Torny F, Lacoste M, Videaud H, Chouly M, Parveau M-C, Couratier P
CMRR Limousin, 15, rue du Docteur-Raymond-Marcland, 87025 Limoges cedex, France.
Rev Neurol (Paris). 2009 Nov;165(11):911-5. doi: 10.1016/j.neurol.2009.02.001. Epub 2009 Mar 25.
Quality of life (QoL) in multiple system atrophy (MSA) is thought to be poorer than in Parkinson's disease (PD), primarily because of motor impairment, autonomic dysfunction and depression. The aim of the study was to investigate QoL in 10 patients with probable MSA (parkinsonian subtype) compared with 10 PD patients matched for motor disability on UPDRS III motor score.
All patients were ambulatory and non-demented. Mean durations of disease in MSA and PD patients were respectively 3.6 and 9.0 years. QoL was assessed using the SF-36 health-related questionnaire and a life satisfaction visual analogue scale. Patients were also evaluated for cognitive function (Mattis Dementia Rating Scale [Mattis DRS], Wisconsin Card Sorting Test [WCST], Stroop, Fluencies), depression (Beck Depression Inventory-II [BDI-II]), apathy (Modified Apathy Evaluation Scale) and were screened for non-motor symptoms (NMS Quest).
The only difference in QoL between MSA and PD patients matched for motor disability was that the SF-36 vitality subscore was more impaired in MSA and negatively correlated with interference index on Stroop word colour testing. Depression and non-motor symptoms were associated with poorer QoL in both groups. Among MSA patients, cognitive impairment (Stroop interference index) and apathy also had a negative impact.
There was no major difference in QoL between MSA and PD patients matched for motor disability with a disease duration about 5 years longer. The SF-36 vitality subscore was more impaired in MSA and associated with interference sensitivity.
多系统萎缩(MSA)患者的生活质量(QoL)被认为比帕金森病(PD)患者更差,主要是由于运动障碍、自主神经功能障碍和抑郁。本研究的目的是调查10例可能为MSA(帕金森亚型)患者的生活质量,并与10例在统一帕金森病评定量表第三部分(UPDRS III)运动评分上运动功能障碍程度相匹配的PD患者进行比较。
所有患者均能行走且无痴呆。MSA和PD患者的平均病程分别为3.6年和9.0年。使用SF - 36健康相关问卷和生活满意度视觉模拟量表评估生活质量。还对患者进行了认知功能评估(马蒂斯痴呆评定量表[Mattis DRS]、威斯康星卡片分类测验[WCST]、斯特鲁普测验、流畅性测试)、抑郁评估(贝克抑郁量表第二版[BDI - II])、淡漠评估(改良淡漠评估量表),并筛查非运动症状(NMS Quest)。
在运动功能障碍程度相匹配的MSA和PD患者中,生活质量的唯一差异在于,MSA患者的SF - 36活力子量表受损更严重,且与斯特鲁普字色测试的干扰指数呈负相关。抑郁和非运动症状在两组中均与较差的生活质量相关。在MSA患者中,认知障碍(斯特鲁普干扰指数)和淡漠也有负面影响。
在病程相差约5年且运动功能障碍程度相匹配的MSA和PD患者中,生活质量没有重大差异。MSA患者的SF - 36活力子量表受损更严重,且与干扰敏感性相关。