Management of restless legs syndrome in chronic liver disease:A challenge for the correct diagnosis and therapy

AIM To investigate the association between restless legs syndrome(RLS) and well-defined chronic liver disease, and the possible therapeutic options. METHODS Two hundred and eleven patients with chronic liver disease, complaining of sleep disturbances, painful leg sensation and daily sleepiness, were included. Patients with persistent alcohol intake, recent worsening of clinical conditions, or hepatitis C virus were excluded. Diagnosis of RLS was suggested by the Johns Hopkins questionnaire and verified by fulfilling the diagnostic criteria by Allen. All patients were tested, both at baseline and during follow-up, with the Hamilton rating scale for depression, sleep quality assessment(PSQI), Epworth sleepiness scale(ESS), International Restless Legs Syndrome Study Group evaluation, and international RLS severity(IRLS) scoring system. Ironfree level, ferritin, folate, vitamin B12 and D-OH25 were detected. Neurological examinations and blood testoccurred at the beginning of the therapy, after 2 wk, and at the 28^(th), 75 th, 105 th, 135 th, 165 th and 205 th day. Regarding therapy, pramipexole or gabapentin were used.RESULTS Patients were moderately depressed, with evident nocturnal sleep problems and concomitant daily sleepiness. Sleep problems and involuntary leg movements had been underestimated, and RLS s yndrome had not be e n c ons ide re d be fore t he neurological visit. All(211/211) patients fulfilled the RLS diagnostic criteria. Twenty-two patients considered their symptoms as mild, according to IRSL, but 189 found them moderate to very severe. No correlation was found between ammonium level and ESS or PSQI. Augmentation was rather precocious in our patients(135 th day), and more frequent(35%) than previous data(8.3%-9.1%). The dosage of dopamine agonists was found to be associated with augmentation and appears in range with the literature. Previous intake of alcohol and lower levels of vitamins have been related to the phenomenon in our study.CONCLUSION RLS is a common disorder, requiring rapid diagnosis and treatment. Further research is therefore fundamental.

A review of the neurotransmitter system associated with cognitive function of the cerebellum in Parkinson's disease

The dichotomized brain system is a concept that was generalized from the‘dual syndrome hypothesis’to explain the heterogeneity of cognitive impairment,in which anterior and posterior brain systems are independent but partially overlap.The dopaminergic system acts on the anterior brain and is responsible for executive function,working memory,and planning.In contrast,the cholinergic system acts on the posterior brain and is responsible for semantic fluency and visuospatial function.Evidence from dopaminergic/cholinergic imaging or functional neuroimaging has shed significant insight relating to the involvement of the cerebellum in the cognitive process of patients with Parkinson’s disease.Previous research has reported evidence that the cerebellum receives both dopaminergic and cholinergic projections.However,whether these two neurotransmitter systems are associated with cognitive function has yet to be fully elucidated.Furthermore,the precise role of the cerebellum in patients with Parkinson’s disease and cognitive impairment remains unclear.Therefore,in this review,we summarize the cerebellar dopaminergic and cholinergic projections and their relationships with cognition,as reported by previous studies,and investigated the role of the cerebellum in patients with Parkinson’s disease and cognitive impairment,as determined by functional neuroimaging.Our findings will help us to understand the role of the cerebellum in the mechanisms underlying cognitive impairment in Parkinson’s disease.

Bone cement implantation syndrome during hip replacement in a patient with pemphigus and Parkinson’s disease: A case report

BACKGROUND Bone cement implantation syndrome(BCIS)is characterized by hypotension,arrhythmia,diffuse pulmonary microvascular embolism,shock,cardiac arrest,any combination of these factors,or even death following bone cement implantation.CASE SUMMARY An 80-year-old patient with pemphigus and Parkinson’s disease underwent total hip replacement under spinal subarachnoid block and developed acute pulmonary embolism after bone cement implantation.The patient received mask mechanical ventilation with a continuous intravenous infusion of adrenaline(2μg/mL)at a rate of 30 mL/h.Subsequently,the symptoms of BCIS were markedly alleviated,and the infusion rate of adrenaline was gradually reduced until the infusion was completely stopped 45 min later.The patient was then transferred to the Department of Orthopedics,and anticoagulation therapy began at 12 h postoperatively.No other complications were observed.CONCLUSION This is a rare case of BCIS in a high-risk patient with pemphigus and Parkinson’s disease.

