DOI QR코드

DOI QR Code

Correlation of motor and non-motor symptoms in Parkinson's disease: a factor-analytic convergence study

파킨슨병 환자의 운동과 비운동 증상의 상관관계: 요인 분석 융합 연구

  • Gang, Miyeong (Department of Occupational Therapy, Woosong University)
  • 강미영 (우송대학교 작업치료학과)
  • Received : 2021.10.12
  • Accepted : 2022.04.20
  • Published : 2022.04.28

Abstract

Parkinson's disease (PD) is clinically characterized by a variety of motor and non-motor symptoms, including cognitive and neuropsychiatric symptoms. Integrating a large variety of symptoms into a small number of clinical subtypes could be valuable for appropriate and early therapeutic intervention. As a first step toward this aim, this study attempted to identify correlation patterns among motor, cognitive and neuropsychiatric symptoms in PD without dementia. One hundred four non-demented patients with PD underwent a comprehensive motor, neuropsychological, and neuropsychiatric assessments. Factor analysis was performed to identify correlation patterns among demographic, motor, cognitive and neuropsychiatric variables. The eight factors were extracted: 1 motor-related, 3 cognitive-related and 4 neuropsychiatric factors. We indentified that characteristics of correlation can have associated symptom pattern in the disease process of Parkinson's disease. The current results suggest that a broad range of motor and non-motor symptoms in PD may be reducible to a small number of clinical parameters, which may be useful for identifying clinical subtypes of PD for individual patients.

파킨슨병은 임상적으로 인지 및 신경정신과 증상을 포함한 다양한 운동 및 비운동 증상으로 특징지어진다. 이러한 다양한 증상을 통합하여 임상적 하위유형(clinical subtype)으로 분류하는 것은 초기 치료 개입에 유용할 수 있다. 본 연구에서는 치매로 진단받지 않은 파킨슨병 환자의 운동, 인지, 신경정신증상과의 상관관계 패턴을 확인하고자 한다. 파킨슨병으로 진단받은 104명의 환자에게 운동 및 인지기능 검사와 신경정신증상에 대하여 종합적인 평가를 시행하였다. 인구통계학적 요인과 운동, 인지, 신경정신증상을 포함한 변수 사이의 상관관계를 확인하고 임상적 하위유형을 추출하기 위하여 요인분석을 실시하였다. 분석결과 1개의 운동관련 요인과 3개의 인지관련 요인 및 4개의 신경정신과적 요인이 추출되었다. 본 연구결과 상관관계의 특성이 파킨슨병의 질병과정에서 특징적인 동반증상 패턴을 가질 수 있음을 확인하였으며, 이를 통해 향후 하위유형을 확인하고 치료적 전략을 수립하는데 유용할 수 있을 것으로 사료된다.

Keywords

Acknowledgement

This research is based on the support of 2022 Woosong University Academic Research Funding.

