帕金森病中舌压与握力同MDS-UPDRS第三部分运动症状的差异性关联

文献信息

中文摘要

舌压是一种与吞咽相关的测量指标，与握力相关，而握力是用于评估肌少症的指标。然而，帕金森病（PD）中舌压降低可能不仅反映全身性肌无力，还反映PD相关的运动控制障碍，这提示舌压和握力可能与PD运动症状表现出不同的关联模式。本研究探讨了PD患者中舌压和握力与使用运动障碍学会赞助修订的统一帕金森病评定量表第三部分（MDS-UPDRS）评估的运动症状之间的关联模式。本横断面观察性研究共纳入49名年龄70-85岁的PD患者。评估了舌压、握力和MDS-UPDRS第三部分评分。对MDS-UPDRS第三部分条目进行探索性因子分析，随后基于总分和识别出的因子进行多元回归分析。在调整年龄和性别后，舌压（β = -0.320，p = 0.021）和握力（β = -0.409，p = 0.025）与MDS-UPDRS第三部分总分相关。识别出三个运动症状因子：轴向控制和整体运动输出、肢体运动功能以及震颤。舌压与涉及强直和运动迟缓的肢体运动功能相关，而握力与轴向控制和整体运动输出相关。这些发现提示PD患者舌压降低可能不仅反映全身性肌无力，还反映PD相关运动功能障碍的特定方面。然而，鉴于本研究的横断面性质，需要进一步研究以更好地描述舌压与PD运动症状之间的关系。

英文摘要

Tongue pressure is a swallowing-related measure that correlates with handgrip strength, an indicator used in the assessment of sarcopenia. However, reduced tongue pressure in Parkinson's disease (PD) may reflect not only generalized muscle weakness but also PD-related motor control impairment, raising the possibility that tongue pressure and handgrip strength may show different patterns of association with PD motor symptoms. This study examined the patterns of association between tongue pressure and handgrip strength and motor symptoms assessed using Part III of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) in patients with PD. A total of 49 individuals with PD aged 70-85 years were enrolled in this cross-sectional observational study. Tongue pressure, handgrip strength, and MDS-UPDRS Part III scores were assessed. Exploratory factor analysis of the MDS-UPDRS Part III items was conducted, followed by multiple regression analyses based on the total score and identified factors. After adjusting for age and sex, tongue pressure (β = -0.320, p = 0.021) and handgrip strength (β = -0.409, p = 0.025) were associated with the MDS-UPDRS Part III total score. Three motor symptom factors were identified: axial control and global motor output, limb motor function, and tremor. Tongue pressure was associated with limb motor function involving rigidity and bradykinesia, whereas handgrip strength was associated with axial control and global motor output. These findings suggest that reduced tongue pressure in patients with PD may reflect not only generalized muscle weakness but also specific aspects of PD-related motor dysfunction. However, given the cross-sectional nature of the study, further studies are required to better characterize the relationship between tongue pressure and PD motor symptoms.