Concomitant Othello syndrome and impulse control disorders in a patient with Parkinson’s disease:A case report

BACKGROUND Othello syndrome(OS)is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner,which may lead to extreme behaviors.Impulse control disorders refer to behaviors involving repetitive,excessive,and compulsive activities driven by an intense desire.Both OS and impulse control disorders in Parkinson’s disease(PD)may be side effects of dopamine agonists.At present,there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.CASE SUMMARY We describe a 70-year-old male patient with PD,OS,and impulse control disorders,who presented with a six-month history of the delusional belief that his wife was having an affair with someone.He began to show an obvious increase in libido presenting as frequent masturbation.He had been diagnosed with PD ten years earlier and had no past psychiatric history.In his fourth year of PD,he engaged in binge eating,which lasted approximately one year.Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.CONCLUSION Given its potential for severe consequences,OS should be identified early,especially in patients undergoing treatment with dopamine agonists.

Ogilvie Syndrome Associated to Parkinson’s Disease

Ogilvie’s syndrome is an acute dilatation of a part or all of the colon and rectum without mechanical obstruction. The diagnosis is based on computed tomography (CT) that excludes organic or functional colonic obstruction and?ensures the detection of signs of severity. Rapid diagnosis leads to conservative measures and the resolution of obstruction. Delays in diagnosis can lead to complications imposing a surgical treatment and increased mortality rate. We report the case of a 52 years old woman with Parkinson’s disease, who presented Ogilvie’s syndrome. The initial assessment did not show signs of severity, so medical treatment was introduced but without improvement;for this reason, the surgical procedure was indicated as a cecostomy. There are several theories that explain the pathophysiology of Ogilvie’s syndrome;the most likely is the dysfunction of innervation of the colon which is due to Parkinson’s disease in our case. The diagnosis is based on computed tomography. The treatment is pharmacologic, conservative or surgical depending on the severity of the disease and its evolution.

Antibody-based immunotherapies for Parkinsonian syndromes

What is the rationale for immunotherapies in Parkinsonian syndromes (PS)? PS are neurodegenerative diseases which are clinically characterized by a hypokinetic phenotype in combination with additional motor and non-motor symptoms. One major pathological hallmark of all PS consists of a non-physiological detrimental accumulation of protein aggregates which appear intracellularly in neurons and glial cells but also in the extracellular space (Wong and Krainc, 2017). Depending on the pathogenic protein, PS can be divided into synucleinopathies, characterized by aggregation of the protein alpha-Synuclein (aSyn), and tauopathies, characterized by aggregation of the protein Tau (Levin et al., 2016;Poewe et al., 2017). Clinical syndromes of synucleinopathies include Parkinson’s disease (PD), multiple system atrophy (MSA) and dementia with Lewy bodies, and tauopathies include progressive supranuclear palsy (PSP) and corticobasal degeneration.

Frequency of Comorbid Musculoskeletal Problems in Patients with Parkinson’s Disease: What and When?

Background: Musculoskeletal problems, deteriorating posture and pain are common complaints/comorbidities in Parkinson’s disease (PD). The aim of this study was to investigate the frequency of comorbid musculoskeletal problems in PD, and their relationship with disease stage and severity. Methods: The study was approved by the local ethical committee of Duzce University numbered with 2018/52 on date 26.03.2018. Patients with PD (pwPD) underwent a detailed examination to investigate the possible comorbidity of musculoskeletal findings in the orthopedics and traumatology clinic. Socio-demographic features, disease characteristics, motor and non-motor scores were recorded. Results: Thirty-seven pwPD were enrolled in the study. Mean age was 68.75 ± 10.75 years. Comorbid musculoskeletal problems were rotator cuff syndrome (27%), knee osteoarthritis (24.3%), meniscus (13.5%), lumber disc herniation (10.8%), kyphosis (8.1%), myotendinous diseases (16.3%). Rotator-cuff disease and knee osteoarthritis were most common comorbidities, especially in the “mild” and “moderate” stages of pwPD. Conclusion: Since most of the pwPD, especially the ones that have musculoskeletal complaints prior to the diagnosis of PD, present to the orthopedics and traumatology clinics or physiotherapists, it is mandatory to enhance the awareness of the orthopedic surgeons, and physiotherapy specialist in order to keep PD in mind.

