Department of Psychology, University of Kentucky, Lexington, KY, United States; Department of Neurology, Baylor College of Medicine, Houston, TX, United States.
Department of Psychology, University of Kentucky, Lexington, KY, United States.
J Psychosom Res. 2018 Aug;111:42-49. doi: 10.1016/j.jpsychores.2018.05.007. Epub 2018 May 21.
Parkinson's disease (PD) is a neurodegenerative disorder involving the basal ganglia, resulting in motor and extra-motor deficits. These extra-motor deficits may be reflective of a self-regulatory deficit impacting patients' ability to regulate cognitive processes, thoughts, behaviors, and emotions. There is a need to further examine the prevalence and range of self-regulation (SR) and executive functioning (EF) impairments in PD. This study sought to do so in a sample of patients with PD (N = 31) who underwent deep brain stimulation (DBS) surgery for motor symptom treatment. Patients completed measures indicative of SR and EF including neurocognitive tests, heart rate variability (HRV), and self-report questionnaires to examine these constructs in PD. The highest prevalence of impairments were observed for total impulse control disorder (ICD) symptoms (74%), depressive symptoms (48%), verbal fluency (phonemic: 39%; semantic: 36%), mental flexibility (32%), and self-reported SR impairments (Metacognition: 32%; Behavioral Regulation: 29%). Correlations among theoretically related constructs (i.e., SR, EF) were modest and variable; challenging the idea that SR is a unitary construct for which different domains depend on a common resource. In patients with PD post-DBS, higher resting HRV, thought to be indicative of better autonomic functioning, was linked to better EF in some instances but not others and not significantly associated with self-report SR. Overall, patients with PD exhibit various extra-motor deficits, ranging from subtle to severe. Health care professionals working with patients with PD should recognize the presence of extra-motor deficits, particularly ICDs, and obstacles that might arise from such impairments in patients' daily lives.
帕金森病（PD）是一种涉及基底神经节的神经退行性疾病，导致运动和运动外缺陷。这些运动外缺陷可能反映了自我调节缺陷，影响患者调节认知过程、思维、行为和情绪的能力。需要进一步研究 PD 患者自我调节（SR）和执行功能（EF）损伤的患病率和范围。本研究旨在对接受深部脑刺激（DBS）手术治疗运动症状的 PD 患者（N=31）进行研究。患者完成了表明 SR 和 EF 的措施，包括神经认知测试、心率变异性（HRV）和自我报告问卷，以检查 PD 中的这些结构。观察到最高的损伤发生率是冲动控制障碍（ICD）症状的总发生率（74%）、抑郁症状（48%）、语言流畅性（语音：39%；语义：36%）、心理灵活性（32%）和自我报告的 SR 损伤（元认知：32%；行为调节：29%）。理论上相关结构（即 SR、EF）之间的相关性适度且可变；这挑战了 SR 是一个单一结构的观点，不同的领域取决于共同的资源。在接受 DBS 治疗后的 PD 患者中，被认为是自主功能更好的静息心率变异性（HRV）与某些情况下的 EF 更好相关，但在其他情况下则不相关，与自我报告的 SR 也没有显著相关。总体而言，PD 患者表现出各种运动外缺陷，从轻微到严重不等。与 PD 患者合作的医疗保健专业人员应认识到运动外缺陷的存在，特别是 ICDs，以及这些缺陷可能在患者日常生活中产生的障碍。
