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帕金森病患者中淡漠与中枢性疲劳感知的关联。

The association of apathy with central fatigue perception in patients with Parkinson's disease.

作者信息

Sáez-Francàs Naia, Hernández-Vara Jorge, Corominas Roso Margarita, Alegre Martín José, Casas Brugué Miguel

机构信息

Psychiatry and Legal Medicine Department, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, CIBERSAM, Passeig Vall d'Hebron 119-129 08035, Barcelona, Spain.

出版信息

Behav Neurosci. 2013 Apr;127(2):237-44. doi: 10.1037/a0031531. Epub 2013 Jan 21.

Abstract

This study was designed to evaluate the association of different apathy conceptual domains with central fatigue perception in Parkinson's disease (PD), taking into consideration other nonmotor symptoms. To this end, 90 consecutive PD patients (66.7% men, mean age 61.44 ± 13.2 years) underwent a comprehensive neurological and psychiatric examination, including the Structured Clinical Interview for DSM-IV, Parkinson Fatigue Scale, Lille Apathy Rating Scale, Hamilton Depression Scale, and State-Trait Anxiety Inventory. A linear regression model was applied to analyze the relationship between apathy and its different conceptual domains with fatigue severity. Thirty-seven (41.1%) patients presented fatigue. Its presence was associated with higher apathy total scores and with 2 of the 4 apathy conceptual domains (less intellectual curiosity and action initiation) with no associations in the emotion and self-awareness apathy domains. Patients with fatigue scored higher in depression (p < .001), anxiety trait (p < .001), and anxiety state (p = .006). Regression analysis identified that Lille Apathy Rating Scale total score (p = .008), intellectual curiosity and action initiation apathy subscores (p = .001 and p = .003) were associated with fatigue severity in patients with right predominant motor symptoms. Sex, age, disease duration, clinical stage, motor complications, prior psychiatric disorders, and treatment were not significantly associated with presence of fatigue. The findings suggest that some apathy-related domains are more frequent in fatigued PD and may be related with fatigue severity.

摘要

本研究旨在评估帕金森病(PD)中不同的淡漠概念领域与中枢性疲劳感知之间的关联,并考虑其他非运动症状。为此,90例连续的PD患者(66.7%为男性,平均年龄61.44±13.2岁)接受了全面的神经和精神检查,包括DSM-IV结构化临床访谈、帕金森疲劳量表、里尔淡漠评定量表、汉密尔顿抑郁量表和状态-特质焦虑量表。应用线性回归模型分析淡漠及其不同概念领域与疲劳严重程度之间的关系。37例(41.1%)患者出现疲劳。疲劳的存在与较高的淡漠总分以及4个淡漠概念领域中的2个(智力好奇心降低和行动启动减少)相关,在情感和自我意识淡漠领域无关联。疲劳患者在抑郁(p<.001)、特质焦虑(p<.001)和状态焦虑(p=.006)方面得分更高。回归分析确定,里尔淡漠评定量表总分(p=.008)、智力好奇心和行动启动淡漠子分数(p=.001和p=.003)与右侧为主的运动症状患者的疲劳严重程度相关。性别、年龄、病程、临床分期、运动并发症、既往精神障碍和治疗与疲劳的存在无显著关联。研究结果表明,一些与淡漠相关的领域在疲劳的PD患者中更为常见,可能与疲劳严重程度有关。

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