Olfaction Disorders

嗅觉障碍
  • 文章类型: Journal Article
    背景技术精神麻痹(GPI)以认知障碍为特征,神经精神症状,大脑结构异常,模仿许多神经精神疾病。在许多神经精神疾病中,嗅觉功能障碍与认知能力下降和神经精神症状有关。然而,目前尚不清楚GPI患者是否出现嗅觉功能障碍,以及嗅觉功能障碍是否与其临床表现相关.材料和方法40名GPI患者和37名健康对照(HCs)接受了“SniffinSticks”测试电池,迷你精神状态检查,和神经精神量表来测量嗅觉功能,认知功能,和神经精神症状,分别。使用视觉评估量表评估脑结构异常,包括内侧颞叶萎缩(MTA)视觉评定量表和Fazekas量表。结果与HC相比,GPI患者表现出显著的嗅觉功能障碍,如气味阈值(OT)的缺陷(P=0.001)所示,气味辨别(OD)(P<0.001),气味识别(OI)(P<0.001)。在GPI患者中,OI与认知功能呈正相关(r=0.57,P<0.001),但是嗅觉功能和神经精神症状之间没有发现显著的相关性,血,或脑脊液生物标志物(快速血浆反应蛋白环卡试验和梅毒螺旋体颗粒凝集试验),或脑结构异常(MTA和Fazekas量表评分)。中介分析表明,GPI患者的OI受损分别由认知障碍和OT受损介导。结论GPI患者表现出整体嗅觉功能障碍。OI与认知功能相关,OI受损是由GPI患者的认知障碍介导的。因此,OI可以作为反映GPI患者认知功能的标志物。
    BACKGROUND General paresis of the insane (GPI) is characterized by cognitive impairment, neuropsychiatric symptoms, and brain structural abnormalities, mimicking many neuropsychiatric diseases. Olfactory dysfunction has been linked to cognitive decline and neuropsychiatric symptoms in numerous neuropsychiatric diseases. Nevertheless, it remains unclear whether patients with GPI experience olfactory dysfunction and whether olfactory dysfunction is associated with their clinical manifestations. MATERIAL AND METHODS Forty patients with GPI and 37 healthy controls (HCs) underwent the \"Sniffin Sticks\" test battery, Mini-Mental State Examination, and Neuropsychiatric Inventory to measure olfactory function, cognitive function, and neuropsychiatric symptoms, respectively. Brain structural abnormalities were evaluated using visual assessment scales including the medial temporal lobe atrophy (MTA) visual rating scale and Fazekas scale. RESULTS Compared with HCs, patients with GPI exhibited significant olfactory dysfunction, as indicated by deficits in the odor threshold (OT) (P=0.001), odor discrimination (OD) (P<0.001), and odor identification (OI) (P<0.001). In patients with GPI, the OI was positively correlated with cognitive function (r=0.57, P<0.001), but no significant correlation was found between olfactory function and neuropsychiatric symptoms, blood, or cerebrospinal fluid biomarkers (rapid plasma reagin circle card test and Treponema pallidum particle agglutination test), or brain structural abnormalities (MTA and Fazekas scale scores). Mediation analysis indicated that the impaired OI in patients with GPI was mediated by cognitive impairment and impaired OT respectively. CONCLUSIONS Patients with GPI exhibited overall olfactory dysfunction. OI is correlated with cognitive function and the impaired OI is mediated by cognitive impairment in patients with GPI. Thus, OI may serve as a marker for reflecting cognitive function in patients with GPI.
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  • 文章类型: Journal Article
    背景:从COVID-19康复一年多后,很大一部分人,他们中的许多人在医疗保健部门工作,仍然报告嗅觉障碍。然而,在COVID-19大流行之前,嗅觉功能障碍已经很常见,这使得有必要考虑现有的嗅觉功能障碍基线患病率。建立COVID-19相关嗅觉功能障碍的调整患病率,我们使用心理物理测试评估了在第一波大流行期间感染COVID-19的医护人员的嗅觉功能.
