Research Of Correlation Between The Region Of Onset Of Initial Motor Symptom And Related Factors

BackgroundParkinson's disease(PD)is a chronic progressive neurodegenerative disease which is common in the old people associated with significant disability.The Characteristic clinical manifestations include difficulty with coordinated movement such as asymmetric resting tremor,rigidity,and bradykinesia and non-motor symptoms such as hyposmia,constipation,mood disorders and dementia and so on,which is attributed to the degeneration of the dopaminergic neurons and the reduced level of dopamine in brain.According to the population epidemiological investigation recently,PD is bedeviling around 0.3%general people,occurring in about 1%in individuals aged 60 years or older and increasing to about 4-5%of those aged 85 years or older.Around 40%-75%patients will die of PD as well as about 50%patients will be disabled after suffering the disease for about 10-20 years.Hence,it is the second most common neurodegenerative disorder after Alzheimer's disease(AD)on account of the high incidence and disability rate.The initial motor symptom is diverse,such as tremor,bradykinesia or rigidity as well as the region of onset.Meanwhile,it is unknown whether the initial region of motor symptom is correlative to the related factors or not.According to the research,following risk factors are related to the onset of PD,including drinking,smoking,tea,pesticides and so on.Besides,there are no relevant correlation between the onset of PD and following risk factors,including degree of education,hypertension,type II diabetes and positive family history and so on.So far,there has no research explored the significant factors of the diversity of the region of onset of initial motor symptom.Thus I devote myself to analyze whether the onset of upper limbs will be correlated of such factors,including age,gender,degree of education,basic diseases and so on.ObjectiveTo explore the correlation between the position of PD's motor symptom of onset-upper limbs,and related factors.MethodsThe subjects include 85 PD inpatients from Jan./2013-Dec./2016 in Shandong provincial hospital affiliated to Shandong university.We applied retrospective analysis to their clinical status by single and multiple logistic analysis of regression,so that we can select the significant correlative risk factors of the region of onset of initial motor symptom.Results1.In our research,a total of 85 PD patients,who meet the criteria of enrollment,are incorporated in the group.Meanwhile,the number of patients whose position of onset of motor symptom is upper limbs is 54(63.5%),the rest is 31(36.5%).whose position of onset of motor symptom is not upper limbs.Among the group,male patients are 42(49.4%)and female patients are 43(50.6%).We cut the group into three parts according to the age of onset,including?44(youth),45-59(middle age),?60(old age)and the number of patients in each group is 10(11.8%),33(38.8%),42(49.4%).At the same time,the degree of education also divides the group into three parts,including ?primary school,junior and senior high school,>high school and the number of patients in each group is 46(54.1%),29(34.1%),10(11.8%).The same condition also occurs in the classification of professions,the detail is farmers 43(50.6%),workers 13(15.3%)and retirees 29(34.1%).According to the special habits,the group is divided into four parts,including no special habits 60(70.6%),smoking 6(7.1%),drinking 9(10.6%),smoking and drinking 10(11.8%).Moreover,the number of the patients who are suffered diabetes and hypertension is 9(10.6%)and 28(32.9%)respectively.2.According to the results of single factor logistic correlated analysis,we could summarize that,among the seven related factors,including gender,age of onset,degree of education,profession,special habits,hypertension and diabetes,the value of p in the related to the onset of upper limbs is 0.449,0.003,0.713,0.226,0.022,0.184,0.128 respectively(p<0.05 represents the existence of statistical significance).Thus,we can conclude that the age of onset and special habits have the significant correlation to the onset of upper limbs.3.The result of multiple factors binary logistic analysis reveals that the correlation of age of onset and onset of upper limbs has significant statistical meaning but not the special habits.Meanwhile,the value of p of<44(youth),45-59(middle age)is 0.020?0.011 and the value of OR is 0.160,0.249 as well as the value of B is-1.833,-1.892 respectively.Besides,the value of B in the age of onset is negative which indicates that when the age of onset is younger of PD patients,the possibility of onset of initial motor symptom from upper limbs is greater.Conclusion1.The following six factors,including gender,profession,degree of education,special habits,hypertension and diabetes,have no significant correlation to the onset of initial motor symptom from upper limbs.2.There is significant correlation between the age of onset and position of onset and the possibility of onset of upper limbs is greater when the age of onset becomes more and more earlier,meanwhile,the risk of as the age of onset of initial motor symptom from upper limbs reduce around 0.1-0.2 along with the addition of age from one younger group to older one.