Bottini Bonfanti Alejandro, Etcheverry José Luis, Persi Gabriel G, Zezza Héctor, Starkstein Sergio, Gatto Emilia M
Instituto de Neurología de Buenos Aires (INBA).
Medicina (B Aires). 2009;69(2):253-8.
Apathy is one of the most prominent non-motor symptoms in Parkinson Disease (PD). Its range of prevalence in PD has been estimated in 20 to 45%. The objective of this work is to assess the prevalence of apathy in PD patients, and its relation with depression and executive function impairment. Fifty seven PD patients (54% women), mean age of 68.7 years, and a disease duration of 7.5 years from diagnosis were included. We used the following scales: UPDRS, Hoehn & Yahr, Mini Mental State Examination, the 14-item Apathy Scale (AS), the Beck Depression Inventory, and Trail Making Test versions A and B (TMT), and Parkinson's Disease Quality of Life Questionnaire (PDQL). Apathy was identified in 31.6%; apathy without depression was present in 33.3% of patients. The TMT A and B were abnormal in 66.7% and 83.3% respectively of the apathetic patients vs. 46.2% and 61.5% in non-apathetic patients. Quality of life was impaired in apathetic patients. In our PD sample apathy is highly prevalent, has a great impact on quality of life and it may occur in the absence of depression. The alterations of TMT in apathetic patients contributes to suggest a positive relationship between apathy and the impairment of executive function secondary to the involvement of frontal-subcortical circuits.
冷漠是帕金森病（PD）最突出的非运动症状之一。其在PD中的患病率估计在20%至45%之间。这项研究的目的是评估PD患者中冷漠的患病率及其与抑郁和执行功能障碍的关系。纳入了57例PD患者（54%为女性），平均年龄68.7岁，自诊断起疾病病程为7.5年。我们使用了以下量表：统一帕金森病评定量表（UPDRS）、 Hoehn & Yahr分级、简易精神状态检查表、14项冷漠量表（AS）、贝克抑郁量表、A和B型连线测验（TMT）以及帕金森病生活质量问卷（PDQL）。31.6%的患者被确定存在冷漠；33.3%的患者存在无抑郁的冷漠。在冷漠患者中，TMT A和B异常的分别占66.7%和83.3%，而非冷漠患者中分别为46.2%和61.5%。冷漠患者的生活质量受损。在我们的PD样本中，冷漠非常普遍，对生活质量有很大影响，且可能在无抑郁的情况下发生。冷漠患者中TMT的改变提示冷漠与额叶 - 皮质下回路受累继发的执行功能障碍之间存在正相关。
