Suzuki Keisuke, Miyamoto Masayuki, Miyamoto Tomoyuki, Okuma Yasuyuki, Hattori Nobutaka, Kamei Satoshi, Yoshii Fumihito, Utsumi Hiroya, Iwasaki Yasuo, Iijima Mutsumi, Hirata Koichi
Department of Neurology, Dokkyo Medical University, 880-Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Parkinsonism Relat Disord. 2009 Jan;15(1):15-9. doi: 10.1016/j.parkreldis.2008.02.002. Epub 2008 Mar 21.
Depression and nocturnal disturbances are frequent in patients with Parkinson's disease (PD). The aim of this study was to determine the correlation between depressive symptoms and nocturnal disturbances in patients with PD in Japan. The subjects of this multi-center cross-sectional study were 188 patients with PD and 144 age-matched controls who were assessed for nocturnal disturbances by the Parkinson's disease sleep scale (PDSS) and for depressive symptoms by Zung Self-Rating Depression Scale (SDS). Depressive symptoms (SDS score of > or =40) were identified in 122 patients (64.9%). The SDS was significantly higher in PD patients than control subjects. The stepwise regression model identified PDSS (p<0.001) and Unified Parkinson's Disease Rating Scale I (mental state) (p=0.002) as significant determinants of SDS. Stepwise regression analysis identified item 15 (daytime sleepiness) (p=0.002), item 13 (early morning tremor) (p=0.008), item 12 (nocturnal dystonia) (p=0.015), and item 3 (sleep maintenance insomnia) (p=0.026) as significant predictors of SDS. Our results indicated that depressive symptoms in PD correlate significantly with nocturnal disturbances, and that daytime sleepiness, dystonia, tremor and sleep fragmentation are the most common nocturnal disturbances in depressed patients with PD.
抑郁症和夜间睡眠障碍在帕金森病（PD）患者中很常见。本研究的目的是确定日本PD患者抑郁症状与夜间睡眠障碍之间的相关性。这项多中心横断面研究的对象是188例PD患者和144例年龄匹配的对照者，通过帕金森病睡眠量表（PDSS）评估夜间睡眠障碍，通过zung自评抑郁量表（SDS）评估抑郁症状。122例患者（64.9%）被确定有抑郁症状（SDS评分≥40）。PD患者的SDS显著高于对照者。逐步回归模型确定PDSS（p<0.001）和统一帕金森病评定量表I（精神状态）（p=0.002）是SDS的重要决定因素。逐步回归分析确定第15项（白天嗜睡）（p=0.002）、第13项（清晨震颤）（p=0.008）、第12项（夜间肌张力障碍）（p=0.015）和第3项（睡眠维持性失眠）（p=0.026）是SDS的重要预测因素。我们的结果表明，PD患者的抑郁症状与夜间睡眠障碍显著相关，白天嗜睡、肌张力障碍、震颤和睡眠片段化是PD抑郁患者最常见的夜间睡眠障碍。
