Dujardin Kathy, Sockeel Pascal, Devos David, Delliaux Marie, Krystkowiak Pierre, Destée Alain, Defebvre Luc
Neurology and Movement Disorders Unit, EA2683, Faculty of Medicine and Lille University Hospital, Lille, France.
Mov Disord. 2007 Apr 30;22(6):778-84. doi: 10.1002/mds.21316.
The objective of this study was to use the Lille Apathy Rating Scale to assess apathy in a large population of Parkinson's disease (PD) patients and identify several different apathy profiles. One hundred fifty-nine patients with probable PD and 58 healthy controls participated in the study. Apathy was assessed using the Lille Apathy Rating Scale. Motor, cognitive, and depressive symptoms were rated on standardized scales. Data were analyzed using linear regression and multivariate analyses of variance. Thirty-two percent of the PD patients were classified as apathetic. Apathy was more frequent in patients with dementia. The four apathy dimensions contributed differently to the overall severity of the apathetic condition. Action initiation and intellectual curiosity had a marked influence. Linear regression analysis revealed that the apathy level was mainly determined by cognitive impairment, not associated with the severity of motor symptoms, and only associated with the apathy subcomponent of the Montgomery and Asberg Depression Rating Scale. Apathy is highly prevalent in PD patients. Apathy profiles vary according to the clinical presentation of PD. The high prevalence of apathy in PD suggests the involvement of frontal-subcortical circuits. Although the neurochemical substrate of apathy remains poorly characterized, the strong link between apathy and cognitive impairment observed in several studies suggests the participation of nondopaminergic circuits.
本研究的目的是使用里尔淡漠评定量表评估大量帕金森病（PD）患者的淡漠情况，并识别几种不同的淡漠特征。159例疑似PD患者和58名健康对照参与了该研究。使用里尔淡漠评定量表评估淡漠情况。运动、认知和抑郁症状采用标准化量表进行评分。数据采用线性回归和多变量方差分析进行分析。32%的PD患者被归类为淡漠型。痴呆患者中淡漠更为常见。四个淡漠维度对淡漠状态的总体严重程度的影响各不相同。行动启动和求知欲有显著影响。线性回归分析显示，淡漠水平主要由认知障碍决定，与运动症状的严重程度无关，仅与蒙哥马利-阿斯伯格抑郁评定量表的淡漠子成分相关。淡漠在PD患者中非常普遍。淡漠特征根据PD的临床表现而有所不同。PD中淡漠的高患病率提示额叶-皮质下环路受累。尽管淡漠的神经化学底物仍未得到很好的描述，但多项研究中观察到的淡漠与认知障碍之间的紧密联系提示非多巴胺能环路的参与。
