Almeida Leonardo, Ahmed Bilal, Walz Roger, De Jesus Sol, Patterson Addie, Martinez-Ramirez Daniel, Vaillancourt David, Bowers Dawn, Ward Herbert, Okun Michael S, McFarland Nikolaus R
Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States.
Department of Neurology, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Mov Disord Clin Pract. 2017 Mar-Apr;4(2):191-197. doi: 10.1002/mdc3.12382. Epub 2016 Jun 24.
To compare the incidence and prevalence of depressive symptoms in atypical parkinsonian (APD) syndromes versus Parkinson disease (PD).
In a large retrospective patient cohort we analyzed the incidence and prevalence of depressive symptoms using the Beck Depression Inventory (BDI) and evaluated subjects longitudinally on subsequent visits. For individuals who followed in subsequent visits we calculated incidence rates in person-years as a measure of incidence.
We identified 361 patients with APD including Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), Multiple System Atrophy (MSA) and Dementia with Lewy Bodies (DLB), and 2352 PD controls. The mean BDI values were significantly higher in APD (F=14.19, p < 0.001). A significantly higher proportion of APD subjects screened positive for depressive symptoms both at initial and subsequent patient visits (p < 0.001), which appeared to be more severe in the APD subgroups. UPDRS part III and disease duration weakly correlated with depressive symptoms.
Our results suggest that the incidence and prevalence of depressive symptoms are higher in APD and appear also to be more severe than in PD. Depressive symptoms in APD are common and affect patients regardless of disease duration or motor severity.
比较非典型帕金森综合征(APD)与帕金森病(PD)中抑郁症状的发病率和患病率。
在一个大型回顾性患者队列中,我们使用贝克抑郁量表(BDI)分析抑郁症状的发病率和患病率,并在后续随访中对受试者进行纵向评估。对于后续随访的个体,我们计算人年发病率作为发病率的衡量指标。
我们确定了361例APD患者,包括进行性核上性麻痹(PSP)、皮质基底节变性(CBD)、多系统萎缩(MSA)和路易体痴呆(DLB),以及2352例PD对照。APD患者的平均BDI值显著更高(F=14.19,p<0.001)。在初次和后续患者随访中,APD受试者筛查出抑郁症状阳性的比例显著更高(p<0.001),这在APD亚组中似乎更为严重。统一帕金森病评定量表第三部分(UPDRS part III)和病程与抑郁症状的相关性较弱。
我们的结果表明,APD中抑郁症状的发病率和患病率更高,而且似乎比PD更严重。APD中的抑郁症状很常见,且无论病程或运动严重程度如何都会影响患者。