A 3-year clinical prospective investigation: establishment of anassessment questionnaire for Parkinson's disease with motor complications
10.3760/cma.j.issn.1006-7876.2013.01.008
- VernacularTitle:三年前瞻性临床研究初步构建帕金森病运动并发症危险评估量表
- Author:
Ying WAN
;
Xiaoyu REN
;
Yarong WEI
;
Mingzhu ZHOU
;
Haiyan HE
;
Jing GAN
;
Lixia LU
;
Jiaying WU
;
Wei CHEN
;
Zhenguo LIU
- Publication Type:Journal Article
- Keywords:
Parkinson disease;
Movement disorders;
Incidence;
Prospective studies;
Risk assessment questionnaire
- From:
Chinese Journal of Neurology
2013;(1):26-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective To derive a questionnaire to assess the risk of developing motor complications through a 3-year prospective investigation on 71 patients of Parkinson' s disease (PD) in the out clinic at our hospital.Methods Three years after the first assessment,71 PD out patients were reassessed using various scales,including Unified Parkinson Disease Rating Scale,Hoehn-Yahr grade,Mini Mental State Exam,Hamilton Depression Scale and Hamilton Anxiety Scale.Results The incidence of motor complications was 43.6% (31/71).Logistic regression analysis showed that the prognostic factors for motor fluctuation were age of onset ≤ 54 (OR =6.4,95% CI 1.7-24.5,P =0.006),the occurrence of swallowing difficulty (OR =3.8,95 % CI 1.0-14.1,P =0.04) and depression (OR =4.0,95 % CI 1.1-13.7,P =0.03),and the prognostic factors for dyskinesia were age of onset ≤54 (OR =48.5,95% CI 1.9-121.0,P:0.02),the occurrence of falling (OR =64.1,95% CI 2.9-142.2,P =0.008) and the daily levodopa dosage > 600 mg(OR =17.5,95% CI 1.1-276.2,P =0.04).Based on the regression model,the assessment questionnaire for motor complicationsincludes the followings:the questionnaire for motor fluctuations:the age of onset ≤54,2 points; the occurrence of swallowing difficulty,1 point; the occurrence of depression,1 point; the questionnaire for dyskinesia:the onset age ≤54,2 points; the occurrence of falling,3 points; daily levodopa dosage > 600 mg,2 points.In all patients in this study,21.7% (10/46) was asscssed to a total scorc of 0-1 which is associated with a low risk of motor fluctuation,8/16 had a score of 2 which is associated with intermediate risk and 8/9 got a score of 3-4 associated high risk; 10.2% (5/49) had a score of 0-2,a low risk of dyskinesia,4/13 had a score of 3-4,a intermediate risk and 7/9 got a score of 5-7 which is associated with a high risk.Conclusions Age onset ≤54,the occurrence of swallowing difficulty,falling and depression,daily levodopa dosage > 600 mg were considered to be the prognostic factors of motor complications in PD.The questionnaire may help to stratify PD patients into low-risk,medium-risk and high-risk groups for motor complications and the higher the score in the questionnaire is related to the higher risk of motor complications.