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与接受脑深部刺激治疗的帕金森病患者身体健康相关生活质量相关的变量。

Variables associated with physical health-related quality of life in Parkinson's disease patients presenting for deep brain stimulation.

作者信息

Diaz Alexandre Paim, Freitas Fernando Cini, de Oliveira Thais Maria Emília, da Silva Areas Fernando Zanela, Schwarzbold Marcelo Liborio, Debona Rodrigo, Nunes Jean Costa, Guarnieri Ricardo, Martinez-Ramirez Daniel, Prediger Rui Daniel, Wagle Shukla Aparna, Linhares Marcelo Neves, Walz Roger

机构信息

Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive Unit 24, New York, NY, 10032, USA.

Centro de Ciências da Saúde (CCS), Centro de Neurociências Aplicadas (CeNAp), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.

出版信息

Neurol Sci. 2016 Nov;37(11):1831-1837. doi: 10.1007/s10072-016-2681-z. Epub 2016 Jul 25.

Abstract

Deep brain stimulation (DBS) benefits Parkinson's disease (PD) patient's quality of life specially in domains as mobility, activities of daily living (ADL) and bodily discomfort (BD), but little is known about the variables associated with these HRQOL domains in patients presenting for DBS. The objective is to evaluate variables associated with of HRQOL in a Brazilian sample of PD patients presenting for DBS treatment, specifically in the domains related with motor symptoms. In a cross-sectional study of 59 PD patients evaluated at outpatient Unit for Movement Disorders, multiple linear regression analysis was performed to identify independent variables associated with mobility, ADL and BD domains of the 39-item Parkinson's disease questionnaire (PDQ-39). UPDRS III "on" scores, duration of the disease, age, presence of comorbidities and anxiety and depressive symptoms quantified by hospital anxiety and depression scale (HADS), were the independent variables. In our results, HADS scores were independently associated to mobility domain: β coefficient 1.36 (95 % CI 0.55-2.15) and BD domain: β coefficient 1.57 (95 % CI 0.67-2.48). UPDRS III "on" scores were independently associated to mobility domain: 0.42 (95 % CI 0.03-0.81). The model of each multiple linear regression analysis explains 25 % of the mobility domain variability (p < 0.01) and 24 % of the BD domain variability (p < 0.01). Psychiatric symptoms were at least as relevant to quality of life as motor symptoms in PD patients presenting for DBS treatment. The effect of treating these psychiatric symptoms on patients' HRQOL deserves further investigation.

摘要

深部脑刺激(DBS)有益于帕金森病(PD)患者的生活质量,尤其在运动能力、日常生活活动(ADL)和身体不适(BD)等方面,但对于接受DBS治疗的患者中与这些健康相关生活质量(HRQOL)领域相关的变量知之甚少。目的是评估巴西接受DBS治疗的PD患者样本中与HRQOL相关的变量,特别是在与运动症状相关的领域。在对59例在运动障碍门诊接受评估的PD患者进行的横断面研究中,进行了多元线性回归分析,以确定与39项帕金森病问卷(PDQ-39)的运动能力、ADL和BD领域相关的独立变量。独立变量包括统一帕金森病评定量表(UPDRS)III期“开”期评分、病程、年龄、合并症的存在以及通过医院焦虑抑郁量表(HADS)量化的焦虑和抑郁症状。在我们的结果中,HADS评分与运动能力领域独立相关:β系数为1.36(95%置信区间0.55-2.15),与BD领域独立相关:β系数为1.57(95%置信区间0.67-2.48)。UPDRS III期“开”期评分与运动能力领域独立相关:0.42(95%置信区间0.03-0.81)。每个多元线性回归分析模型解释了运动能力领域变异性的25%(p<0.01)和BD领域变异性的24%(p<0.01)。在接受DBS治疗的PD患者中,精神症状与生活质量的相关性至少与运动症状一样。治疗这些精神症状对患者HRQOL的影响值得进一步研究。

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