身体活动的幂型自相关指数定量化反映帕金森病的程度

Power-law Temporal Autocorrelation of Activity Reflects Severity of Parkinson's Disease

目的:评价便携式加速度记录仪定量化监测帕金森病(PD)运动障碍的程度与症状波动。方法:51例PD患者根据Hoehn-Yahr分级分为轻症组(n=27)和重症组(n=24),将便携式加速度记录仪佩戴于患者手腕连续记录6d以上。评价PD患者的主观症状程度、解析localmaxima与localminima型身体活动的幂型自相关指数来监测患者的症状波动。对重症组和轻症组患者的状况好与差、抗PD药物使用前后进行比较。结果:所有PD患者,状况好或是治疗后患者的local maxima型幂型自相关指数值均小于症状重或治疗前,并且不受震颤的影响。结论:利用幂型自相关指数法解析加速度记录仪所记录的身体运动,能够客观定量化评价PD的程度,可作为PD患者门诊疗效评价的工具。

ABSTRACT Aim： To obtain a reliable, objective scale representing disease severity for appropriate management of patients with Parkinson＇ s disease （PD）. Methods： Fifty-one patients with PD at the Department of Neurology, Tokyo University Hospital, were classified into mild（n=27） or severe groups （n=24） depending on their Hoehn-Yahr scores, and wore accelerometers on their wrists for more than six consecutive days. During the time, their subjective assessments of symptom severity were monitored and the power-law exponents （ α ） for local maxima and minima of fluctuations in the activity time series were analyzed. Statistical comparisons were made between the severe and mild groups of individual patients on ＂good condition＂ and ＂bad condition＂ days, as well as between days before and after anti-parkinsonism medication. Results： In all patients, the α for local maxima was always lower when PD was mild than when severe. Presence of tremor did not influence the α for local maxima. Conclusion： Actigraph monitoring of PD and analysis of its powerlaw correlation may provide useful objective information for controlling PD in outpatient clinics and for evaluating new anti-parkinsonism drugs.