Ying Huang1, Sidan Du1, Durong Chen1, Yao Qin1, Jing Cui1, Hongjuan Han1, Xiaoyan Ge1, Wenlin Bai1, Xinnan Zhang1, Hongmei Yu2,3. 1. Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China. 2. Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China. yu@sxmu.edu.cn. 3. Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Taiyuan, China. yu@sxmu.edu.cn.
Abstract
BACKGROUND: Excessive daytime sleepiness (EDS) and autonomic dysfunction have been verified to impair activity of daily living (ADL) in patients with Parkinson's disease (PD). Whether EDS can affect ADL in PD patients through autonomic dysfunction is still unclear. The purpose of this study is to explore the longitudinal mediation effect of autonomic dysfunction between EDS and ADL. METHODS: Data used in this study were from six-follow-up visits of 413 patients with newly diagnosed PD from the Parkinson's Progression Markers Initiative (PPMI). We used latent growth mediation modeling (LGMM) to explore whether the autonomic dysfunction is a longitudinal mediator between EDS and ADL. RESULTS: The results showed that as the disease progresses, EDS (P < 0.001) and autonomic dysfunction (P < 0.001) gradually worsened and ADL (P < 0.001) gradually decreased in PD patients. In addition, the more severe the patients' EDS symptom, the more worsened the symptoms of autonomic dysfunction, which result in a decrease in ADL. Both the intercept (95% CI: 0.142, 0.308) and the slope (95% CI: 0.083, 0.331) of autonomic dysfunction showed a partial mediating effect, and a longitudinal mediation effect was presented. CONCLUSION: Longitudinal changes in EDS affect the ADL of PD patients directly or indirectly by affecting the symptoms of autonomic dysfunction. Controlling the symptoms of autonomic dysfunction may improve the ADL of PD patients with EDS.
BACKGROUND: Excessive daytime sleepiness (EDS) and autonomic dysfunction have been verified to impair activity of daily living (ADL) in patients with Parkinson's disease (PD). Whether EDS can affect ADL in PD patients through autonomic dysfunction is still unclear. The purpose of this study is to explore the longitudinal mediation effect of autonomic dysfunction between EDS and ADL. METHODS: Data used in this study were from six-follow-up visits of 413 patients with newly diagnosed PD from the Parkinson's Progression Markers Initiative (PPMI). We used latent growth mediation modeling (LGMM) to explore whether the autonomic dysfunction is a longitudinal mediator between EDS and ADL. RESULTS: The results showed that as the disease progresses, EDS (P < 0.001) and autonomic dysfunction (P < 0.001) gradually worsened and ADL (P < 0.001) gradually decreased in PD patients. In addition, the more severe the patients' EDS symptom, the more worsened the symptoms of autonomic dysfunction, which result in a decrease in ADL. Both the intercept (95% CI: 0.142, 0.308) and the slope (95% CI: 0.083, 0.331) of autonomic dysfunction showed a partial mediating effect, and a longitudinal mediation effect was presented. CONCLUSION: Longitudinal changes in EDS affect the ADL of PD patients directly or indirectly by affecting the symptoms of autonomic dysfunction. Controlling the symptoms of autonomic dysfunction may improve the ADL of PD patients with EDS.
Authors: D Santos García; T de Deus Fonticoba; E Suárez Castro; C Borrué; M Mata; B Solano Vila; A Cots Foraster; M Álvarez Sauco; A B Rodríguez Pérez; L Vela; Y Macías; S Escalante; P Esteve; S Reverté Villarroya; E Cubo; E Casas; S Arnaiz; F Carrillo Padilla; M Pueyo Morlans; P Mir; P Martinez-Martin Journal: Parkinsonism Relat Disord Date: 2019-07-29 Impact factor: 4.891
Authors: Robert D Abbott; G Webster Ross; John E Duda; Chol Shin; Jane H Uyehara-Lock; Kamal H Masaki; Lenore J Launer; Lon R White; Caroline M Tanner; Helen Petrovitch Journal: Neurology Date: 2019-08-30 Impact factor: 9.910
Authors: Eduardo De Pablo-Fernandez; Carmen Tur; Tamas Revesz; Andrew J Lees; Janice L Holton; Thomas T Warner Journal: JAMA Neurol Date: 2017-08-01 Impact factor: 18.302