The Tower of Hanoi for Evaluating Dysexecutive Syndrome in Patients with Parkinson’s:Standardization Values

Objective: The Tower of Hanoi measures executive functions using non-verbal content and requires perception of position in space. The main objective of this study is to standardize the use of the TOH as a measurement tool in Parkinson’s disease. Patients and Methods: Of the Control Group subjects, 192 (59.6%) were women, 223 subjects (69.25%) were able to perform the TOH with 3 discs. In the Parkinson’s Group, there were 57 women (39.3%), and 66 subjects (45.5%) did not get past that level. Results: If we take the TOH (with 3 or 4 discs) as a tool for discriminating between those who have dysexecutive syndrome and those who do not, we find that the Parkinson’s Group presents dysexecutive syndrome significantly more frequently than the Control Group (p ≤ 0.0064). Conclusion: We can conclude that dysexecutive syndrome is frequent in Parkinson’s patients and it is more prevalent than in the general population.

Linking restless legs syndrome with Parkinson’s disease:clinical,imaging and genetic evidence

Restless legs syndrome(RLS)and Parkinson’s disease(PD)are both common neurological disorders.There has been much debate over whether an etiological link between these two diseases exists and whether they share a common pathophysiology.Evidence pointing towards a link includes response to dopaminergic agents in PD and RLS,suggestive of underlying dopamine dysfunction in both conditions.The extrastriatal dopaminergic system,in particular altered spinal dopaminergic modulation,may be variably involved in PD patients with RLS symptoms.In addition,there is now evidence that the nigrostriatal system,primarily involved in PD,is also affected in RLS.Furthermore,an association of RLS with the parkin mutation has been suggested.The prevalence of RLS has also been reported to be increased in other disorders of dopamine regulation.However,clinical association studies and functional imaging have produced mixed findings.Conflicting accounts of emergence of RLS and improvement in RLS symptoms after deep brain stimulation(DBS)also contribute to the uncertainty surrounding the issue.Among the strongest arguments against a common pathophysiology is the role of iron in RLS and PD.While elevated iron levels in the substantia nigra contribute to oxidative stress in PD,RLS is a disorder of relative iron deficiency,with symptoms responding to replacement therapy.Recent ultrasonography studies have suggested that,despite overlapping clinical features,the mechanisms underlying idiopathic RLS and RLS associated with PD may differ.In this review,we provide a concise summary of the clinical,imaging and genetic evidence exploring the link between RLS and PD.

Sleep disorders and chronic kidney disease

Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.

Sleep-associated movement disorders and the risk of cardiovascular disease: A systematic review and metaanalysis

AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.

