Apathy and Anxiety in De Novo Parkinson's Disease Predict the Severity of Motor Complications.
作者： Jared T. Hinkle , Kate Perepezko , Lorenzo L. Gonzalez , Kelly A. Mills , Gregory M. Pontone
DOI: 10.1002/MDC3.13117
关键词:
摘要: Background Neuropsychiatric and affective symptoms are prevalent in prodromal clinical Parkinson's disease (PD). Some evidence suggests that they may also signify risk for motor complications (motor fluctuations dyskinesias) of dopamine replacement therapy (DRT). Objective To determine whether neuropsychiatric present de novo PD (ie, before DRT initiation) predict the severity eventual DRT. Methods We used clinical, demographic, neurobehavioral, neuroimaging data from Progression Markers Initiative (PPMI), a multicenter observational study. Participants were unmedicated at enrollment 361 initiated during PPMI follow-up. Cox proportional hazard multivariate ordinal mixed-effects regression models to evaluate relationship between baseline as measured by Movement Disorders Society-revised Unified Disease Rating Scale (MDS-UPDRS). Results The cumulative incidences dyskinesias follow-up (6.0 ± 1.5 years) 34.3% 59.9%, respectively. Both apathy high trait-anxiety (top quartile) conveyed over two-fold increases dyskinesia onset adverse impact on activities daily living caused both fluctuations. longitudinal was significantly predicted apathy, but not depression. Models adjusted dimensionally related (eg autonomic dysfunction) potential confounding variables dose). Conclusions Apathy anxiety levels be biomarkers vulnerability earlier more disabling
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