    方法:自大流行开始以来,不断对参与者进行SARS-CoV-2IgG抗体测试。为了评估人群中嗅觉功能障碍的基线率,并控制先前有嗅觉功能障碍的个体的倾斜招募的可能性,将一致的SARS-CoV-2IgG初治个体作为对照组进行检测.
    结果:在与COVID-19签约15个月后,37%的医护人员表现出嗅觉数量上的减少,与对照组中只有20%的个体相比。51%的COVID-19康复个体报告了定性症状,而对照组只有5%。在COVID-19诊断后2.6年的一项随访研究中,24%的所有测试恢复个体仍然经历了假发。
    结论:总之,65%的医护人员在感染COVID-19后15个月经历了阵发性/低症。与对照组相比,嗅觉功能障碍在人群中的患病率增加了41个百分点.两年半后,24%的SARS-CoV-2感染者的阵痛症状仍然挥之不去。考虑到感染和检测之间的时间,嗅觉问题可能在多个个体中不完全可逆。
    BACKGROUND: More than a year after recovering from COVID-19, a large proportion of individuals, many of whom work in the healthcare sector, still report olfactory dysfunctions. However, olfactory dysfunction was common already before the COVID-19 pandemic, making it necessary to also consider the existing baseline prevalence of olfactory dysfunction. To establish the adjusted prevalence of COVID-19 related olfactory dysfunction, we assessed smell function in healthcare workers who had contracted COVID-19 during the first wave of the pandemic using psychophysical testing.
    METHODS: Participants were continuously tested for SARS-CoV-2 IgG antibodies since the beginning of the pandemic. To assess the baseline rate of olfactory dysfunction in the population and to control for the possibility of skewed recruitment of individuals with prior olfactory dysfunction, consistent SARS-CoV-2 IgG naïve individuals were tested as a control group.
    RESULTS: Fifteen months after contracting COVID-19, 37% of healthcare workers demonstrated a quantitative reduction in their sense of smell, compared to only 20% of the individuals in the control group. Fifty-one percent of COVID-19-recovered individuals reported qualitative symptoms, compared to only 5% in the control group. In a follow-up study 2.6 years after COVID-19 diagnosis, 24% of all tested recovered individuals still experienced parosmia.
    CONCLUSIONS: In summary, 65% of healthcare workers experienced parosmia/hyposmia 15 months after contracting COVID-19. When compared to a control group, the prevalence of olfactory dysfunction in the population increased by 41 percentage points. Parosmia symptoms were still lingering two-and-a half years later in 24% of SARS-CoV-2 infected individuals. Given the amount of time between infection and testing, it is possible that the olfactory problems may not be fully reversible in a plurality of individuals.
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  • 文章类型: English Abstract
    Objective:To evaluate the subjective olfactory function in chronic sinusitis(CRS)patients with asthma after nasal endoscopic surgery and associated factors that may affect olfactory function. Methods:The study included 90 CRS patients with asthma from January 2008 to December 2020,and all of them underwent endoscopic sinus surgery(ESS). VAS score of olfactory function before and after surgery were collected,and the data at baseline,3 months,6 months,1 year,3 years,5 years,8 years and 10 years after surgery were compared. Factors affecting olfactory function were analyzed in a generalized mixed linear model,which including age,surgical procedure,allergic rhinitis and so on.Results: The olfactory VAS scores were significantly lower at 3 months,6 months,1 year,3 years,and 5 years postoperatively compared with baseline,and the difference was statistically significant(P<0.05).Olfactory VAS scores at 8 and 10 years postoperatively were not statistically different from baseline(P>0.05).Age(≥60 years),aspirin intolerance syndrome,Lund-Kennedy score,modified sinus CT olfactory cleft score,and follow-up time were risk factors, and radical sinus surgery is a protective factor.Conclusion:Subjective olfactory scores in CRS patients with asthma after ESS remain relatively stable for 5 years postoperatively.Prior history of surgery did not affect postoperative subjective olfactory scores. Age,aspirin intolerance syndrome, Lund-Kennedy score,modified sinus CT olfactory cleft score, follow-up time,and surgical approach were strongly associated with subjective olfactory scores in CRS patients with asthma,and radical surgery had a protective effect on olfaction.
