Table 3_Knowledge of Parkinson’s disease among non-PD specialists: a web-based survey in South China.docx

BackgroundParkinson’s disease (PD) is a prevalent, disabling neurodegenerative disorder. Early diagnosis and treatment of PD remains challenging due to the absence of definitive diagnostic tests and the non-specificity of its clinical manifestations. Initial consultations for PD symptoms often involve specialists who are not specifically trained in PD. Consequently, it is imperative to assess the general knowledge regarding PD among these specialists to develop optimal educational strategies and enhance early recognition and diagnosis of PD.
MethodsWe developed a questionnaire covering motor symptoms, non-motor symptoms, prodromal symptoms, risk factors and antiparkinsonian medications based on published guidelines, and conducted the web-based survey via Wenjuan xing (https://www.wjx.cn/) among physicians not specializing in PD in Guangdong Province, China.
ResultsA total of 312 respondents, working in 28 diverse departments across 64 hospitals of three different categories, were eligible for data analysis. Notably, 95.2% of the respondents were aware of rest tremor as a motor symptom, yet only 76.9% recognized bradykinesia as a motor symptom. Regarding non-motor symptoms, erectile dysfunction, urinary dysfunction, restless legs, olfactory loss, orthostatic hypotension, rapid eye movement behavior disorder (RBD), lower back pain and diaphoresis, were recognized by less than 50% of the respondents. Additionally, with the exception of subthreshold parkinsonism or abnormal quantitative motor testing, prodromal symptoms such as excessive daytime somnolence, depression (± anxiety), olfactory loss, urinary dysfunction, RBD, and constipation were recognized by 36.5–48.7% of the respondents. First-degree relatives with PD received recognition from 86.5% of the respondents, whereas the remaining risk factors were recognized by 50–60% of the participants. Concerning protective factors for PD, recognition was limited to no more than 23%. Levodopa and dopamine releasers were the most widely recognized antiparkinsonian medications, while the recognition of other medications was below 70%. Variables such as medical degrees, professional titles, hospital categories, and education subjects contributed to statistical differences in PD knowledge.
ConclusionAmong non-PD specialists in south China, current knowledge regarding PD, including non-motor symptoms, prodromal symptoms, risk and protective factors, and antiparkinsonian medications, is relatively inadequate. This necessitates targeted education and training to improve their understanding and recognition of PD.

背景 帕金森病（Parkinson’s disease, PD）是一种常见且致残的神经退行性疾病。由于缺乏明确的诊断检测手段，且其临床表现缺乏特异性，帕金森病的早期诊断与治疗仍面临挑战。因帕金森病症状首次就诊时，接诊的往往是未接受过帕金森病专项培训的专科医师。因此，评估此类医师的帕金森病相关基础知识水平，对于制定最优教育策略、提升帕金森病的早期识别与诊断能力至关重要。
方法 本研究基于已发表的指南开发了涵盖运动症状、非运动症状、前驱症状、危险因素及抗帕金森病药物的调查问卷，并通过问卷星（Wenjuanxing，https://www.wjx.cn/）在中国广东省对非帕金森病专科医师开展了网络问卷调查。
结果 本研究共纳入来自中国广东省64家分属三类不同等级的医院、28个不同科室的312名受访医师进行数据分析。值得注意的是，95.2%的受访者知晓静止性震颤（rest tremor）属于帕金森病运动症状，但仅76.9%的受访者能够识别运动迟缓（bradykinesia）为该病的运动症状。针对非运动症状，仅不足50%的受访者能够识别勃起功能障碍、排尿功能障碍、不宁腿综合征、嗅觉减退、体位性低血压、快速眼动睡眠行为障碍（rapid eye movement behavior disorder, RBD）、腰背痛及多汗。此外，除阈下帕金森症或定量运动检测异常外，日间过度嗜睡、抑郁（伴/不伴焦虑）、嗅觉减退、排尿功能障碍、RBD及便秘等前驱症状的识别率为36.5%~48.7%。86.5%的受访者知晓一级亲属患帕金森病为相关危险因素，其余危险因素的识别率则为50%~60%。关于帕金森病的保护因素，其识别率均不超过23%。左旋多巴（Levodopa）与多巴胺释放剂是最常被识别的抗帕金森病药物，其余药物的识别率均低于70%。医学学位、职称、医院等级及受教育学科等变量，均与帕金森病知识水平的统计学差异相关。
结论 在中国南方的非帕金森病专科医师中，当前对于帕金森病的相关知识（包括非运动症状、前驱症状、危险因素与保护因素及抗帕金森病药物）仍相对匮乏。因此，亟需开展针对性的教育与培训，以提升其对帕金森病的认知与识别能力。