There are individual differences in motor deficits, despite a similar degree of dopamine neuronal loss in Parkinson's disease (PD), called motor reserve (MR). Factors enhancing MR have been documented previously, but the influence of initial MR on the long-term prognosis remains unclear. In this longitudinal study, we enrolled 205 patients with de novo PD to estimate individual MR based on initial motor deficits and striatal dopamine depletion using the residual-based approach. We assessed the risk of developing levodopa-induced dyskinesia (LID) or freezing of gait (FOG) and longitudinal increases in levodopa-equivalent dose (LED) according to MR estimates using the Cox regression model and linear mixed model, respectively. Throughout the follow-up period (≥3 years), greater MR estimates were associated with a lower risk for LID and FOG. In addition, patients with high MR received lower LED than those with low MR. These findings suggest that the initial MR, that is, individual's capacity to cope with PD-related pathologies, can be maintained with disease progression and can modulate the risk for LID or FOG.

中文翻译：

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帕金森病的初始运动储备和长期预后

尽管帕金森病 (PD) 中的多巴胺神经元损失程度相似，称为运动储备 (MR)，但运动缺陷存在个体差异。先前已记录了增强 MR 的因素，但初始 MR 对长期预后的影响仍不清楚。在这项纵向研究中，我们招募了 205 名新发 PD 患者，以使用基于残差的方法根据初始运动缺陷和纹状体多巴胺耗竭估计个体 MR。我们分别使用 Cox 回归模型和线性混合模型根据 MR 估计评估了发生左旋多巴引起的运动障碍 (LID) 或步态冻结 (FOG) 和纵向增加左旋多巴等效剂量 (LED) 的风险。在整个随访期间（≥3 年），较高的 MR 估计值与较低的 LID 和 FOG 风险相关。此外，高 MR 患者接受的 LED 低于低 MR 患者。这些发现表明，初始 MR，即个体应对 PD 相关病理的能力，可以随着疾病进展而维持，并且可以调节 LID 或 FOG 的风险。