    目的:研究伴哮喘的慢性鼻窦炎(CRS)患者鼻内镜手术后主观嗅觉变化及影响嗅觉功能的相关因素。 方法:回顾2008年1月-2020年12月就诊于北京同仁医院的90例伴有哮喘的CRS患者的临床资料,所有患者均行鼻内镜手术治疗。统计手术前后嗅觉VAS评分,对比基线、术后3个月、6个月、1年、3年、5年、8年及10年的嗅觉变化。将年龄、手术方式、变应性鼻炎(AR)等因素纳入广义混合线性模型,分析影响嗅觉VAS评分变化的因素。 结果:与基线比较,术后3个月、6个月、1年、3年、5年的嗅觉VAS评分明显降低,差异有统计学意义(P<0.05)。术后8年、10年的嗅觉VAS评分与基线比较差异无统计学意义(P>0.05)。年龄(≥60岁)、阿司匹林耐受不良综合征、Lund-Kennedy评分、改良鼻窦CT嗅区评分、随访时间及手术方式对嗅觉VAS评分有影响(P<0.05)。 结论:伴哮喘的CRS患者的主观嗅觉评分在术后5年内相对稳定。既往手术史不影响术后主观嗅觉。年龄、阿司匹林耐受不良综合征、Lund-Kennedy评分、改良鼻窦CT嗅区评分、随访时间、手术方式与伴有哮喘的CRS患者主观嗅觉密切相关,轮廓化鼻内镜手术较功能性鼻内镜手术对伴哮喘的CRS患者的嗅觉改善更好。.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    物质使用障碍(SUD)加剧了长发COVID的影响,特别是增加味觉和嗅觉障碍的风险。分析来自TriNetX的回顾性队列数据和超过3300万条记录(2020年1月至2022年12月),这项研究集中于1,512,358名参与者,揭示SUD显着增加了长期COVID患者经历味觉障碍和嗅觉缺失的可能性。结果表明,与对照组相比,SUD患者的感觉障碍发生率更高,老年人和妇女尤其脆弱。发现患有SUD的吸烟者患嗅觉和味觉障碍的风险增加。这些发现强调了早期筛查的重要性,诊断,以及对有SUD病史的长型COVID患者的干预措施,提示临床医生需要监测与感觉功能障碍相关的抑郁和焦虑,以进行全面护理。
    Substance use disorder (SUD) exacerbates the impact of Long-COVID, particularly increasing the risk of taste and olfactory disorders. Analyzing retrospective cohort data from TriNetX and over 33 million records (Jan 2020-Dec 2022), this study focused on 1,512,358 participants, revealing that SUD significantly heightens the likelihood of experiencing taste disturbances and anosmia in Long-COVID sufferers. Results indicated that individuals with SUD face a higher incidence of sensory impairments compared to controls, with older adults and women being particularly vulnerable. Smokers with SUD were found to have an increased risk of olfactory and taste dysfunctions. The findings underscore the importance of early screening, diagnosis, and interventions for Long-COVID patients with a history of SUD, suggesting a need for clinicians to monitor for depression and anxiety linked to sensory dysfunction for comprehensive care.
