Analysis Of Onset Forms And Related Factors In The Progress Of Parkinson's Disease

Objective:To analyze the disease progression of Parkinson's disease(PD)patients with different onset forms,explore the influence of baseline characteristics such as handedness,gender and onset age on disease progression,and provide evidence for clinician to evaluating disease progression.Methods:Based on the established inclusion and exclusion criteria,this study collected 58 PD patients in the Neurology Department of First Affiliated Hospital of Kunming Medical University from January 2017 to September 2019.This study compared the differences of H-Y and UPDRS progression in different gender,handedness,age,onset age,course of disease,Hoehn-Yahr(H-Y)classification,and the unified Parkinson's disease rating scale revised by the International Association for Motor Disorders(MDS-UPDRS)groups.Results:1.Analysis of demographic data shows that there is no significant difference in gender,handedness and age between different onset symptoms(tremor/non-tremor)groups and different onset side(dominant/non-dominant)groups.2.Analysis of medical history data shows that:? The average onset age of non-dominant onset group is older than that of dominant onset group(P<0.05),but there is no significant difference between different onset symptoms groups.?There is no significant difference in the course of disease between different onset symptoms(tremor/non-tremor)groups and different onset side(dominant/non-dominant)groups.3.Analysis of clinical data shows that:? There is no significant difference in the disease stages(the early stage is H-Y 1?2.5 grade and the advanced stage is H-Y 3?5 grade)between different onset symptoms groups and different onset side groups.?There are no significant difference in the UPDRS-? scores and UPDRS-D scores between different onset symptoms groups and different onset side groups.?The UPDRS-ND scores of non-dominant onset group is higher than that of dominant onset group(18.14±6.28 vs 13.22±8.22,P<0.05),but there is no significant difference between different onset symptoms groups.4.Analysis of disease progression and its related factors shows that:?There is no significant difference in the rate of H-Y progression,UPDRS-?progression and UPDRS-D progression between different onset symptoms groups and different onset side.?The rate of UPDRS-ND progression of non-dominant onset group is faster than that of dominant onset group(P<0.05),but there is no significant difference between different onset symptoms groups.?The rate of UPDRS-ND progression is faster than that of UPDRS-D progression in non-dominant onset group(6.74 vs 3.79,P<0.05),and the rate of UPDRS-D progression is faster than that of UPDRS-ND progression in dominant onset group(3.57 vs 2.25,P<0.05).?There is no significant difference in the rate of H-Y progression,UPDRS-?progression,UPDRS-D progression and UPDRS-ND progression between left-dominant patients and right-dominant patients.?Age of onset is not only positively correlated with the rate of H-Y progression,UPDRS-? progression,UPDRS-D progression and UPDRS-ND progression(P<0.05),but also positively correlated to the rate of UPDRS-D progression in non-tremor onset group and dominant onset group(P<0.05).?There is no significant difference in the rate of H-Y progression,UPDRS-?progression,UPDRS-D progression and UPDRS-ND progression between male and female patients.?In tremor onset group,the rate of H-Y progression and UPDRS-? progression of male are faster than female(P<0.05).And in non-dominant onset group,the rate of H-Y progression of male is faster than female also(P<0.05).5.Analysis of UPDRS-? progression rate and its related factors shows that:?UPDRS-? progression rate is significantly affected by the combination of onset symptoms,onset side,handedness,onset age and gender(P<0.05).?UPDRS-? progression rate is significantly affected by the age of onset independently:the older the onset age,the faster the progression.?UPDRS-? progression rate is significantly affected by the gender independently:the progresses rate in male patients is faster than that in female patients.?UPDRS-? progression rate is significantly affected by the interaction between handedness and onset age:the significant influence of onset age on UPDRS-III progression rate is more obvious in left-dominant patients.?UPDRS-? progression rate may be indirectly affected by handedness via affecting the onset age and gender.?UPDRS-? progression rate may be indirectly affected by the side of onset(dominant/non-dominant)via affecting the onset age,gender and handedness.?UPDRS-? progression rate may be indirectly affected by the symptoms of onset(tremor/non-tremor)via affecting the onset age and handedness,similar to affected by the side of onset.Conclusions:1.The rate of dyskinesia progress is significantly affected by the combination of onset symptoms,onset side,handedness,onset age and gender.And the more evaluation factors,the more reliable.2.Identifying tremor in the early stage is helpful for clinicians to evaluate PD disease progression.3.Dyskinesia usually progresses faster on the onset side of PD patients.And if the non-dominant onset,the progression of dyskinesia on the onset side is greatly accelerated.4.The onset symptoms,onset side and handedness may affect the rate of dyskinesia progress indirectly via affecting the onset age or gender.5.The older the onset age,the faster the PD progresses,especially for left-dominant patients.6.PD progresses in female patients is slower than that in male patients,but it may only be manifested in tremor onset group and non-dominant onset group.