Introduction
Materials and methods
Ethics declarations
Ethics approval and consent to participate
Data collection and patient information
Diagnosis of PD
Clinical data collection
Transcranial sonography
Functional MRI (fMRI)
Data analysis
Results
Clinical demographic results
N-CI (n = 48) | F-CI (n = 58) | L-CI (n = 66) | P | |
---|---|---|---|---|
Age of onset (years) Mean ± SD | 14–77 (53.20 ± 11.29) | 47–73 (60.08 ± 4.78) | 32.5–75 (59.82 ± 10.28) | <0.001a 0.862b |
Age of first treatment (years) Mean ± SD | 29–78 (58.00 ± 10.58) | 51–78 (64.53 ± 4.36) | 33–80 (64.89 ± 10.92) | <0.001a 0.816b |
Gender | ||||
Male | 34 | 35 | 46 | 0.429c |
Female | 14 | 23 | 20 | |
Ethnicity | ||||
Han | 46 | 57 | 64 | 0.749e |
Others | 2 | 1 | 2 | |
Family history | 2 | 4 | 3 | 0.787e |
Smoking history | 9 | 15 | 29 | 0.010c/0.005cd |
Drinking history | 10 | 4 | 9 | 0.105e |
Hypertension | 17 | 20 | 27 | 0.727c |
Diabetes | 9 | 15 | 18 | 0.551c |
Hyperlipidemia | 10 | 11 | 14 | 0.948c |
History of head injury | 3 | 5 | 6 | 0.849e |
History of carbon monoxide poisoning | 6 | 5 | 11 | 0.407c |
Duration of disease (years) Mean ± SD | 0.5-20 (4.80 ± 4.38) | 0.5-20 (4.46 ± 4.14) | 0.5-30 (5.08 ± 5.19) | 0.763a |
Comparison of MS and NMS among subgroups
Comparison of F-CI and N-CI and non-FCI (L-CI and N-CI) clinical symptoms at the first treatment
Clinical symptoms | F-CI (n = 58) | N-FCI (n = 114) | N-CI (n = 48) | P1 | P2 |
---|---|---|---|---|---|
MS | |||||
Bradykinesia | 58 | 114 | 48 | NA | NA |
Rest tremor | 49 | 98 | 41 | 0.794c | 0.894c |
Rigidity | 36 | 66 | 31 | 0.598c | 0.789c |
Mental symptoms | |||||
Memory deficit | 31 | 48 | 18 | 0.158c | 0.101c |
RCP | 5 | 12 | 3 | 0.692c | 0.928e |
Cognitive impairment | 58 | 0 | 0 | NA | NA |
Somnipathy | 14 | 17 | 7 | 0.137c | 0.219c |
Anxiety | 25 | 41 | 13 | 0.363c | 0.087c |
Depression | 21 | 36 | 9 | 0.542c | 0.047c |
Apathy | 5 | 6 | 2 | 0.395c | 0.599e |
Autonomic symptoms | |||||
Constipation | 33 | 71 | 26 | 0.495c | 0.778c |
Hyperhidrosis | 2 | 1 | 1 | 0.547e | NA* |
Postural hypotension | 10 | 19 | 6 | 0.924c | 0.497c |
Dysuria | 31 | 57 | 23 | 0.669c | 0.571c |
Salivation | 11 | 15 | 4 | 0.315c | 0.199e |
Sexual dysfunction | 5 | 13 | 9 | 0.573c | 0.125c |
Sensory disturbance | |||||
Olfactory dysfunction | 18 | 36 | 20 | 0.942c | 0.256c |
Pain | 11 | 19 | 8 | 0.707c | 0.759c |
Spasm | 0 | 1 | 1 | NA | NA |
Numbness | 1 | 5 | 2 | 0.646e | 0.868c |
RLS | 2 | 4 | 1 | NA* | NA* |
Comparison of clinical symptoms at the first treatment and cumulative and newly added symptoms at the last treatment between L-CI and N-CI
Clinical symptoms | L-CI (n = 66) | N-CI (n = 48) | P1 | L-CI t/n (n = 66) | N-CI t/n (n = 48) | P2 | P3 |
---|---|---|---|---|---|---|---|
MS | |||||||
Bradykinesia | 66 | 48 | NA | 66/11 | 48/10 | NA | 0.571c |
Rest tremor | 57 | 41 | 0.886c | 58/7 | 43/9 | 0.777c | 0.123c |
Rigidity | 35 | 31 | 0.217c | 37/8 | 34/10 | 0.108c | 0.208c |
Mental symptoms | |||||||
Memory deficit | 30 | 18 | 0.396c | 55/28 | 26/10 | 0.001c | 0.016c |
RCP | 9 | 3 | 0.337e | 22/13 | 7/4 | 0.023c | 0.157c |
Cognitive impairment | 0 | 0 | NA | 66/0 | 0/0 | NA | NA |