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  • 文章类型: Journal Article
    背景:COVID-19显示了神经系统并发症的可能性,例如嗅觉和味觉丧失,以及呼吸系统问题。呼吸训练和神经系统后遗症的康复对于改善呼吸功能和生活质量至关重要,这项研究的目的是评估肺和神经康复计划的疗效。
    目的:应用治疗以减少呼吸困难,增加消耗能力,增加肺活量和呼吸肌力量,SARS-CoV-2后患者的嗅觉和味觉敏感性增加。
    方法:对220例诊断为COVID-19且进化超过5个月的患者进行了一项随机对照实验研究,呼吸困难或感觉疲劳,包括嗅觉和味觉问题,其中200名患者完成了研究。将100例患者随机分配到干预组,包括吸气训练治疗计划(PowerbreastPlus®)结合有氧运动和嗅觉味觉治疗31天,对照组为100名患者,31天没有任何类型的治疗。
    结果:该研究在新冠肺炎后患者中进行了5个月。将200例患者分为干预组(n=100)和对照组(n=100)。两组之间的比较显示肺活量测定变量的显着差异;强迫肺活量(p<.001;Eta2(0.439);平均值:0,6135),FEV1/FVC之间的比率(p<0.01;Eta2(0.728);平均值:9,313),峰值吸气压力(p<0.01;Eta2(0.906);平均值:4,526);用改良的Borg量表(p<0.01;Eta2(0.811);平均值:1,481)和改良的医学研究委员会量表(p<0.01;Eta2(0.881);平均值:0.777);最后,在神经变量中发现了变化,在新加坡气味和味道问卷的问题中,治疗后的嗅觉如何?(p<0.01;Eta2(0.813);平均值:1,721)和治疗后的味觉如何?(p<0.01;Eta2(0.898);平均值:1,088)。
    结论:使用PowerbrokePlus®设备实施呼吸康复治疗计划,有氧运动和神经康复与嗅觉和味觉训练,是针对因SARS-CoV-2病毒而遭受此类后遗症的患者的呼吸和神经系统后遗症的治疗选择。Clinicaltrials.gov:NCT05195099.首次发布于2022年1月18日;最后更新发布于2022年6月29日。
    BACKGROUND: COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequelae are essential to improve respiratory function and thus quality of life, and the aim of this study is to evaluate the efficacy of a pulmonary and neurological rehabilitation program.
    OBJECTIVE: To apply a treatment to reduce dyspnea, increase exertional capacity, increase vital capacity and respiratory muscle strength, together with an increase in olfactory and gustatory sensitivity in post-SARS-CoV-2 patients.
    METHODS: A randomised controlled experimental study was conducted in 220 patients with a medical diagnosis of COVID-19 and more than 5 months of evolution, dyspnoea or perceived fatigue, including olfactory and gustatory perception problems, of whom 200 patients completed the study. 100 patients were randomly assigned to the intervention group, consisting of an inspiratory training treatment plan (Powerbreathe Plus®) combined with aerobic exercise and olfactory gustatory treatment for 31 days, and 100 patients to the control group, for 31 days without any type of therapy.
    RESULTS: The study was conducted in post-Covid-19 patients for 5 months. Two hundred patients were divided into an intervention group (n = 100) and a control group (n = 100). The comparison between the groups showed significant differences in spirometric variables; forced vital capacity (p < .001; Eta2 (0.439); Mean: 0,6135), the ratio between both FEV1/FVC (p < 0.01; Eta2 (0.728); Mean:9,313), peak inspiratory pressure (p < 0.01; Eta2 (0.906); Mean:4,526); changes were observed in dyspnoea measured with the modified Borg scale (p < 0.01; Eta2 (0.811); Mean:1,481) and the modified Medical Research Council scale (p < 0.01; Eta2 (0.881); Mean: 0.777); finally, changes were found in neurological variables, in the questions of the Singapore Smell and Taste Questionnaire, How was your sense of smell after treatment? (p < 0.01; Eta2 (0.813); Mean: 1,721) and How is your sense of taste after treatment? (p < 0.01; Eta2 (0.898); Mean: 1,088).