References

  1. D. Berg et al. (2015). MDS research criteria for prodromal Parkinson's disease. Movement Disorders, 30(12), 1600-1611. DOI : 10.1002/mds.26431
  2. A. Zaidel, D. Arkadir, Z. Israel & H. Bergman. (2009). Akineto-rigid vs. tremor syndromes in Parkinsonism. Current Opinion in Neurology, 22(4), 387-393. DOI : 10.1097/WCO.0b013e32832d9d67
  3. D. Urso et al. (2021). Disentangling the PIGD classification for the prediction of cognitive impairment in de novo Parkinson's disease. Journal of Neurology. DOI: 10.1007/s00415-021-10730-3
  4. J. Pagonabarraga & J. Kulisevsky. (2012). Cognitive impairment and dementia in Parkinson's disease. Neurobiology of Disease, 46(3), 590-596. DOI : 10.1016/j.nbd.2012.03.029
  5. Y. Shoji et al. (2014). Neural substrates of cognitive subtypes in Parkinson's disease: a 3-year longitudinal study. PLoS ONE, 9(10), e110547. DOI : 10.1371/journal.pone.0110547
  6. D. Burn et al. (2006). Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society, 21(11), 1899-1907. DOI : 10.1002/mds.21077
  7. D. Aarsland, J. P. Taylor & D. Weintraub. (2014). Psychiatric issues in cognitive impairment. Movement disorders : official journal of the Movement Disorder Society, 29(5), 651-662. DOI : 10.1002/mds.25873
  8. D. Weintraub, D. Aarsland, K. R. Chaudhuri, R. D. Dobkin, A. FG. Leentjens, M. Rodriguez-Violante, A. Schrag, (2022). The neuropsychiatry of Parkinson's disease: advances and challenges. The Lancet Neurology, 21(1), 89-102. DOI : 10.1016/S1474-4422(21)00330-6
  9. K. R. Chaudhuri, D. G. Healy & A. H. Schapira. (2006). Non-motor symptoms of Parkinson's disease: diagnosis and management. The Lancet Neurology, 5(3), 235-245. DOI : 10.1016/S1474-4422(06)70373-8
  10. S. M. van Rooden, W. J. Heiser, J. N. Kok, D. Verbaan, J. J. van Hilten & J. Marinus. (2010). The identification of Parkinson's disease subtypes using cluster analysis: a systematic review. Movement disorders : official journal of the Movement Disorder Society, 25(8), 969-978. DOI : 10.1002/mds.23116
  11. W. R. Gibb & A. J. Lees. (1988). The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 51(6), 745-752. DOI : 10.1136/jnnp.51.6.745
  12. M. M. Hoehn & M. D. Yahr. (1967). Parkinsonism: onset, progression and mortality. Neurology, 17(5), 427-442. DOI : 10.1212/wnl.17.5.427
  13. T. Ishioka et al. (2011). Illusory misidentifications and cortical hypometabolism in Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society, 26(5), 837-843. DOI : 10.1002/mds.23576
  14. J. L. Cummings, M. Mega, K. Gray, S. Rosenberg-Thompson, D. A. Carusi & J. Gornbein. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44(12), 2308-2314. DOI : 10.1212/wnl.44.12.2308
  15. M. Uchiyama et al. (2012). Pareidolias: complex visual illusions in dementia with Lewy bodies. Brain : a journal of neurology, 135(Pt 8), 2458-2469. DOI : 10.1093/brain/aws126
  16. T. A. Brown. (2015). Confirmatory Factor Analysis for Applied Research. New York : Guilford Publications.
  17. A. H. Lee & D. Weintraub. (2012). Psychosis in Parkinson's disease without dementia: common and comorbid with other non-motor symptoms. Movement disorders : official journal of the Movement Disorder Society, 27(7), 858-63. DOI : 10.1002/mds.25003
  18. D. Weintraub et al. (2015). Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society, 30(7), 919-927. DOI : 10.1002/mds.26170
  19. Y. Nagahama, T. Okina, N. Suzuki & M. Matsuda. (2010). Neural correlates of psychotic symptoms in dementia with Lewy bodies. Brain : a journal of neurology, 133(2), 557-567. DOI : 10.1093/brain/awp295
  20. D. Weintraub & E. Mamikonyan. (2019). Impulse Control Disorders in Parkinson's Disease. Treatment in Psychiatry, 176(1), 5-11. DOI : 10.1176/appi.ajp.2018.18040465
  21. F. Giovannelli, C. Menichetti, L. Kiferle et al. (2022). Impulsivity traits and awareness of motor intention in Parkinson's disease: a proof-of-concept study. Neurol Sci, 43, 335-340. DOI : 10.1007/s10072-021-05325-9
  22. A. Avila, X. Cardona, J. Bello, P. Maho, F. Sastre & M. Martin-Baranera. (2011). Impulse control disorders and punding in Parkinson's disease: the need for a structured interview. Neurologia, 26(3), 166-172. DOI : 10.1016/j.nrl.2010.09.007
  23. Takahashi, Maiko et al. (2022). Validation of the Japanese Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Parkinson's Disease 2022. DOI : 10.1155/2022/1503167
  24. D. Weintraub, A. S. David, A. H. Evans, J. E. Grant & M. Stacy. (2015). Clinical spectrum of impulse control disorders in Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society, 30(2), 121-127. DOI : 10.1002/mds.26016
  25. C. Pont-Sunyer et al. (2015). The onset of nonmotor symptoms in Parkinson's disease (the ONSET PD study). Movement disorders : official journal of the Movement Disorder Society, 30(2), 229-237. DOI : 10.1002/mds.26077
  26. I. Litvan et al. (2012). Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Movement disorders : official journal of the Movement Disorder Society, 27(3), 349-356. DOI : 10.1002/mds.24893
  27. J. G. Goldman, H. Weis, G. Stebbins, B. Bernard & C. G. Goetz. (2012). Clinical differences among mild cognitive impairment subtypes in Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society, 27(9), 1129-1136. DOI : 10.1002/mds.25062
  28. M. Broeders, R. M. de Bie, D. C. Velseboer, J. D. Speelman, D. Muslimovic & B. Schmand. (2013). Evolution of mild cognitive impairment in Parkinson disease. Neurology, 81(4), 346-352. DOI : 10.1212/WNL.0b013e31829c5c86