11C-β-CFT PET/CT与TCS检测对PD及APS的鉴别诊断价值研究

目的 探讨11C-甲基-N-2β-甲基酯-3β-(4-氟-苯基)托烷(11C-β-CFT)正电子发射断层显像/X线计算机体层成像(PET/CT)及经颅超声(TCS)检测对帕金森病(PD)及非典型帕金森综合征(APS)的鉴别诊断价值。方法 选取2020年5月至2021年6月该院核医学科行11C-β-CFT PET/CT检测的患者91例,其中PD 55例(PD组),APS 36例(APS组)。同时选取无相关神经系统疾病的健康者11例作为对照组。根据黑质回声强度将研究对象进一步分为阳性组(38例)和阴性组(41例)。比较各组相关检测参数,采用受试者工作曲线对相关指标诊断效能进行分析。结果 PD组、APS组、对照组11C-β-CFT PET/CT检测参数(尾状核不对称指数除外)比较,差异有统计学意义(P<0.05)。对照组各检测参数与PD组比较,差异有统计学意义(P<0.05)。PD组尾状核及前壳核11C-β-CFT摄取值与APS组比较,差异有统计学意义(P<0.05)。PD组、APS组、对照组黑质高回声面积分别为(0.12±0.19)、(0.22±0.17)、(0.23±0.23)cm2,差异无统计学意义(P>0.05)。阳性组、阴性组11C-β-CFT PET/CT检测参数比较,差异无统计学意义(P>0.05)。11C-β-CFT PET/CT检测参数与黑质高回声面积无相关性(P>0.05)。后壳核11C-β-CFT摄取值对PD和APS的诊断效能最佳。前壳核11C-β-CFT摄取值鉴别PD和APS的诊断效能相对较高,但仍不能对PD和APS准确鉴别。结论11C-β-CFT PET/CT检测有助于PD的诊断与鉴别诊断,对于存在运动症状的疑诊PD患者,TCS检测也可提供一些有效信息。

Imaging biomarkers in Parkinson’s disease and Parkinsonian syndromes:current and emerging concepts

Two centuries ago in 1817,James Parkinson provided the first medical description of Parkinson’s disease,later refined by Jean-Martin Charcot in the mid-to-late 19th century to include the atypical parkinsonian variants(also termed,Parkinson-plus syndromes).Today,Parkinson’s disease represents the second most common neurodegenerative disorder with an estimated global prevalence of over 10 million.Conversely,atypical parkinsonian syndromes encompass a group of relatively heterogeneous disorders that may share some clinical features with Parkinson’s disease,but are uncommon distinct clinicopathological diseases.Decades of scientific advancements have vastly improved our understanding of these disorders,including improvements in in vivo imaging for biomarker identification.Multimodal imaging for the visualization of structural and functional brain changes is especially important,as it allows a‘window’into the underlying pathophysiological abnormalities.In this article,we first present an overview of the cardinal clinical and neuropathological features of,1)synucleinopathies:Parkinson’s disease and other Lewy body spectrum disorders,as well as multiple system atrophy,and 2)tauopathies:progressive supranuclear palsy,and corticobasal degeneration.A comprehensive presentation of wellestablished and emerging imaging biomarkers for each disorder are then discussed.Biomarkers for the following imaging modalities are reviewed:1)structural magnetic resonance imaging(MRI)using T1,T2,and susceptibilityweighted sequences for volumetric and voxel-based morphometric analyses,as well as MRI derived visual signatures,2)diffusion tensor MRI for the assessment of white matter tract injury and microstructural integrity,3)proton magnetic resonance spectroscopy for quantifying proton-containing brain metabolites,4)single photon emission computed tomography for the evaluation of nigrostriatal integrity(as assessed by presynaptic dopamine transporters and postsynaptic dopamine D2 receptors),and cerebral perfusion,5)positron emission tomography for gauging nigrostriatal functions,glucose metabolism,amyloid and tau molecular imaging,as well as neuroinflammation,6)myocardial scintigraphy for dysautonomia,and 7)transcranial sonography for measuring substantia nigra and lentiform nucleus echogenicity.Imaging biomarkers,using the‘multimodal approach’,may aid in making early,accurate and objective diagnostic decisions,highlight neuroanatomical and pathophysiological mechanisms,as well as assist in evaluating disease progression and therapeutic responses to drugs in clinical trials.