    CONCLUSIONS: The implementation of a respiratory rehabilitation treatment plan with the Powerbreathe Plus® device, aerobic exercise and neurorehabilitation with olfactory and gustatory training, is a therapeutic option against respiratory and neurological sequelae in patients who have suffered such sequelae due to the SARS-CoV-2 virus. Clinicaltrials.gov: NCT05195099. First posted 18/01/2022; Last Update Posted 29/06/2022.
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  • 文章类型: Journal Article
    嗅觉功能障碍是一种常见的COVID-19症状,带来治疗挑战。
    我们旨在研究频率控制耳针治疗COVID-19相关嗅觉功能障碍的疗效。
    随机,参与者盲临床试验在RasoulAkram医院进行(IRCT20210311050671N1).招募了40名患者,20例患者被随机分配到实验组或对照组.主要结果是患者嗅觉质量的改善。使用气味鉴定测试确认嗅觉功能障碍。干预组采用耳频针刺治疗2次,间隔一周,而对照组则接收了相同数量的关闭激光会话。指示两组使用鼻给他米松滴剂。要求患者在每次干预前后以10点视觉模拟量表对其嗅觉能力进行排名。次要结果是相关的副作用。
    协方差分析显示,两组之间的调整分数存在显着差异(F[37,1]=37.463;p=0.000,Eta2=0.503)。干预组治疗后嗅觉质量从2.80±1.76改善为5.22±3.40(p=0.007),对照组无明显变化(p=0.184)。三名患者报告了短暂和短暂的副作用,比如恶心,头痛,头晕,在干预后的头几个小时。
    频率控制耳针是治疗COVID-19相关嗅觉功能障碍的有效选择。该研究强调了替代疗法在治疗这种疾病方面的潜力,并且需要进一步的研究来调查其长期影响。
    UNASSIGNED: Olfactory dysfunction is a common COVID-19 symptom, posing treatment challenges.
    UNASSIGNED: We aimed to investigate the efficacy of frequency-controlled ear acupuncture in treating COVID-19-related olfactory dysfunction.
    UNASSIGNED: A randomized, participant-blind clinical trial occurred at the Rasoul Akram Hospital (IRCT20210311050671N1). Forty patients were recruited, and 20 patients were randomly assigned to either the experimental or control group. The primary outcome was the improvement in patients\' quality of smell. The olfactory dysfunction was confirmed using the Smell Identification Test. The intervention group received two sessions of acupuncture treatment according to auricular frequency treatment, with a one-week interval, while the control group received an equal number of switched-off laser sessions. Both groups were instructed to use nasal betamethasone drops. The patients were asked to rank their ability to smell before and after each intervention on a 10-point visual analog scale. Secondary outcomes were related side effects.
    UNASSIGNED: Covariance analysis revealed a significant difference in adjusted scores between the groups (F [37, 1] = 37.463; p = 0.000, Eta2 = 0.503). The smell quality improved from 2.80 ± 1.76 to 5.22 ± 3.40 after treatment in the intervention group (p = 0.007), while the control group showed no significant change (p = 0.184). Three patients reported short and transient side effects, such as nausea, headache, and dizziness, in the first hours after the intervention.
    UNASSIGNED: Frequency-controlled ear acupuncture is an effective option for treating COVID-19-related olfactory dysfunction. The study highlights the potential of alternative therapies in the treatment of this condition, and further research is warranted to investigate its long-term effects.
