Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Psychology, Loyola University of Maryland, Baltimore, MD, USA.
J Parkinsons Dis. 2015;5(2):351-9. doi: 10.3233/JPD-140484.
Apathy and depression are associated with poor cognition in patients with Parkinson's disease (PD). However, the cognitive signature of each syndrome is not well understood. The cognitive consequences of having apathy or depression, versus apathy and depression, are also unclear.
This study investigated the unique and combined effects of apathy and depression on cognition in PD patients.
PD patients were identified from a clinical research database as having self-reported apathy (n = 21), depression (n = 11), or both (n = 43). PD patients without apathy or depression served as the Control group (n = 49). The groups were of similar age, education, disease severity, age of symptom onset, and medication status. A multivariate analysis of variance (MANOVA) compared the groups on 17 neuropsychological test scores in the domains of attention, motor and psychomotor speed, construction, language, episodic memory, and executive functioning.
There was a significant overall effect of group: F(18,276) = 2.12, p = 0.006, ηp2=0.12. Univariate analyses and planned contrasts revealed medium-sized effects distinguishing only the control group and the group with both apathy and depression (ηp2=0.06-0.12) on measures of verbal fluency and manual, processing, and psychomotor speed.
PD patients with apathy alone or depression alone did not perform worse than PD controls on neuropsychological tests. Patients with apathy and depression performed worse than controls, but only on speed-based measures. This suggests that apathy and depression are associated with the same or similar circuits as those of cognitive and motor speed.
淡漠和抑郁与帕金森病（PD）患者的认知能力下降有关。然而，每种综合征的认知特征尚不清楚。淡漠和抑郁，与同时存在淡漠和抑郁相比，它们对认知的影响也不明确。
本研究旨在探讨淡漠和抑郁对 PD 患者认知的单独和共同影响。
从临床研究数据库中确定 PD 患者，这些患者有报告的淡漠（n=21）、抑郁（n=11）或两者（n=43）。没有淡漠或抑郁的 PD 患者作为对照组（n=49）。这些组在年龄、教育程度、疾病严重程度、症状出现年龄和药物治疗状况方面相似。使用多元方差分析（MANOVA）比较了注意力、运动和精神运动速度、结构、语言、情景记忆和执行功能等领域的 17 项神经心理学测试得分。
存在显著的组间差异：F(18,276)=2.12，p=0.006，ηp2=0.12。单变量分析和计划对比显示，仅控制组和同时存在淡漠和抑郁的组在语言流畅性和手动、处理和精神运动速度方面有中等大小的差异（ηp2=0.06-0.12）。
仅有淡漠或抑郁的 PD 患者在神经心理学测试中表现并不比 PD 对照组差。同时存在淡漠和抑郁的患者表现不如对照组，但仅在基于速度的测试中表现如此。这表明淡漠和抑郁与认知和运动速度的相同或相似的大脑回路有关。
