| 李芳菲
，林施暖
，崔雨莎
，冯涛.基于多巴反应性的帕金森病震颤分型和电生理特征[J].神经损伤功能重建,2025,(4):197-202 |
| 基于多巴反应性的帕金森病震颤分型和电生理特征 |
| Classification and Electrophysiological Features of Parkinson's Disease Tremor Based onDopamine Reactivity |
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| DOI： |
| 中文关键词: 帕金森病 震颤 多巴胺反应性 急性左旋多巴冲击试验 震颤分析 |
| 英文关键词: Parkinson's disease tremor dopamine responsiveness acute levodopa challenge test tremor analysis |
| 基金项目:国家自然科学基金
项目（通过外周神
经调控对 PD 震颤
脑能量活动的体感
反馈机制研究，No.
82271459；帕 金 森
病姿势性震颤的神
经震荡机制研究，
No. 82071422） |
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| 中文摘要: |
| 目的：探讨多巴胺抵抗型及反应型帕金森震颤患者的震颤特征。方法：本研究为回顾性分析。纳入
帕金森病患者197例，至少有一个肢体出现静止性或姿势性震颤，所有患者完善急性左旋多巴冲击试验及
震颤分析。震颤改善值＜5分为多巴胺抵抗型（116例），震颤改善值≥5分为多巴胺反应型（81例）。比较
2组患者在静止、姿势、意向以及持物状态时的震颤形式和频率。结果：与多巴胺抵抗型相比，多巴胺反应型
的基线统一帕金森病评定量表第3部分（UPDRS-Ⅲ）总分及震颤总分更高、病程更长、左旋多巴等效剂量更
大（均P＜0.05），急性左旋多巴冲击试验震颤的最大改善率和改善值更大（均P＜0.05）。2组在上肢意向性
震颤及上肢持物状态下，震颤肌肉收缩形式和频率的分布差异存在统计学意义（P＜0.05）；2组在下肢静止
性震颤及姿势性震颤状态下，震颤肌肉收缩形式和频率的分布差异存在统计学意义（P＜0.05）。结论：帕金
森病震颤对左旋多巴存在反应异质性。不同反应型在不同状态下的震颤肌肉收缩形式和频率的分布存在
差异，震颤分析可为帕金森震颤多巴胺反应性不同类型的鉴别及治疗提供客观、实用依据。 |
| 英文摘要: |
| To investigate the characteristics of tremor in patients with dopamine-resistant and
dopamine-responsive tremor in Parkinson's disease (PD). Methods: This study is a retrospective analysis. A
total of 197 PD patients with at least one limb exhibiting resting or postural tremor were included. All patients
underwent an acute levodopa challenge test and tremor analysis. Patients with a tremor improvement score of
less than 5 points were classified as dopamine-resistant (116 cases), while those with a tremor improvement
score of 5 points or more were classified as dopamine-responsive (81 cases). The tremor patterns and frequencies
in the resting, postural, intentional, and object-holding states were compared between the two groups. Results:
Compared to the dopamine-resistant group, the dopamine-responsive group had a higher baseline Unified
Parkinson’s Disease Rating Scale Part III (UPDRS-III) total score and tremor total score, longer disease
duration, and higher levodopa equivalent dose (all P<0.05). The maximum improvement rate and improvement
value of tremor during the acute levodopa challenge test were also greater in the dopamine-responsive group
(both P<0.05). There were statistically significant differences in the distribution of tremor muscle contraction
patterns and frequencies between the two groups in the upper limb intentional tremor and upper limb
object-holding state (P<0.05). Additionally, there were statistically significant differences in the distribution of
tremor muscle contraction patterns and frequencies between the two groups in the lower limb resting and postural tremor states (P<0.05).
Conclusion: The tremor of PD exhibits heterogeneity in its response to levodopa. Different responsive types show variations in the
distribution of tremor muscle contraction patterns and frequencies under different conditions. Tremor analysis can provide objective and
practical evidence for the differentiation and treatment of various dopamine-responsive types of Parkinson's tremor. |
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