Marino S E, Meador K J, Loring D W, Okun M S, Fernandez H H, Fessler A J, Kustra R P, Miller J M, Ray P G, Roy A, Schoenberg M R, Vahle V J, Werz M A
Experimental and Clinical Pharmacology, University of Minnesota, 717 Delaware Street SE, Room 517, Minneapolis, MN 55414, USA.
Epilepsy Behav. 2009 Mar;14(3):459-64. doi: 10.1016/j.yebeh.2008.12.007. Epub 2009 Jan 6.
Clinicians monitor cognitive effects of drugs primarily by asking patients to describe their side effects. We examined the relationship of subjective perception of cognition to mood and objective cognitive performance in healthy volunteers and neurological patients.
Three separate experiments used healthy adults treated with lamotrigine (LTG) and topiramate (TPM), adults with epilepsy on LTG or TPM, and patients with idiopathic Parkinson's disease. Correlations were calculated for change scores on and off drugs in the first two experiments and for the single assessment in Experiment 3.
Across all three experiments, significant correlations were more frequent (chi(2)=259, P < or = 0.000) for mood versus subjective cognitive perception (59%) compared with subjective versus objective cognition (2%) and mood versus objective cognitive performance (2%).
Subjective perception of cognitive effects is related more to mood than objective performance. Clinicians should be aware of this relationship when assessing patients' cognitive complaints.
临床医生主要通过询问患者来描述药物的副作用,以此监测药物对认知的影响。我们研究了健康志愿者和神经疾病患者认知的主观感受与情绪及客观认知表现之间的关系。
三项独立实验分别纳入了接受拉莫三嗪(LTG)和托吡酯(TPM)治疗的健康成年人、正在服用LTG或TPM的癫痫成年患者以及特发性帕金森病患者。在前两项实验中计算了用药和停药时的变化分数之间的相关性,在实验3中计算了单次评估的相关性。
在所有三项实验中,与主观认知与客观认知(2%)以及情绪与客观认知表现(2%)相比,情绪与主观认知感受之间的显著相关性更为常见(χ² = 259,P ≤ 0.00)(59%)。
认知效果的主观感受与情绪的关系比与客观表现的关系更为密切。临床医生在评估患者的认知主诉时应注意这种关系。