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  • 文章类型: Journal Article
    儿童轻度颅脑外伤后的创伤后嗅觉功能障碍的患病率为3%至58%,影响这种变化的潜在因素,包括创伤性脑损伤的严重程度和评估方法。这项前瞻性纵向研究检查了儿童轻度创伤性脑损伤与嗅觉功能障碍之间的关系。纳入75例轻度颅脑损伤患儿和年龄匹配的健康对照组。使用Sniffin\'Sticks电池评估嗅觉功能,重点是嗅觉阈值和气味识别。研究发现,与健康对照组相比,轻度创伤性脑损伤儿童的嗅觉功能受损,特别是嗅觉阈值得分。患者组嗅觉功能障碍的患病率为33%,并持续1年。没有发现创伤性脑损伤症状之间的显著关联(例如健忘症,意识丧失)和嗅觉功能障碍。该研究强调了评估轻度创伤性脑损伤后儿童嗅觉功能的重要性,考虑到它对日常生活的潜在影响。虽然大多数嗅觉功能障碍似乎是短暂的,长期随访对于充分了解康复过程至关重要。这些发现为有关该主题的有限文献提供了宝贵的见解,并敦促将嗅觉评估纳入小儿轻度创伤性脑损伤的管理中。
    The prevalence of posttraumatic olfactory dysfunction in children after mild traumatic brain injury ranges from 3 to 58%, with potential factors influencing this variation, including traumatic brain injury severity and assessment methods. This prospective longitudinal study examines the association between mild traumatic brain injury and olfactory dysfunction in children. Seventy-five pediatric patients with mild traumatic brain injury and an age-matched healthy control group were enrolled. Olfactory function was assessed using the Sniffin\' Sticks battery, which focuses on olfactory threshold and odor identification. The study found that children with mild traumatic brain injury had impaired olfactory function compared with healthy controls, particularly in olfactory threshold scores. The prevalence of olfactory dysfunction in the patient group was 33% and persisted for 1 yr. No significant association was found between traumatic brain injury symptoms (e.g. amnesia, loss of consciousness) and olfactory dysfunction. The study highlights the importance of assessing olfactory function in children after mild traumatic brain injury, given its potential impact on daily life. Although most olfactory dysfunction appears transient, long-term follow-up is essential to fully understand the recovery process. The findings add valuable insights to the limited literature on this topic and urge the inclusion of olfactory assessments in the management of pediatric mild traumatic brain injury.
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  • 文章类型: Journal Article
    虽然以前的研究已经检查了儿童的嗅觉功能障碍,新型冠状病毒SARS-CoV-2无疑对它们的嗅觉产生了前所未有的影响,这是无法考虑的。本报告的目的是提供大流行期间嗅觉功能障碍流行病学的数据,并将该数据集与大流行前的数据集进行比较。我们假设URTI相关的嗅觉功能障碍增加。方法回顾性分析2020年3月至2022年6月就诊于嗅觉和味觉门诊的儿科患者资料。检查了嗅觉功能障碍的主要原因的频率,并将其与较旧数据集的三个子集进行了比较。结果52例患者纳入分析。大多数儿童由于上呼吸道感染(URTI)而出现嗅觉功能障碍(52%)。34%的病例存在先天性嗅觉功能障碍。鼻窦疾病和特发性病例分别占6%和4%,分别,而头部创伤是最不常见的原因(2%)。这与旧集合的结果相反。URTI相关嗅觉功能障碍的频率显著增加。头部外伤相关或先天性嗅觉功能障碍的频率显着降低。我们的患者队列和三个子集之间的其他病因没有显着差异。结论COVID-19大流行导致我们的数据集与大流行前时间子集之间的病因患病率存在差异。与URTI相关的嗅觉功能障碍的频率激增可能归因于涉及嗅觉上皮中固定细胞的新型病理机制。
    BACKGROUND: Although previous studies have examined olfactory dysfunction in children, the novel coronavirus SARS-CoV-2 has certainly had an unprecedented effect on their olfaction, which could not be taken into consideration. The aim of this report was to present data on the epidemiology of olfactory dysfunction during the pandemic and compare this dataset with a pre-pandemic set. We hypothesized an increase in URTI-related olfactory dysfunction.
    METHODS: Data of paediatric patients consulting a smell and taste clinic between March 2020 and June 2022 were retrospectively analysed. The frequency of major causes of olfactory dysfunction was examined and compared with three subsets of an older dataset.
