Leentjens Albert F G, Dujardin Kathy, Marsh Laura, Martinez-Martin Pablo, Richard Irene H, Starkstein Sergio E, Weintraub Daniel, Sampaio Cristina, Poewe Werner, Rascol Oliver, Stebbins Glenn T, Goetz Christopher G
Department of Psychiatry, Maastricht University Hospital, Maastricht, The Netherlands.
Mov Disord. 2008 Oct 30;23(14):2004-14. doi: 10.1002/mds.22229.
Apathy is a common condition in Parkinson's disease (PD) and is generally defined as a lack of motivation. It is associated with more severe cognitive dysfunction and a decrease in activities of daily living (ADL) performance. Anhedonia, the inability to experience pleasure, can be a symptom of both depressive and apathetic syndromes. The Movement Disorder Society (MDS) commissioned a task force to assess the clinimetric properties of apathy and anhedonia scales in PD patients. A systematic literature review was conducted to identify scales that have either been validated or used in PD patients. Apathy scales identified for review include the Apathy Evaluation Scale (AES), the Apathy Scale (AS), the Apathy Inventory (AI), and the Lille Apathy Rating Scale (LARS). In addition, item 4 (motivation/initiative) of the Unified Parkinson's Disease Rating Scale (UPDRS) and item 7 (apathy) of the Neuropsychiatric Inventory (NPI) were included. Anhedonia scales identified for review were the Snaith-Hamilton Pleasure Scale (SHAPS) and the Chapman scales for physical and social anhedonia. Only the AS is classified as "recommended" to assess apathy in PD. Although item 4 of the UPDRS also meets the criteria to be classified as recommended, it should be considered for screening only because of the obvious limitations of a single item construct. For the assessment of anhedonia, only the SHAPS meets the criteria of "Suggested." Information on the validity of apathy and anhedonia scales is limited because of the lack of consensus on diagnostic criteria for these conditions.
冷漠是帕金森病（PD）的常见症状，通常被定义为缺乏动力。它与更严重的认知功能障碍以及日常生活活动（ADL）表现下降有关。快感缺失，即无法体验愉悦，可能是抑郁和冷漠综合征的症状。运动障碍协会（MDS）委托一个特别工作组评估PD患者冷漠和快感缺失量表的计量学特性。进行了系统的文献综述，以确定已在PD患者中验证或使用的量表。确定用于综述的冷漠量表包括冷漠评估量表（AES）、冷漠量表（AS）、冷漠量表（AI）和里尔冷漠评定量表（LARS）。此外，统一帕金森病评定量表（UPDRS）的第4项（动机/主动性）和神经精神科问卷（NPI）的第7项（冷漠）也包括在内。确定用于综述的快感缺失量表是斯奈斯 - 汉密尔顿愉悦量表（SHAPS）以及查普曼身体和社交快感缺失量表。在PD患者中，仅AS被归类为“推荐”用于评估冷漠。尽管UPDRS的第4项也符合被归类为推荐的标准，但由于单项结构存在明显局限性，仅应将其用于筛查。对于快感缺失的评估，只有SHAPS符合“建议”标准。由于对这些病症的诊断标准缺乏共识，冷漠和快感缺失量表的有效性信息有限。