Somnipathy | 10 | 7 | 0.933c | 23/13 | 16/9 | 0.866c | 0.899c |
Anxiety | 28 | 13 | 0.092c | 33/7 | 22/9 | 0.660c | 0.123c |
Depression | 27 | 9 | 0.012c | 35/10 | 17/9 | 0.062c | 0.611c |
Apathy | 4 | 2 | 0.982e | 5/1 | 2/0 | 0.724e | NA |
Autonomic symptoms | |||||||
Constipation | 45 | 26 | 0.127c | 54/15 | 35/9 | 0.257c | 0.607c |
Hyperhidrosis | 0 | 1 | NA | 1/1 | 2/1 | 0.779e | NA* |
Postural hypotension | 13 | 6 | 0.309c | 25/13 | 17/11 | 0.788c | 0.677c |
Dysuria | 34 | 23 | 0.704c | 44/11 | 34/11 | 0.637c | 0.404c |
Salivation | 11 | 4 | 0.308e | 16/5 | 8/4 | 0.327c | NA* |
Sexual dysfunction | 4 | 9 | 0.071e | 6/2 | 10/1 | 0.075c | NA |
Sensory disturbance | |||||||
Olfactory dysfunction | 16 | 20 | 0.048c | 27/11 | 26/6 | 0.161c | 0.537c |
Pain | 11 | 8 | NA* | 16/6 | 11/5 | 0.896c | 0.813c |
Spasm | 0 | 1 | NA | 0/0 | 1/0 | NA | NA |
Numbness | 3 | 2 | NA* | 4/2 | 2/0 | 0.982e | NA |
RLS | 3 | 1 | 0.849e | 3/0 | 1/0 | 0.873e | NA |
Comparison of TCS results between the first and last examinations
N-CI(n = 48) | F-CI (n = 58) | L-CI (n = 66) | P1 | P2 | P3 | ||
---|---|---|---|---|---|---|---|
Interval time (Years) Mean ± SD | 0.50-7.67 (3.09 ± 1.76) | 0.50-8.33 (3.34 ± 1.86) | 1.00-8.00 (2.77 ± 1.84) | 0.232a | NA | NA | |
Midbrain area | |||||||
Total | First | 4.833 ± 0.667 | 0.01a | NA | NA | ||
Last | 4.999 ± 0.777 | ||||||
Subgroup | First | 4.854 ± 0.708 | 4.782 ± 0.642 | 4.863 ± 0.665 | NA | NA | 0.141a /0.018a /0.434a |
Last | 4.977 ± 0.733 | 5.071 ± 0.725 | 4.952 ± 0.856 | ||||
Ultrasound grading | |||||||
First | SNH+ | 22 | 20 | 29 | 0.07c | NA | 0.307c /0.186c/0.023c |
Last | SNH+ | 27 | 27 | 42 | |||
Ultrasound grading changes | 0.001c | ||||||
Up | 9 | 13 | 19 | NA | 0.899c/0.219c/0.418c | NA | |
Down | 4 | 8 | 6 | NA | 0.565e/NAe/0.409c | NA |
Logistics regression analysis
Logistics regression analysis of the demographics and clinical symptoms of F-CI and N-CI
Logistics regression analysis of demographics, first clinical symptoms, and first ultrasound grading of L-CI and N-CI
Logistics regression analysis of cumulative clinical symptoms, last ultrasound grading, and demographics of patients with L-CI and N-CI at the last treatment
Risk factors for PDD in patients with cognitive impairment
PDD (n = 27) | N-PDD (n = 97) | OR | |
---|---|---|---|
Gender (Male) | 19 | 61 | 1.402 |
Smoking history | 17 | 70 | 0.656 |
Drinking history | 1 | 12 | 0.272 |
Hyperlipidemia | 6 | 19 | 1.173 |
Diabetes | 8 | 26 | 1.150 |
Hypertension | 12 | 35 | 1.417 |
Bradykinesia | 27 | 97 | NA |
Tremor | 22 | 85 | 0.621 |
Rigidity | 20 | 56 | 2.091 |
Memory deficit | 22 | 76 | 1.216 |
RCP | 15 | 17 | 5.882 |
Somnipathy | 5 | 37 | 0.369 |
Anxious | 20 | 71 | 1.046 |
Depressed | 18 | 75 | 0.587 |
Nonchalance | 3 | 8 | 1.390 |
Constipation | 21 | 73 | 1.151 |
Hyperhidrosis | 0 | 4 | NA |
Postural hypotension | 11 | 38 | 1.067 |
Dysuria | 16 | 65 | 0.716 |
Salivation | 6 | 20 | 1.100 |
Sexual dysfunction | 1 | 9 | 0.350 |
Olfactory dysfunction | 16 | 41 | 1.987 |
Pain | 6 | 29 | 0.670 |
Spasm | 0 | 0 | NA |
Numbness | 0 | 6 | NA |
RLS | 2 | 5 | 1.472 |
SNH | 16 | 53 | 1.208 |