| Objective:To investigate the clinical characteristics and non-motor symptoms in patients with Parkinson’s disease(PD);To further study the relationship between chronic pain,Restless legs syndrome(RLS),anxiety,depression,cognitive disorders,sleep disorders and other non-motor symptoms.Methods:1.We enrolled 81 cases of patients diagnosed with primary PD who visited the Second Hospital of Shandong University.And we collected general clinical data of all patients(gender,age,duration of disease,levodopa equivalent daily dose,etc.).Hoehn-Yahr Scale(H-Y)and Part III of Unified Parkinson’s Disease Rating Scale(UPDRS-III)were used to assess motor symptoms.The following scales were checked to evaluate non-motor symptoms:Visual Analogue Scale(VAS),International RLS Scale(IRLS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD-17),Montreal Cognitive Assessment(MoCA),Pittsburgh Sleep Quality Index(PSQI),Activity Daily Living Scale(ADL).The diagnosis of white matter lesion(WML)was based on the results of MRI.We divided WML’ severity into 4 levels according to the visual scale of Fazekas.2.According to VAS score,patients were divided into the PD-associated pain group(PD-P)and the non-pain group(PD-nP).We analyzed the difference of clinical data between the two groups,and then applied logistic regression model to study possible influencing factors for PD-associated pain.3.We used single factor analysis method and multivariate binary logistic regression model to explore the risk factors for RLS of PD.4.The relationship between pain and RLS in PD patients was analyzed.5.According to WML diagnosis,the patients were divided into three groups:group A(no or mild WML),group B(moderate WML)and group C(severe WML).We analyzed the effect of white matter lesion(WML)on motor and non-motor symptoms in patients with PD.Results:1.In thid study,28 patients(34.6%)were in the PD-P group and 35 patients were in the PD-nP group.There were no significant differences in gender,age and HAMD scores between the two groups.The course of disease,levodopa equivalent daily dose,H-Y stage,UPDRS-III,HAMA,MoCA,PSQI,ADL scores of PD-P compared with PD-nP were significant differences(P<0.05).And logistic regression analysis showed that only H-Y stage was independent influencing factors of PD-associated pain(P=0.002,OR=6.636).2.Compared with patients without RLS,the course of disease,LEDD,PSQI and HAMD of PD patients with RLS were higher(P<0.05).And multivariate binary logistic regression analysis showed that only PSQI score was correlated with PD pain(P=0.015,OR=1.286).3.There was no statistical difference in the prevalence counts of RLS between PD-P group and PD-nP group.The mean RLS severity of PD-P patients was higher than that of PD-nP patients without pain(20.00±4.15 VS 15.13±5.96),but the difference was not statistically significant(P>0.05).4.The age,onset age,HAMD,MOCA and ADL scores of PD patients with different degrees of white matter lesions in the three groups were significant differences(P<0.05).And multivariate logistic regression analysis showed that,compared with patients without WML or with mild WML,the older PD patients were,the higher the risk of moderate WML was(β=0.250>0,OR=1.284).The higher the HAMD score,the higher the risk of severe WML(β=0.176>0,OR=1.193).Conclusion:1.PD patients with pain have a longer course of disease,suffer from more severe motor symptoms,and need higner doses of dopamine drugs;Moreover,they are more likely to suffer from anxiety,sleep disorders,cognitive disorders,and have lower self-care ability.The severity of motor symptoms in PD patients may be an independent risk factor for pain.2.Patients with PD accompanied by RLS have a longer course of disease,a higher equivalent dose of levodopa,poorer sleep quality,and are more prone to depression.3.Chronic pain in PD patients may not be an influential factor for occurrence and severity of RLS symptom.4.The older and more depressed PD patients tend to have more severe white matter lesions. |
PDF Full Text Request