Division of Neurology, The First Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
Geriatr Gerontol Int. 2011 Jul;11(3):275-81. doi: 10.1111/j.1447-0594.2010.00678.x. Epub 2011 Jan 17.
Anhedonia has been proposed as a specific mood disorder related to the dopaminergic nerve dysfunction seen in Parkinson's disease (PD). This study examined hedonic tone in patients with PD using the Snaith-Hamilton Pleasure Scale (SHAPS) and investigated the associations with depressive mood by the Self-Rating Questionnaire for Depression (SRQ-D).
This study examined 100 patients with PD and 111 age-matched controls (C2) recruited from 300 healthy subjects (C1) to compare the frequency of anhedonia and to clarify whether anhedonia in PD is associated with depression and anti-Parkinson medication.
Forty-six percent of PD patients revealed possible/probable depression and 10 patients (10%) with PD showed anhedonia as compared to 3.3% in C1 and 2.7% in C2. The reduction in hedonic tone was related to depression in PD. Among 10 PD patients with anhedonia, seven were in anhedonia with depression and three were in anhedonia without depression. There was no sex difference in anhedonia and depression. No patients treated with pramipexole showed anhedonia but also the highest proportion of normal hedonic tone was found in patients treated with pramipexole among PD patients. In analysis of each SHAPS item, no significant difference was seen on social interaction scores in contrast to the significant reduction of interest/pastimes and sensory experience and food/drink scores between PD patients and C1/C2.
Anhedonia may overlap depressive syndrome but some PD patients without depression presented anhedonia. Pramipexole could maintain hedonic tone. The PD patients could enjoy attracting attention and wish to do things helpful for others.
快感缺失被认为是一种与帕金森病（PD）中多巴胺能神经功能障碍相关的特定心境障碍。本研究使用 Snaith-Hamilton 快感量表（SHAPS）评估 PD 患者的快感水平，并通过抑郁自评问卷（SRQ-D）调查与抑郁情绪的关联。
本研究共纳入 100 名 PD 患者和 111 名年龄匹配的对照者（C2），从 300 名健康受试者（C1）中进行招募，以比较快感缺失的频率，并阐明 PD 中的快感缺失是否与抑郁和抗帕金森病药物有关。
46%的 PD 患者出现可能/肯定的抑郁，10 名 PD 患者（10%）出现快感缺失，而 C1 为 3.3%，C2 为 2.7%。快感缺失与 PD 中的抑郁有关。在 10 名出现快感缺失的 PD 患者中，7 名同时存在抑郁和快感缺失，3 名仅存在快感缺失而无抑郁。快感缺失和抑郁在性别上无差异。普拉克索治疗的患者中没有出现快感缺失，但在 PD 患者中，普拉克索治疗组的快感正常比例最高。在对每个 SHAPS 项目的分析中，与 C1/C2 相比，社会互动评分无显著差异，但兴趣/娱乐和感官体验以及食物/饮料评分显著降低。
快感缺失可能与抑郁综合征重叠，但一些无抑郁的 PD 患者也出现了快感缺失。普拉克索可能维持快感水平。PD 患者可能享受引起注意和希望做对他人有帮助的事情。
