Purpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results. 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, ), probable rapid eye movement sleep behavior disorder (beta = 2.71, ), excessive daytime sleepiness (beta = 1.88,), impulsivity and compulsivity (beta = 2.42, ), and increasing age (beta = 1.05, ) were more likely to have high dysautonomic scores. Conclusion. Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.

中文翻译：

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下尿路和胃肠功能障碍在早期帕金森病中很常见

目的。自主神经功能障碍是帕金森病 (PD) 的常见非运动特征和早期表现。PD中的自主神经功能障碍与较差的预后相关。我们试图描述早期 PD 患者的自主神经功能障碍并确定相关因素。方法。进行了一项观察性、横断面、描述性和分析性研究，以评估来自帕金森病进展标志物倡议的早期 PD 患者。我们利用帕金森病结局量表-自主神经功能障碍问卷来确定自主神经症状的患病率和频率。该队列分为高和低的自主神经功能障碍评分。回归模型确定了独立解释我们早期 PD 队列中的自主神经功能障碍评分的变量。结果。414 名 PD 患者诊断时的平均年龄为 61.1 (SD 9.7) 岁，平均病程为 6.7 (SD 6.6) 个月。在所有患者中，43.7% (181/414) 的自主神经功能障碍评分较高。泌尿和胃肠道症状是最普遍和经常报告的自主神经障碍症状。疲劳患者（β = 4.28，),可能是快速眼动睡眠行为障碍 (beta = 2.71,),白天过度嗜睡 (beta = 1.88,)、冲动性和强迫性 (beta = 2.42,)和年龄增长 (beta = 1.05,)更有可能有较高的自主神经功能障碍评分。结论。下尿路和胃肠道症状在早期 PD 患者中普遍且频繁。疲劳、睡眠障碍、冲动和强迫症以及年龄是自主神经功能障碍的预测因素。这组早期 PD 患者在病程中以自主神经症状为主，并与更严重的疾病相关。