Sousa Mário, Moreira Fradique, Jesus-Ribeiro Joana, Marques Inês, Cunha Flávia, Canário Nádia, Freire António, Januário Cristina
Coimbra Hospital and University Centre, Neurology Department, Coimbra, Portugal.
Faculty of Medicine of the University of Coimbra, Coimbra, Portugal.
Eur Neurol. 2018;79(1-2):13-20. doi: 10.1159/000481981. Epub 2017 Nov 13.
BACKGROUND/AIMS: Apathy is one of the most frequent, disabling and difficult-to-treat symptoms that show up in many neurodegenerative disorders. The aim of this study was to assess and compare apathy profile in Parkinson's and Huntington's patients using the same comprehensive instruments to measure apathy, cognition and depressive symptoms.
We consecutively assessed Parkinson's disease (PD) and Huntington's disease (HD) patients recruited from a Movement Disorders Unit. In all patients, information related to demographics, clinical data, motor score (Movement Disorders Society-Unified Parkinson Disease Rating Scale; Unified Huntington Disease Rating Scale), cognition (Montreal Cognitive Assessment scale), depressive symptoms (Beck Depression Inventory II) and apathy (Apathy Evaluation Scale - clinical version) was collected. Patients with dementia or major depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised criteria were excluded from the study.
Seventy-five patients were enrolled, 45 with PD and 30 with HD. Apathy was present in 42.5% of PD patients and 51.7% of HD patients. In PD patients, apathy was associated with motor score, shorter duration of disease, lower dose of levodopa equivalent daily dose and depressive symptomatology, whereas in HD patients, apathy was related to disease duration, motor score and cognitive impairment.
We found a similar prevalence of apathy in PD and HD patients but with different clinical correlations and different apathy domains involved, and this may warrant the development of different therapeutic approaches.
背景/目的：冷漠是许多神经退行性疾病中最常见、致残且难以治疗的症状之一。本研究的目的是使用相同的综合工具来测量冷漠、认知和抑郁症状，以评估和比较帕金森病和亨廷顿病患者的冷漠特征。
我们连续评估了从运动障碍科招募的帕金森病（PD）和亨廷顿病（HD）患者。在所有患者中，收集了与人口统计学、临床数据、运动评分（运动障碍协会统一帕金森病评定量表；统一亨廷顿病评定量表）、认知（蒙特利尔认知评估量表）、抑郁症状（贝克抑郁量表第二版）和冷漠（冷漠评估量表 - 临床版）相关的信息。根据《精神障碍诊断与统计手册》第四版修订标准诊断为痴呆或重度抑郁的患者被排除在研究之外。
共纳入75例患者，其中45例为PD患者，30例为HD患者。42.5%的PD患者和51.7%的HD患者存在冷漠症状。在PD患者中，冷漠与运动评分、疾病病程较短、左旋多巴等效日剂量较低以及抑郁症状相关，而在HD患者中，冷漠与疾病病程、运动评分和认知障碍有关。
我们发现PD和HD患者中冷漠的患病率相似，但临床相关性和涉及的冷漠领域不同，这可能需要开发不同的治疗方法。
