Cubo E, Bernard B, Leurgans S, Raman R
Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Clin Neuropharmacol. 2000 Nov-Dec;23(6):331-4. doi: 10.1097/00002826-200011000-00006.
The objective of this study was to define risk factors for depression in patients with idiopathic Parkinson's disease (PD) and to evaluate the correlation of depression with cognitive function and the primary domains of parkinsonian motor dysfunction tremor, bradykinesia, rigidity, gait and balance impairment. The risk factors for depression in patients with PD remain controversial. Several investigators have demonstrated a significant association between cognitive dysfunction and depression, but motoric and disease variables can confound this evaluation and have shown an inconsistent relation to depression. A consecutive series of 88 patients with PD were examined using the motor subscale of the Unified Parkinson's Disease Rating Scale (UPDRSm), Hoehn-Yahr stage (HY), and Hamilton Rating Scale for Depression (HRSD). Major depression was diagnosed according to the criteria in the Diagnostic and Statistic Manual of Mental Disorders, 4th edition. Gender, age, handedness, PD duration, side of PD onset, motor fluctuations, UPDRSm total score, daily Levodopa dose, and Mini-Mental State Examination score (MMSE) were analyzed using multivariate and univariate logistic regression, Fisher's Exact test, and Pearson correlations. Major depression was diagnosed in 12 patients (7.3%). Low MMSE score, axial bradykinesia, gait and balance impairment were strongly significant predictors of depression. In conclusion, depression and physical function are important factors impairing the quality of life for patients with PD, and regular depression screening and treatment should focus on patients with PD who have cognitive impairment, high axial bradykinesia, gait and balance impairment.
本研究的目的是确定特发性帕金森病（PD）患者发生抑郁的危险因素，并评估抑郁与认知功能以及帕金森病运动功能障碍的主要方面（震颤、运动迟缓、强直、步态和平衡障碍）之间的相关性。PD患者发生抑郁的危险因素仍存在争议。一些研究人员已证实认知功能障碍与抑郁之间存在显著关联，但运动和疾病变量可能会混淆这一评估，并且它们与抑郁的关系并不一致。使用统一帕金森病评定量表（UPDRSm）的运动分量表、Hoehn-Yahr分期（HY）和汉密尔顿抑郁评定量表（HRSD）对连续的88例PD患者进行了检查。根据《精神疾病诊断与统计手册》第4版中的标准诊断重度抑郁。使用多变量和单变量逻辑回归、Fisher精确检验以及Pearson相关性分析了性别、年龄、利手、PD病程、PD起病侧、运动波动、UPDRSm总分、每日左旋多巴剂量和简易精神状态检查表评分（MMSE）。12例患者（7.3%）被诊断为重度抑郁。低MMSE评分、轴性运动迟缓、步态和平衡障碍是抑郁的强烈显著预测因素。总之，抑郁和身体功能是损害PD患者生活质量的重要因素，定期的抑郁筛查和治疗应关注有认知障碍、高度轴性运动迟缓、步态和平衡障碍的PD患者。
