Incidence and predictors of postural abnormalities in Parkinson's disease: a PPMI cohort study.

Autor: Fabbri, Margherita, Campisi, Corrado, Ledda, Claudia, Rinaldi, Domiziana, Tsukita, Kazuto, Romagnolo, Alberto, Imbalzano, Gabriele, Zibetti, Maurizio, Rizzone, Mario Giorgio, Pontieri, Francesco Ernesto, Lopiano, Leonardo, Artusi, Carlo Alberto
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Zdroj: Journal of Neurology; Jul2024, Vol. 271 Issue 7, p4628-4634, 7p
Abstrakt: Background: Axial postural abnormalities (PA) are invalidating symptoms of Parkinson's disease (PD). Risk factors for PA are unknown. Objectives: We sought to evaluate PA incidence and risk factors over the first 4–6 years of PD. Methods: We included 441 PD patients from the Parkinson's Progression Markers Initiative (PPMI) cohort with data at diagnosis and after 4-year follow-up. PA was defined according to a posture item ≥ 2 at the Movement Disorder Society-sponsored-revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) in Off therapeutic condition. The Kruskal–Wallis test was used to compare characteristics of patients without PA ('no-PA'), with PA at disease onset ('baseline-PA'), and PA developed during follow-up ('develop-PA'). To identify predictors of PA development, univariate and multivariate Cox regression analyses were performed considering demographic, clinical and therapeutic variables. Results: 10.9% of patients showed PA at baseline and 23.7% developed PA within the first 4–6 years since diagnosis. Older age, malignant phenotype, higher MDS-UPDRS part III, Hoehn & Yahr, and dysautonomia (SCOPA-AUT) score, and lower levels of physical activity were predictors of PA development at the univariate analysis. Older age (Hazard ratio [HR] per year: 1.041) and higher MDS-UPDRS part III score (HR per point: 1.035) survived as PA development predictors in the multivariate analysis. Conclusions: PPMI cohort data show that > 30% of PD patients present PA within the first 4–6 years of disease. Older age at onset and higher motor burden are associated with a higher risk for PA development. The protective role of physical activity merits to be further investigated. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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