Lancet Psychiatry:帕金森患者认知障碍预测新方法

2017-06-17 zhangfan MedSci原创

研究为帕金森病患者认知功能完整或受损提供了一个潜在的测试方法,将有助于认知干预试验在帕金森防治中发挥更大的作用。

认知衰退是帕金森病情恶化的临床表现。近日研究人员开发了一种临床-遗传评分来预测患者全脑认知障碍程度。

在这项纵向分析研究中,研究人员根据1986-2016年间北美和欧洲的9项帕金森患者临床研究数据,建立了一个全脑认知功能障碍的预测算法(名为简易精神状态检查[MMSE] ) 。

在1986-2016年间的9项大型帕金森临床研究,共包含3200名患者进行了27022项试验研究。根据MMSE评价法,235名患者基线得分≤25以及135名首次发病时间超过12年的患者被排除在外。模型开发样本患者共1350人,6个研究队列,12.8年随访5165次。发病年龄,基线MMSE、受教育年限、测试成绩、性别、抑郁病情和β-葡糖脑苷脂酶(GBA)突变状态被纳入预测模型。模型检测样本包含1132名患者,随访8.6年进行19127次随访。模型开发组(95% CI 0.82–0.90) 以及检测组(95% CI 0.78–0.91),10年内认知风险评分预测曲线下面积(AUC)均大于0.85。认知风险评分得分最高的1/4患者,较最低的1/4患者,全脑认知功能障碍的风险增加(HR 18.4,95% CI 9.4-36.1)。以0.196最为预测截止点,痴呆或致残性认知功能障碍AUC为0.88 (95% CI 0.79–0.94),阴性预测率0.92(95% 0.88–0.95)且在10000随机抽样子集中保持稳定。

研究为帕金森病患者认知功能完整或受损提供了一个潜在的测试方法,将有助于认知干预试验在帕金森防治中发挥更大的作用。

原始出处:

Ganqiang Liu et al. Prediction of cognition in Parkinson's disease with a clinical–genetic score: a longitudinal analysis of nine cohorts. Lancet Psychiatry. June 16 2017.

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    2018-04-06 howi
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    2017-06-18 惠映实验室

    神经系统很复杂,攻克PD

    0

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