老年帕金森病与不宁腿综合征的相关性及研究进展

老年帕金森(PD)是临床上常见的一种神经系统变性疾病,其与不宁腿综合征(RLS)的相关性一直以来都是临床研究的重点。老年PD、RLS临床表现不完全相同,且RLS也是老年PD的一种临床并发症,二者均存在多巴胺能系统功能异常,在病理学机制、临床症状学、生理学等方面也存在一定的关联。RLS的临床症状及双下肢无自主活动欲望很可能对老年PD患者睡眠及精神状况产生负面影响,进而加重老年PD患者病情,目前尚无治疗RLS的特效药,了解其发病机理、临床发病率及与老年PD相关症状的关联性有助于为RLS的个体化治疗提供帮助。本综述围绕近年来的相关研究文献,分别从发病机制、流行病学调查、临床表现及治疗方面探究老年PD与RLS的相关性。

帕金森病伴睡眠障碍的研究进展

帕金森病(PD)是一种与运动和非运动症状相关的大脑退行性疾病,与环境、遗传、神经系统老化等多种因素有关。近年的调查研究显示,中国PD平均患病年龄60岁,在65岁以上人群中,每10万人约1700名患者。睡眠障碍是PD的非运动症状之一,临床表现包括失眠、白天过度嗜睡、不宁腿综合征、快速眼动期睡眠行为障碍以及睡眠呼吸障碍等多种类型。由于存在个体差异,PD伴睡眠障碍疾病治疗过程中应在医生指导下选择最适合患者个体的药物。本文对PD睡眠障碍发病机制和常用药物治疗方案进行综述,希望能够为今后PD伴睡眠障碍的治疗提供新的思路。

睡眠周期性肢体运动与缺血性脑血管病研究进展

缺血性脑血管病是我国临床常见疾病,其发病率及死亡率持续上升,为我国社会及家庭带来沉重负担。睡眠周期性肢体运动(PLMS)是不自觉的、有节律的肢体运动,通常指睡眠时异常的下肢的规律运动。大量证据表明,频繁发作的夜间周期性腿部运动与高血压、冠心病和缺血性脑血管病等其他疾病密切相关。本文对PLMS病理学机制以及其与缺血性脑血管病的关系研究进展予以综述。

黄煌辨体质分阶段治疗帕金森病经验

黄煌教授认为,“风胜则动”为帕金森病发生的基本病机,病位在肝与筋脉,与肺、脾、肾、心等脏关系密切。本病分为痰热生风证、热盛动风证、正虚风中证、阳虚动风证和虚劳化风证五个证型,并根据病程所处的不同阶段分期论治,以“方-病-人”诊疗模式辨其体质精准选方用药。早期以痰热生风证、热盛动风证为主,治宜清热,兼顾化痰、通腑、熄风、镇惊,方选柴胡加龙骨牡蛎汤、风引汤;中期以正虚风中证为主,治宜祛风散邪、益气养血并重,方选续命汤;晚期以阳虚动风证和虚劳化风证为主,治宜温补理虚,兼顾调气行水,方选真武汤、薯蓣丸。黄教授在临证施治过程中治风却不拘泥于熄风,求其生风之本、风中之因,切合病机,随证化裁,还注重调整体质偏颇,从整体上平衡阴阳、调畅气机、调和脏腑,辨体质分阶段治疗帕金森病,效如桴鼓。

