荷蘭研究人員不久前發(fā)現(xiàn)，能否騎自行車可以成為區(qū)別普通帕金森氏癥和非典型帕金森氏癥的簡易方法。在一項試驗中，大部分普通帕金森氏癥患者還能騎自行車，而超過半數(shù)的非典型帕金森氏癥患者喪失了這個能力。

荷蘭奈梅亨大學(xué)的研究人員在新一期英國醫(yī)學(xué)雜志《柳葉刀》（The Lancet）上報告說，他們請100多名帕金森氏癥患者嘗試騎自行車，然后與其實際醫(yī)學(xué)診斷結(jié)果對照。結(jié)果發(fā)現(xiàn)，普通帕金森氏癥患者中只有約4%的人不能騎自行車，而非典型帕金森氏癥患者中有超過50%的人喪失了騎自行車的能力。

與普通帕金森氏癥患者相比，非典型帕金森氏癥患者往往在認知、記憶、動作協(xié)調(diào)能力等方面有更多問題，需要采取不同的治療手段。研究人員說，騎自行車需要良好的平衡性和動作協(xié)調(diào)能力，因此非典型帕金森氏癥患者往往會喪失這一能力。

據(jù)介紹，常規(guī)的帕金森氏癥醫(yī)學(xué)診斷，需要先給患者服用一系列針對普通帕金森氏癥的藥物，觀察其反應(yīng)。如這些藥未顯示出效果，再服用一系列針對非典型帕金森氏癥的藥物，再觀察患者的生理反應(yīng)，最終才能診斷出是那種類型。這一過程繁瑣費事，有時還會耽誤治療時間，而通過騎自行車區(qū)別這個方法雖然并非100%準確，但簡單易行，因此研究人員認為可將“騎車”診斷法與常規(guī)醫(yī)學(xué)診斷配合使用。

帕金森氏癥是一種常見于中老年人的神經(jīng)系統(tǒng)疾病，主要癥狀是震顫、動作遲緩、肌肉僵硬等。

推薦原文出處：

The Lancet   doi:10.1016/S0140-6736(11)60018-4

The “bicycle sign” for atypical parkinsonism

MB Aerts a b, WF Abdo a c, BR Bloem a

Differentiation of Parkinson's disease from atypical parkinsonism is important clinically, for adequate patient counselling, and scientifically, to ascertain proper inclusion in clinical trials. The differential diagnosis remains challenging, even with current clinical insights and modern ancillary investigations.1 Here, we suggest that the answer to one simple question—“Can you still ride a bicycle?”—offers good diagnostic value for separating Parkinson's disease from atypical parkinsonism.

We did a prospective observational study in 156 consecutive patients with parkinsonism, but without a definitive diagnosis. At baseline, patients received a structured interview, comprehensive neurological assessment, and cerebral MRI. The interview included a standard question about whether, when, and why cycling had become impossible. The gold standard was the diagnosis after 3 years, which was based on the clinical follow-up including repeat neurological examination, response to treatment, and MRI. All assessments were done by a single, experienced examiner. All patients gave informed consent, as approved by the local ethics committee.

Before their first disease manifestation, 111 patients rode a bicycle (table). 45 went on to develop a gold-standard diagnosis of Parkinson's disease and 64 a form of atypical parkinsonism. At the time of inclusion (median disease duration 30 months), 34 of the 64 patients with atypical parkinsonism had stopped cycling, as opposed to only two of the 45 patients with Parkinson's disease (sensitivity 52%, specificity 96%; AUC 0·74, 95% CI 0·64—0·83). The loss of cycling abilities was present for all forms of atypical parkinsonism. Regression analysis revealed no significant effect of age, parkinsonism, or ataxia on the ability to cycle, suggesting that this was an independent marker of atypical parkinsonism.

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