于嗅觉功能，而SMG MIBG摄取的敏感性与嗅觉功能相当。主要唾液腺的MIBG摄取量可将PD与低渗性PSP区分开来。

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引用次数: 0