| Objective:Parkinson’s disease(PD)is the second largest neurodegenerative disease,which is characterized by static tremor,bradykinesia,muscle rigidity and postural balance disorder.The occurrence of behavior disorder during REM sleep(RBD)is closely related to PD.Previous studies have shown that PD patients with RBD have more serious motor disorders,tremors and gait abnormalities,but there are few studies on the differences of specific quantitative gait data.In this study,the differences of gait parameters between PD patients with or without RBD were compared to seek potential motion markers.Methods:97 patients with Parkinson’s syndrome who were first diagnosed in our hospital from March 2021 to November 2022 were selected.After admission,the scores of the Unified Parkinson’s Disease Rating Scale(UPDRS),the Parkinson’s Sleep Quality Scale(PDSS),the Hamilton Anxiety and Depression Scale(HAMA,HAMD),and the Simple Mental State Examination Scale(MMSE)were improved,and the subjects who met the criteria were screened for the Occupant polysomnography(PSG),and the PD patients were divided into the group with RBD and the group without RBD according to the sleep results.The gait parameters of PD patients were obtained by gait analysis.Pearson correlation analysis was used to evaluate the correlation between gait parameters and UPDRS score,and two independent samples t-test was used to analyze the difference of gait parameters between the two groups.Results:1.The incidence of PD with RBD: 97 patients with Parkinson’s syndrome were included in this study,and 54 patients with PD who met the criteria were included in the final study.Among them,26 patients with RBD,accounting for 48.15%,and 28 patients without RBD,accounting for 51.85%.There was no significant difference between the two groups in age,course of disease,body weight,daily dose of levodopa,H-Y stage,simple intelligence scale score and UPDRS score(p > 0.05).The proportion of males in RBD group was lower than that in NRBD group,and the difference between groups was statistically significant(p<0.05).The score of Parkinson’s sleep disorder scale in RBD group was lower than that in NRBD group,and the difference between groups was statistically significant(p<0.05).2.Correlation analysis of gait parameters and UPDRS scale score: the weight difference of bipedal walking was positively correlated with the total score and the third part of the UPDRS scale(r=0.329 p < 0.05,r=0.333 p<0.05),and the step length difference of left and right feet was positively correlated with the total score and the third part of the UPDRS scale(r=0.494 p<0.01,r=0.514 p<0.01).The support phase was positively correlated with the total score and the third part of the UPDRS scale(r=0.677 p < 0.01,r=0.756 p<0.01).The walking speed was negatively correlated with the total score and the third part of the UPDRS scale(r=-0.695 p < 0.01,r=-0.691 p<0.01).The step length was negatively correlated with the total score and the third part of the UPDRS scale(r=-0.635 p < 0.01,r=-0.632p<0.01).3.Analysis of differences in gait parameters between RBD group and NRBD group: the difference of left and right foot step length in RBD group was greater than that in NRBD group,and the difference between groups was statistically significant(p<0.05).The proportion of typical gait cycle in the affected side of RBD group was lower than that in NRBD group,and the difference between groups was statistically significant(p<0.05).There was no significant difference between the two groups in walking speed,step length,step width,support phase and weight difference of left and right feet(p>0.05).4.RBD,weight,Simplified Mental State Scale score,stride speed,and stride length are predictive factors for typical gait cycles.The probability of typical gait cycles occurring in the RBD group is 0.267 times higher than that in the non RBD group.For every 1 point increase in MMSE score,the probability of typical gait cycles occurring is 1.905 times higher.5.The ROC area under the curve for body weight was0.686(95%CI:0.561-0.865,p <0.05),and the sensitivity was 60%,71.4% specificity,and a cutoff value> 66.5.The area under the curve of ROC of step speed was 0.889(95%CI:0.750-1.000,p <0.01),and the body weight had 95% sensitivity,85.7%specificity,and a cutoff value> 52.The area under the ROC curve of the step size was 0.764(95%CI:0.626-0.903,p <0.01),and the body weight had 85% sensitivity and 71.4% specificity,with a cutoff> 29.5.Conclusion:Early Parkinson’s disease patients with or without RBD did not show significant differences in gait speed and stride length.The difference in bipedal stride length and typical gait cycle are characteristic gait parameters for Parkinson’s disease patients with RBD. |
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