파킨슨병 환자의 개인별 Wearing-off 증상 및 해결책 현황 조사를 위한 설문 연구

A Questionnaire Study to Investigate the Symptoms and Solutions of Wearing-off in Parkinson's Disease Patients

  • 박미소 (대전대학교 대전한방병원 임상시험센터) ;
  • 박상수 (대전대학교 대전한방병원 임상시험센터) ;
  • 류호룡 (대전대학교 한의과대학 심계내과학교실) ;
  • 편우석 (노스이스턴대학교 데이터사이언스학과) ;
  • 허왕정 (노스이스턴대학교 데이터사이언스학과) ;
  • 박신영 (노스이스턴대학교 데이터사이언스학과)
  • Miso S. Park (Clinical Trial Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Sang Soo Park (Clinical Trial Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Horyong Yoo (Department of Cardiology and Neurology, College of Korean Medicine, Daejeon University) ;
  • Jaeson Pyeon (Department of Data Science, Northeastern University) ;
  • Wang Jung Hur (Department of Cardiology and Neurology, College of Korean Medicine, Daejeon University) ;
  • Shin Young Park (Department of Cardiology and Neurology, College of Korean Medicine, Daejeon University)
  • 투고 : 2023.07.13
  • 심사 : 2023.08.02
  • 발행 : 2023.08.30

초록

Objectives: Parkinson's disease (PD) is currently the most rapidly increasing degenerative brain disease due to population aging and westernization of lifestyle. Levodopa is the most commonly used drug to manage PD symptoms. However, levodopa has a problem in that the wearing-off phenomenon occurs as the duration and dose of administration increase. In order to investigate the wearing-off phenomenon in PD patients and devise countermeasures, we conducted a questionnaire survey in Korea. Methods: For the study, a questionnaire with a total of seven items was prepared. Part IV of the MDS-UPDRS (Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale) and the WOQ-9 (9-symptom Wearing-off Questionnaire) were used as references. Results: Of the 48 patients who completed the questionnaire, all 47 patients who completed the questionnaire experienced the wearing-off phenomenon. Only one of the patients diagnosed with PD a year ago did not experience the wearing-off phenomenon. Patients frequently mentioned a lack of sleep and stress as aggravating factors for wearing-off. They also stated that in order to resolve the off-state, they walked, massaged, warmed up the body, stretched and exercised. Conclusions: Because wearing-off is such a common occurrence, it is thought necessary to develop wearing-off prevention and resolution measures that PD patients can use in their daily lives.

키워드

과제정보

본 연구는 보건복지부의 재원으로 한국보건산업진흥원의 보건의료기술연구개발사업 지원에 의하여 이루어진 것임(과제고유번호: HF20C0174).

참고문헌

  1. Dorsey E, Sherer T, Okun MS, Bloem BR. The emerging evidence of the Parkinson pandemic. J Parkinson Dis. 2018;8(s1):S3-8.
  2. Lee JE, Choi JK, Lim HS, Kim JH, Cho JH, Kim GS. et al. The prevalence and incidence of Parkinson's disease in South Korea: a 10-year nationwide population-based study. J Korean Neurol Assoc. 2017;35(4):191-8.
  3. Dorsey ER, Bloem BR. The Parkinson pandemic-a call to action. JAMA Neurol. 2018;75(1):9-10.
  4. Marsden CD, Parkes JD. " On-off" effects in patients with Parkinson's disease on chronic levodopa therapy. Lancet. 1976;307(7954):292-6.
  5. Antonini A, Martinez-Martin P, Chaudhuri RK, Merello M, Hauser R, Katzenschlager R. et al. Wearing-off scales in Parkinson's disease: critique and recommendations. Mov Disord. 2011;26(12):2169-75.
  6. Seo JH, Cheon SM, Kim JW. The Correlation of ON and OFF Status With Clinical Characteristics in Patients With Parkinson's Disease. J Mov Disord. 2008;1(2):65-70.
  7. Stacy M, Bowron A, Guttman M, Hauser R, Hughes K, Larsen JP. et al. Identification of motor and nonmotor wearing-off in Parkinson's disease: comparison of a patient questionnaire versus a clinician assessment. Mov Disord. 2005;20(6):726-33.
  8. Olanow CW, Poewe W, Rascol O, Stocchi F. On-demand therapy for OFF episodes in Parkinson's disease. Mov Disord. 2021;36(10):2244-53.
  9. Factor SA, Molho ES. Emergency department presentations of patients with Parkinson's disease. Am J Emerg Med. 2000;18(2):209-15.
  10. Victorino JN, Shibata Y, Inoue S, Shibata T. Understanding Wearing-Off Symptoms in Parkinson's Disease Patients using Wrist-Worn Fitness Tracker and a Smartphone. Procedia Comput Sci. 2022;196:684-91.
  11. Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez- Martin P. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23(15):2129-70.
  12. Stacy M, Hauser R, Oertel W, Schapira A, Sethi K, Stocchi F. et al. End-of-dose wearing off in Parkinson disease: a 9-question survey assessment. Clin Neuropharmacol. 2006;29(6):312-21.
  13. Antonini A, Martinez-Martin P, Chaudhuri RK, Merello M, Hauser R, Katzenschlager R. et al. Wearing-off scales in Parkinson's disease: critique and recommendations. Mov Disord. 2011;26(12):2169-75.
  14. Damasio AR, Castro-Caldas A, Levy A. The on-off effect. Adv Neurol. 1973;3:11-22.
  15. Sweet RD, McDowell FH. Five years' treatment of Parkinson's disease with levodopa: therapeutic results and survival of 100 patients. Ann Intern Med. 1975;83(4):456-63.
  16. Chou KL, Stacy M, Simuni T, Miyasaki J, Oertel WH, Sethi K. et al. The spectrum of "off" in Parkinson's disease: what have we learned over 40 years?. Parkinsonism Relat Disord. 2018;51:9-16.