Abstract

Background:

Non-motor symptoms (NMS) of various anatomical origins are seen in early stage idiopathic Parkinson’s disease (IPD).

Objective:

To analyse when and how NMS are linked together at this stage of the disease.

Methods:

Prospective study recruiting 64 IPD patients with ≤3 years of disease duration and 71 age-matched healthy controls (HC). NMS were clustered in 7 non-motor domains (NMD): general cognition, executive function, visuospatial function, autonomic function, olfaction, mood, and sleep. Correlation coefficients ≥|0.3| were considered as significant. Bootstrapped correlation coefficients between the scores were generated in both groups. Fourteen IPD patients and 19 HC were available for a follow-up study two years later.

Results:

The mean age of both groups was similar. 58% of IPD patients and 37% of HC were male (p = 0.01). At baseline IPD patients performed less well than HC on all NMD (p value between 0.0001 and 0.02). Out of 91 possible correlations between NMD, 21 were significant in IPD patients and 14 in HC at the level of ≥|0.3|. The mean correlation level was higher in IPD patients than in HC, as evidenced by the higher box plot of correlation coefficients. Visuospatial scores at baseline were predictive of the motor deterioration at the follow-up exam.

Conclusion:

At early IPD stage various NMS are linked together, although not connected by anatomical networks. Such a clinical NMD connectome suggests almost synchronous disease initiation at different sites as also supported by fMRI findings. Alternatively, there may be compensation-driven interconnectivity of NMD.

中文翻译：

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早期帕金森病的临床非运动连接组。

 抽象的

 背景：

早期特发性帕金森病 (IPD) 中可见各种解剖学来源的非运动症状 (NMS)。

 客观的：

分析 NMS 在疾病的这一阶段何时以及如何联系在一起。

 方法：

前瞻性研究招募了 64 名病程≤3 年的 IPD 患者和 71 名年龄匹配的健康对照 (HC)。 NMS 分为 7 个非运动域（NMD）：一般认知、执行功能、视觉空间功能、自主功能、嗅觉、情绪和睡眠。相关系数≥|0.3|被认为是重要的。在两组中都生成了分数之间的自举相关系数。两年后，14 名 IPD 患者和 19 名 HC 参加了后续研究。

 结果：

两组的平均年龄相似。 58% 的 IPD 患者和 37% 的 HC 患者为男性 ( p = 0.01)。基线时，IPD 患者在所有 NMD 方面的表现均低于 HC（ p值在 0.0001 至 0.02 之间）。在 NMD 之间 91 种可能的相关性中，21 种在 IPD 患者中显着，14 种在 HC 中显着，水平≥|0.3|。 IPD 患者的平均相关水平高于 HC，相关系数较高的箱线图证明了这一点。基线时的视觉空间评分可以预测后续检查中的运动恶化。

 结论：

在早期 IPD 阶段，各种 NMS 链接在一起，尽管不是通过解剖网络连接。这种临床 NMD 连接组表明不同部位的疾病几乎是同步发生的，这也得到了功能磁共振成像结果的支持。或者，可能存在补偿驱动的 NMD 互连性。