Department of Neurology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
Concord Centre for Mental Health, Concord Repatriation General Hospital, Sydney, NSW, Australia.
J Psychiatr Res. 2020 Nov;130:75-81. doi: 10.1016/j.jpsychires.2020.07.017. Epub 2020 Aug 4.
The psychomotor retardation that may be seen in major depression represents an interesting parallel to bradykinesia, a core feature of Parkinson's disease. Psychomotor retardation has been correlated with the severity of depression and is a predictor of response to electroconvulsive therapy (ECT). Psychomotor retardation has typically been assessed by subjective clinical judgement including clinical rating scales. Gross activity levels have also been measured with actigraphy previously. The Parkinson's KinetiGraph (PKG) was developed to assess bradykinesia, dyskinesia and tremor in Parkinson's disease and allows for an objective assessment of motor symptoms over time. It has not been used previously to assess motor symptoms in depression. The aim of the current pilot study was to use the PKG to objectively measure both bradykinesia and immobility in depressed inpatients undergoing ECT before, during and at the end of therapy and review correlations with depressive symptomatology and treatment response. The majority of patients (9/12) had PKG defined bradykinesia at baseline and 7/9 of these improved with ECT. All patients with bradykinesia who remitted clinically demonstrated improvements in bradykinesia scores. PKG defined immobility was present at baseline in 11/12 total patients and improved in the majority of these patients (9/11) post ECT. Correlations between clinically assessed melancholia and PKG measures were significant (r = 0.701, p 0.011 at baseline to r = 0.655, p 0.021 at end). A strong association between bradykinesia and immobility scores and depression severity was not seen. The PKG is a potentially useful wearable technology to objectively assess motor symptoms in depression.
在重度抑郁症中可能出现的精神运动迟缓与帕金森病的核心特征——运动迟缓有有趣的相似之处。精神运动迟缓与抑郁的严重程度相关，是电休克治疗（ECT）反应的预测因子。精神运动迟缓通常通过包括临床评分量表在内的主观临床判断来评估。以前也使用活动记录仪测量过总活动水平。帕金森氏运动图（PKG）是为评估帕金森病中的运动迟缓、运动障碍和震颤而开发的，可以对随时间推移的运动症状进行客观评估。以前没有将其用于评估抑郁症中的运动症状。本研究旨在使用 PKG 在接受 ECT 治疗的抑郁症住院患者治疗前、治疗期间和治疗结束时客观测量运动迟缓，同时评估与抑郁症状和治疗反应的相关性。大多数患者（9/12）在基线时有 PKG 定义的运动迟缓，其中 7/9 在 ECT 后改善。所有临床缓解的运动迟缓患者的运动迟缓评分均有改善。12 例患者中有 11 例在基线时有 PKG 定义的运动不能，这些患者中的大多数（9/11）在 ECT 后运动不能得到改善。临床评估的忧郁症与 PKG 测量之间的相关性具有显著性（r=0.701，p=0.011 在基线时到 r=0.655，p=0.021 在结束时）。运动迟缓与运动不能评分和抑郁严重程度之间没有很强的关联。PKG 是一种用于客观评估抑郁症中运动症状的潜在有用的可穿戴技术。
