Nocturnal manifestations of atypical and vascular parkinsonism: How do they differ from Parkinson's disease?

被引：5

作者：

Bhidayasiri, Roongroj ^{[1
,2
,3
]}

Jitkritsadakul, Onanong ^{[1
,2
]}

Petchrutchatachart, Sitthi ^{[1
,2
]}

Kaewwilai, Lalita ^{[1
,2
]}

Panyakaew, Pattamon ^{[1
,2
]}

Boonrod, Nonglak ^{[1
,2
]}

Colosimo, Carlo ^{[4
]}

机构：

[1] Chulalongkorn Univ Hosp, Chulalongkorn Ctr Excellence Parkinsons Dis & Rel, Dept Med, Fac Med, Bangkok 10330, Thailand

[2] King Chulalongkorn Mem Hosp, Thai Red Cross Soc, Bangkok 10330, Thailand

[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA

[4] Univ Roma La Sapienza, Dipartimento Sci Neurol, I-00185 Rome, Italy

来源：

JOURNAL OF NEURAL TRANSMISSION | 2014年 / 121卷

关键词：

Atypical parkinsonism; Vascular parkinsonism; Modified Parkinson's Disease Sleep Scale; Nocturnal Akinesia Dystonia and Cramp Score; Urinary incontinence; Nocturnal akinesia; Nonmotor symptom; MULTIPLE SYSTEM ATROPHY; PROGRESSIVE SUPRANUCLEAR PALSY; SLEEP SCALE; DIAGNOSTIC-CRITERIA; NONMOTOR SYMPTOMS; DISORDERS; DISABILITY; WORKSHOP;

D O I：

10.1007/s00702-014-1198-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

While nocturnal disturbances of Parkinson's disease (PD) are increasingly recognized as being part of a continuum that includes daytime manifestations, there is still little analysis in the medical literature that assesses these complex phenomena in patients with atypical (AP) and vascular parkinsonisms (VP). The objective of our study was to determine the prevalence of these disturbances in patients with AP and VP and to determine the range of nighttime symptoms that occur compared with those in patients with PD. This comparison was done using a semi-structured interview and self-rated questionnaires in 63 AP and VP patients (PSP 24, MSA 24, CBD 5, and VP 10), and 208 PD patients. 61 AP and VP patients (96.8 %) and 201 PD patients (96.6 %) reported at least one nocturnal symptom with a score of less than 6 on the Modified Parkinson's Disease Sleep Scale (MPDSS). Nocturnal akinesia, as measured on the Nocturnal Akinesia, Dystonia, and Cramp Score, was found to be significantly greater in patients with PSP (p = 0.006), MSA (p = 0.002), and CBD (p = 0.012) than PD patients, but not VP patients (p = 0.428). Like those with PD, patients with AP and VP identified the problem of getting up at night to urinate (MPDSS item 8) as being the most frequent and troublesome nocturnal symptom. MSA and PSP patients reported more frequent (p = 0.001) and troublesome (p < 0.001) urinary incontinence (MPDSS item 9) than PD patients and MSA patients had more severe problems with unexpectedly falling asleep during the day (MPDSS item 15) than PD patients (p = 0.003). In summary, our study determined that nocturnal manifestations are commonly experienced by patients with AP and VP and highlighted specific nocturnal symptoms, which are more prevalent and troublesome in certain AP syndromes. The concept of 24-h control of symptoms should not be limited to only PD and we recommend that all who are involved in the care of AP and VP patients should realize that many nocturnal symptoms are experienced by these patients and a multidisciplinary approach should be utilized to address these problems.

引用

页码：S69 / S77

页数：9