Research Of Factors For Motor Complications In Patients With Parkinson’s Disease

Objectives To investigate the influence factors of motor complications in Parkinson’s disease.Methods A case-control study was conducted on 82 patients with PD who were tr eated in the first hospital of Hebei Medical University from July 2015 to July 2016.Medical histories such as age,sex,age of onset,course of disease,CO exposure history,smoking,hyposmia,constipation,daytime sleepiness,symptomatic hypotensi on,micturition,REM sleep behavior disorder(RBD)were collected.The levodopa e quivalent dose(LED)was calculated.The Hamilton Anxiety Scale 14-item version(HAMA14)and Hamilton Depression Scale 24-item version(HAMD24)were used to evaluate the anxiety and depression.The Montreal Cognitive Assessment(Mo CA)w as used to evaluate the cognitive function.The Unified Parkinson’s Disease Rating Scale Part Ⅲ(UPDRSⅢ)was used to evaluate the motor function and the Hoehn-Y ahr stage was used to evaluate the severity of the disease.The Unified Parkinson’s Disease Rating Scale Part IV(UPDRS IV)were used to evaluate the motor complic ations.According to medical histories,physical examination and evaluation results o f UPDRS IV patients were grouped,the patients with motor complications defined as case group and non-motor complications defined as control group,the patients w ith dyskinesia defined as case group and non-motor complications defined as control group.The factors difference between groups were analyzed using SPSS17.0 statisti cal software.Multivariate logistic regression analysis were performed by motor com plications and dyskinesia as the dependent variable to find the independent risk fact ors of motor complications and dyskinesia.The receiver operating characteristic(RO C)curves of LED in predicting motor complications and dyskinesia were drawn to find the optimal cutoff value.Results 1 Among 82 patients,36(43.90%)were with motor complications,46(56.10%)were without motor complications,36(43.90%)were with motor fluctuations,33(40.24%)were with wear-off,23(28.05%)were with “on-off” phenomenon,2(2.44%)were with open phase delay,16(19.51%)were with dyskinesia,12(14.63%)were with peak dose,4(4.88%)were with diphasic dyskinesia,none were with dystonic.2 The course of disease,HAMA14 score,HAMD24 score,UPDRSⅢ score,Hoehn-Yahr Stage,LED were significantly higher in patients with motor com plications than in those without motor complications,there were significant differenc es between the two groups(P<0.05).The course of disease,HAMA14 score,UPD RSⅢ score,Hoehn-Yahr Stage,LED were significantly higher in patients with dysk inesia than in those without motor complications,and there were significant differen ces between the two groups(P<0.05).3 The multiple logistic regression analysis showed that the course of disease(OR=5.322,95%CI=1.407-20.122,P=0.014),mo tor dysfunction(OR=4.621,95%CI=1.254-17.034,P=0.021),LED(OR=16.937,95%CI=4.493-63.923,P=0.000)were the independent risk factors of exacerbation of motor complications.The other multiple logistic regression analysis showed that the course of disease(OR=6.940,95%CI=1.006-47.867,P=0.049),motor dysfunction(OR=6.931,95%CI=1.126-42.684,P=0.037),LED(OR=16.792,95%CI=2.764-102.002,P=0.002)were the independent risk factors of exacerbation of dyskinesia.4 T he area under the receiver operating characteristic curves of the LED in predicting motor complication and dyskinesia were 0.872 and 0.877,the corresponding optimal cutoff value were 512.50 mg and 531.25 mg respectively.Conclusions 1 There are longer the course of disease,more serious anxiety and de pression,poor motor function,severe of the disease and higher LED in PD patients with motor complications.2 In patients with motor complications,there are longer t he course of disease,more serious anxiety,poor motor function,severe of the disea se and higher LED in PD patients with dyskinesia.3 With the prolongation of the course of disease,the aggravation of motor dysfunction and the accumulation of LE D,the risk of motor complications increased.4 The LED?512.50 mg can be used a s an early screening index of motor complication and the LED?531.25 mg can be u sed as an early screening index of dyskinesia.