    RESULTS: A total of 52 patients were included in the analysis. Most children presented with olfactory dysfunction due to upper respiratory tract infection (URTI) (52%). Congenital olfactory dysfunction was present in 34% of cases. Sinonasal disorders and idiopathic cases accounted for 6 and 4%, respectively, whereas head trauma was the least common cause (2%). This was in contrast with the results of the older set. The frequency of URTI-related olfactory dysfunction increased significantly. The frequency of head-trauma-related or congenital olfactory dysfunction showed marked reductions. There were no significant differences regarding the other aetiologies between our patient cohort and the three subsets.
    CONCLUSIONS: The COVID-19 pandemic has resulted in differences regarding the prevalence of aetiologies between our dataset and the subsets of pre-pandemic times. The surge of the frequency of URTI-related olfactory dysfunction may be ascribed to a novel pathomechanism involving sustentacular cells in the olfactory epithelium.
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  • 文章类型: Journal Article
    背景:帕金森病(PD)的特征是在经典运动症状发作之前的前驱阶段。前驱PD的持续时间和临床表现差异很大,表明这一阶段潜在的异质性。这种差异引发了一个问题,即特定因素是否会导致前驱PD的进展速度不同。
    方法:本研究包括来自帕金森病进展标志物倡议的前驱PD患者。对他们进行随访以评估疾病进展。对随访期间收集的数据进行分析,以确定前驱PD疾病快速进展的潜在预测因素。
    结果:在这项研究中,61例前驱PD患者入组。其中,43例患者同时表现为RBD和低讲症,17人单独患有食欲不振,1例基线时仅有RBD。13名(21.3%)前驱PD参与者表现出快速的疾病进展,其中两个病例发展为非神经系统疾病。在MDS-UPDRSII评分和UPSIT评分方面,快速进展组和非快速进展组之间观察到显着差异。纵向分析显示,在快速进展组中,MDS-UPDRSIII评分和MDS-UPDRS总分显着增加。回归分析确定MDS-UPDRSII评分和UPSIT评分是前驱PD疾病快速进展的预测因子。
    结论:我们的研究结果表明,MDS-UPDRSII评分和UPSIT评分可能是与疾病快速进展相关的临床标志物。需要进一步研究和开发精确的生物标志物和先进的评估方法,以增强我们对前驱PD及其进展模式的理解。
    Parkinson\'s disease (PD) is characterized by a prodromal phase preceding the onset of classic motor symptoms. The duration and clinical manifestations of prodromal PD vary widely, indicating underlying heterogeneity within this stage. This discrepancy prompts the question of whether specific factors contribute to the divergent rates of progression in prodromal PD.
    This study included prodromal PD patients from the Parkinson\'s progression marker initiative. They were followed up to assess the disease progression. The data collected during the follow-up period were analyzed to identify potential predictors of rapid disease progression in prodromal PD.
    In this study, 61 individuals with prodromal PD were enrolled. Among them, 43 patients presented with both RBD and hyposmia, 17 had hyposmia alone, and 1 had RBD alone at baseline. 13 (21.3%) prodromal PD participants exhibited rapid disease progression, with two of these cases advancing to non-neurological diseases. Significant differences were observed between the rapid progression group and no rapid progression group in terms of MDS-UPDRS II score and UPSIT score. Longitudinal analysis showed a significant increase in the MDS-UPDRS III score and MDS-UPDRS total score in the rapid progression group. Regression analyses identified the MDS-UPDRS II score and UPSIT score as predictors of rapid disease progression in prodromal PD.
    Our study findings suggest that the MDS-UPDRS II score and UPSIT score may serve as clinical markers associated with rapid disease progression. Further research and development of precise biomarkers and advanced assessment methods are needed to enhance our understanding of prodromal PD and its progression patterns.
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