Maggi Gianpaolo, D'Iorio Alfonsina, Di Meglio Diana, Vinciguerra Annarita, Amboni Marianna, Vitale Carmine, Santangelo Gabriella
Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy.
Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
J Neural Transm (Vienna). 2020 Jun;127(6):893-898. doi: 10.1007/s00702-020-02179-x. Epub 2020 Apr 1.
Anxiety is a common neuropsychiatric symptom in Parkinson's disease (PD). Until now, anxiety has been consistently related to cognitive deficits and severity of motor symptoms, whereas the association between anxiety and motor subtypes (TD-PD, tremor dominant and PIGD-PD, postural instability/gait disturbances dominant) revealed contrasting results. The present study aims to investigate the relationship between PD motor subtypes and anxiety and to explore whether the relationship between anxiety and cognitive deficits occurs in a specific PD motor subtype. Consecutive PD outpatients were recruited and divided into TD-PD and PIGD-PD groups according to Jankovic et al.'s criteria. All participants underwent a neuropsychological battery to evaluate anxiety, apathy, the global cognitive functioning, memory abilities, executive and visuo-constructional functions. Thirty-six patients with TD-PD and 35 patients with PIGD-PD were enrolled. The two groups did not differ on demographical and clinical variables. As for the severity of anxiety, no significant difference between the two groups was found. Regression analysis revealed that higher anxiety score was associated with poorer performance on constructional visuospatial test in both TD-PD and PIGD-PD. Clinical variables were not associated with anxiety in the two groups. Our findings indicated that the severity of anxiety was not associated with any PD motor subtypes. Moreover, regression analysis revealed that impaired visuo-constructional abilities are related to anxiety independently of PD motor subtypes. Since altered fronto-parietal network might be one of the pathogenetic mechanisms underpinning anxiety and constructional visuospatial deficits, the treatment of cognitive dysfunctions might reduce anxious symptoms.
焦虑是帕金森病（PD）常见的神经精神症状。到目前为止，焦虑一直与认知缺陷和运动症状的严重程度相关，而焦虑与运动亚型（TD-PD，震颤为主型和PIGD-PD，姿势不稳/步态障碍为主型）之间的关联结果却相互矛盾。本研究旨在调查PD运动亚型与焦虑之间的关系，并探讨焦虑与认知缺陷之间的关系是否在特定的PD运动亚型中出现。连续招募PD门诊患者，并根据扬科维奇等人的标准将其分为TD-PD组和PIGD-PD组。所有参与者均接受了一套神经心理学测试，以评估焦虑、冷漠、整体认知功能、记忆能力、执行功能和视觉构建功能。共纳入36例TD-PD患者和35例PIGD-PD患者。两组在人口统计学和临床变量方面无差异。至于焦虑的严重程度，两组之间未发现显著差异。回归分析显示，在TD-PD和PIGD-PD组中，焦虑评分越高与视觉空间构建测试表现越差相关。临床变量与两组的焦虑均无关。我们的研究结果表明，焦虑的严重程度与任何PD运动亚型均无关。此外，回归分析显示，视觉构建能力受损与焦虑相关，且独立于PD运动亚型。由于额顶叶网络改变可能是焦虑和视觉空间构建缺陷的发病机制之一，因此治疗认知功能障碍可能会减轻焦虑症状。