Molecular imaging of movement disorders

Positron emission tomography measures the activity of radioactively labeled compounds which distribute and accumulate in central nervous system regions in proportion to their metabolic rate or blood flow. Specific circuits such as the dopaminergic nigrostriatal projection can be studied with ligands that bind to the pre-synaptic dopamine transporter or post-synaptic dopamine receptors(D1 and D2). Single photon emission computerized tomography(SPECT) measures the activity of similar tracers labeled with heavy radioactive species such as technetium and iodine. In essential tremor, there is cerebellar hypermetabolism and abnormal GABAergic function in premotor cortices, dentate nuclei and ventral thalami, without significant abnormalities in dopaminergic transmission. In Huntington's disease, there is hypometabolism in the striatum, frontal and temporal cortices. Disease progression is accompanied by reduction in striatal D1 and D2 binding that correlates with trinucleotide repeat length, disease duration and severity. In dystonia, there is hypermetabolism in the basal ganglia, supplementary motor areas and cerebellum at rest. Thalamic and cerebellar hypermetabolism is seen during dystonic movements, which can be modulated by globus pallidus deep brain stimulation(DBS). Additionally, GABA-A receptor activity is reduced in motor, premotor and somatosensory cortices. In Tourette's syndrome, there is hypermetabolism in premotor and sensorimotor cortices, as well as hypometabolism in the striatum, thalamus and limbic regions at rest. During tics, multiple areas related to cognitive, sensory and motor functions become hypermetabolic. Also, there is abnormal serotoninergic transmission in prefrontal cortices and bilateral thalami, as well as hyperactivity in the striatal dopaminergic system which can be modulated with thalamic DBS. In Parkinson's disease(PD), there is asymmetric progressive decline in striatal dopaminergic tracer accumulation, which follows a caudal-to-rostral direction. Uptake declines prior to symptom presentation and progresses from contralateral to the most symptomatic side to bilateral, correlating with symptom severity. In progressive supranuclear palsy(PSP) and multiple system atrophy(MSA), striatal activity is symmetrically and diffusely decreased. The caudal-to-rostral pattern is lost in PSP, but could be present in MSA. In corticobasal degeneration(CBD), there is asymmetric, diffuse reduction of striatal activity, contralateral to the most symptomatic side. Additionally, there is hypometabolism in contralateral parietooccipital and frontal cortices in PD; bilateral putamen and cerebellum in MSA; caudate, thalamus, midbrain, mesial frontal and prefrontal cortices in PSP; and contralateral cortices in CBD. Finally, cardiac sympathetic SPECT signal is decreased in PD. The capacity of molecular imaging to provide in vivo time courses of gene expression, protein synthesis, receptor and transporter binding, could facilitate the development and evaluation of novel medical, surgical and genetic therapies in movement disorders.

帕金森病(PD)患者的非运动症状(NMS)及影响评分因素分析

目的观察分析帕金森病患者的非运动症状与影响评分的因素。方法对84例原发性PD患者进行问卷调查,统计分析患者的NMS发生率以及评分影响因素。结果 84例患者中存在任意一种NMS的发生率是95.2%,其中以便秘(79.8%)、尿频尿急(66.7%)和不宁腿综合征(RLS)(57.1%)最为常见,而大便失禁(7.1%)等较少;多元回归分析显示年龄、病程、H-Y分期的回归系数分别为0.115、0.332和2.465,性别则未进入回归方程。结论 NMS广泛存在于PD患者当中,便秘、尿频尿急和RLS的发生率较高。NMS评分受H-Y分期的影响最大,改善运动症状或许可在一定程度上减少NMS的发生。

帕金森病合并不宁腿综合征患者临床特征及影响因素分析

目的:探讨帕金森病(PD)患者中不宁腿综合征(RLS)的临床特征及危险因素。方法:回顾性分析2019年10月至2022年12月于河北医科大学第一医院诊治的PD患者283例,其中合并RLS 160例,未合并RLS 123例。比较合并RLS组(PD-RLS)和未合并RLS组(PD-NRLS)患者间情绪(HAMD_(24)、HAMA_(14))、认知(MMSE)、睡眠(PQSI)、疲劳(BFI)、快速眼动睡眠行为障碍(RBD)、运动症状(UPDRS-Ⅲ)等因素之间的差异,采用Logistic回归分析影响PD患者合并RLS的危险因素。结果:①伴有抑郁、焦虑、睡眠障碍和RBD的PD患者,其RLS发病率高于对照组(P<0.05)。②与PD-NRLS组比较,PD-RLS组患者年龄较小,而HAMD_(24)、HAMA_(14)、PQSI、BFI、RBD、UPDRS-Ⅲ评分更高(P<0.05)。③在PD患者中,RLS与性别、Hoehn-Yahr分期、MMSE评分不相关(P>0.05);RLS与年龄呈负相关(P<0.05)。④多因素Logistic回归分析结果显示年龄、HAMA_(14)是PD患者发生RLS的独立危险因素。结论:PD患者随着年龄增加,其RLS发病风险降低,而PD伴焦虑的患者应警惕RLS的发生,及早识别RLS并给予及时治疗,可提高PD患者的生活质量。