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进行性核上性麻痹患者的执行功能障碍、行为改变和生活质量。

Executive dysfunction, behavioral changes and quality of life in Chinese patients with progressive supranuclear palsy.

机构信息

Department of Neurology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.

Department of Neurology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.

出版信息

J Neurol Sci. 2017 Sep 15;380:182-186. doi: 10.1016/j.jns.2017.07.033. Epub 2017 Jul 24.

Abstract

OBJECTIVES

To explore the prevalence and clinical correlates of executive impairment and behavioral changes, and the determinants of health-related quality of life (HRQoL) in Chinese patients with progressive supranuclear palsy (PSP).

METHODS

This cross-sectional study included 52 patients with PSP. The frontal assessment battery (FAB) was used to assess executive function, while the frontal behavioral inventory (FBI) and Neuropsychiatry Inventory (NPI) were used to assess behavioral changes. The HRQoL of PSP patients was assessed using the Parkinson's disease questionnaire-39 (PDQ-39). The stepwise multiple regression model was use to explore their related factors.

RESULTS

Executive deficits were detected in forty patients (76.9%), and fifty patients (96.2%) displayed varied degrees of frontal behavioral changes. FAB score was associated with Montreal Cognitive Assessment score (β=0.620, P<0.001) and Unified Parkinson's disease Rating Scale (UPDRS) III score (β=-0.238, P=0.025). FBI score was associated with FAB score (β=-0.311, P=0.005) and UPDRS III score (β=0.251, P=0.018). PDQ-39 score was associated with FAB score (β=-0.324, P=0.005), UPDRS III score (β=0.306, P=0.008), and Hamilton Depression Rating Scale score (β=0.353, P=0.001).

CONCLUSIONS

Executive deficits and behavioral changes are common in Chinese PSP patients. Executive functions are associated with disease severity. Patients with executive dysfunction and more severe disease disability are likely to exhibit frontal behavioral abnormalities. Executive dysfunction, disease severity and depression exert an impact on the HRQoL of PSP patients.

摘要

目的

探索中国进行性核上性麻痹(PSP)患者执行功能障碍和行为改变的流行情况及临床相关性,以及健康相关生活质量(HRQoL)的决定因素。

方法

本横断面研究纳入了 52 例 PSP 患者。采用额叶评估量表(FAB)评估执行功能,采用额叶行为量表(FBI)和神经精神问卷(NPI)评估行为改变。采用帕金森病问卷 39 项(PDQ-39)评估 PSP 患者的 HRQoL。采用逐步多元回归模型探讨其相关因素。

结果

40 例(76.9%)患者存在执行功能障碍,50 例(96.2%)患者存在不同程度的额叶行为改变。FAB 评分与蒙特利尔认知评估量表评分(β=0.620,P<0.001)和统一帕金森病评定量表(UPDRS)Ⅲ评分(β=-0.238,P=0.025)呈正相关。FBI 评分与 FAB 评分(β=-0.311,P=0.005)和 UPDRS Ⅲ评分(β=0.251,P=0.018)呈负相关。PDQ-39 评分与 FAB 评分(β=-0.324,P=0.005)、UPDRS Ⅲ评分(β=0.306,P=0.008)和汉密尔顿抑郁量表评分(β=0.353,P=0.001)呈负相关。

结论

中国 PSP 患者普遍存在执行功能障碍和行为改变。执行功能与疾病严重程度相关。执行功能障碍和疾病严重程度较高的患者更可能出现额叶行为异常。执行功能障碍、疾病严重程度和抑郁对 PSP 患者的 HRQoL 有影响。

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