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日本帕金森病患者的快感缺失:使用斯奈斯-汉密尔顿愉悦量表的分析

Anhedonia in Japanese patients with Parkinson's disease: analysis using the Snaith-Hamilton Pleasure Scale.

作者信息

Miura Shiroh, Kida Hideki, Nakajima Jouchi, Noda Kazuhito, Nagasato Kunihiko, Ayabe Mitsuyoshi, Aizawa Hisamichi, Hauser Michael, Taniwaki Takayuki

机构信息

Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.

出版信息

Clin Neurol Neurosurg. 2012 May;114(4):352-5. doi: 10.1016/j.clineuro.2011.11.008. Epub 2011 Dec 2.

Abstract

BACKGROUND

Anhedonia, a lowered ability to experience physical or social pleasure, has recently been recognized as a non-motor symptom of Parkinson's disease.

OBJECTIVE

To identify the frequency of anhedonia and the factors influencing hedonic tone in Japanese patients with Parkinson's disease.

PATIENTS AND METHODS

We recruited 86 consecutive outpatients with a clinical diagnosis of PD attending two Japanese hospitals (one university hospital and one community hospital) in February 2010. We used the self-rating Snaith-Hamilton Pleasure Scale (SHAPS) translated into Japanese language from the original English version to assess and quantify hedonic tone as a subjectively experienced phenomenon. We studied the association of anhedonia with the variables age, age at onset, gender, disease duration, disease severity and antiparkinsonian drugs.

RESULTS

Thirty-nine patients (45%) were male and 47 (55%) were female. Mean age was 72.01±9.07 (49-89) years, with mean age at onset of 64.93±11.42 (31-88) years. Mean disease duration was 7.20±5.54 (1-23) years. The mean Hoehn and Yahr scale was 2.76±0.78. The mean SHAPS score of the total sample was 1.19±1.86. The SHAPS score of 14 patients (16.3%) was 3 or more, indicating anhedonia. The mean SHAPS score was lower in patients taking pramipexole (0.58±0.97) than in patients not taking pramipexole (1.57±2.16). Multiple linear regression analysis identified pramipexole as a significant negative influencing factor on the SHAPS score, while disease severity and entacapone treatment were identified as positive influencing factors. The age, onset age, gender, disease duration, and use of pergolide, amantadine, zonisamide, selegiline, anticholinergic agents and droxidopa did not significantly affect the SHAPS score.

CONCLUSION

Anhedonia is not rare non-motor symptom in Japanese patients with Parkinson's disease. This study suggests an anti-anhedonic property of pramipexole.

摘要

背景

快感缺失,即体验身体或社交愉悦的能力降低,最近被认为是帕金森病的一种非运动症状。

目的

确定日本帕金森病患者中快感缺失的发生率以及影响享乐基调的因素。

患者与方法

2010年2月,我们连续招募了86例在两家日本医院(一家大学医院和一家社区医院)就诊、临床诊断为帕金森病的门诊患者。我们使用从原始英文版本翻译成日语的自评斯奈斯-汉密尔顿快感量表(SHAPS)来评估和量化享乐基调这一主观体验现象。我们研究了快感缺失与年龄、发病年龄、性别、病程、疾病严重程度及抗帕金森病药物等变量之间的关联。

结果

39例患者(45%)为男性,47例(55%)为女性。平均年龄为72.01±9.07(49 - 89)岁,平均发病年龄为64.93±11.42(31 - 88)岁。平均病程为7.20±5.54(1 - 23)年。平均霍恩和亚尔分级为2.76±0.78。总样本的平均SHAPS评分为1.19±1.86。14例患者(16.3%)的SHAPS评分达到3分或更高,表明存在快感缺失。服用普拉克索的患者平均SHAPS评分(0.58±0.97)低于未服用普拉克索的患者(1.57±2.16)。多元线性回归分析确定普拉克索是SHAPS评分的显著负性影响因素,而疾病严重程度和恩他卡朋治疗是正性影响因素。年龄、发病年龄、性别、病程以及使用培高利特、金刚烷胺、唑尼沙胺、司来吉兰、抗胆碱能药物和屈昔多巴对SHAPS评分无显著影响。

结论

快感缺失在日本帕金森病患者中是一种并不罕见的非运动症状。本研究提示普拉克索具有抗快感缺失的特性。

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