Neurology Clinic, Clinical Center Serbia, School of Medicine, University of Belgrade; dr Subotića 6a, Belgrade, Serbia.
Innovation Center, School of Electrical Engineering in Belgrade, Bulevar kralja Aleksandra 73, Belgrade, Serbia; School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, Belgrade, Serbia.
Clin Neurol Neurosurg. 2021 Jan;200:106324. doi: 10.1016/j.clineuro.2020.106324. Epub 2020 Oct 21.
The goal of this study was to analyze how depression associated with Parkinson's disease (PD) affected gait variability in these patients using a dual-task paradigm. Additionally, the dependency of the executive functions and the impact of depression on gait variability were analyzed.
Three subject groups were included: patients with PD, but no depression (PD-NonDep; 14 patients), patients with both PD and depression (PD-Dep; 16 patients) and healthy controls (HC; 15 subjects). Gait was recorded using the wireless sensors. The participants walked under four conditions: single-task, motor dual- task, cognitive dual-task, and combined dual-task. Variability of stride length, stride duration, and swing time was calculated and analyzed using the statistical methods.
Variability of stride duration and stride length were not significantly different between PD-Dep and PD-NonDep patients. The linear mixed model showed that swing time variability was statistically significantly higher in PD-Dep patients compared to controls (p = 0.001). Hamilton Disease Rating Scale scores were significantly correlated with the swing time variability (p = 0.01). Variability of all three parameters of gait was significantly higher while performing combined or cognitive task and this effect was more pronounced in PD-Dep group of patients.
Depression in PD was associated with swing time variability, and this effect was more prominent while performing a dual-task.
Diagnosing and treating depression might be important for gait improvement and fall reduction in PD patients.
本研究旨在分析帕金森病（PD）相关抑郁如何影响这些患者的步态变异性，并使用双重任务范式进行分析。此外，还分析了执行功能的依赖性以及抑郁对步态变异性的影响。
纳入了三组受试者：无抑郁的帕金森病患者（PD-NonDep；14 例）、同时患有 PD 和抑郁的患者（PD-Dep；16 例）和健康对照组（HC；15 例）。使用无线传感器记录步态。参与者在四种条件下行走：单任务、运动双重任务、认知双重任务和组合双重任务。使用统计方法计算和分析步长、步幅和摆动时间的变异性。
PD-Dep 和 PD-NonDep 患者的步幅时间和步幅长度变异性无显著差异。线性混合模型显示，PD-Dep 患者的摆动时间变异性明显高于对照组（p=0.001）。汉密尔顿疾病评定量表评分与摆动时间变异性显著相关（p=0.01）。在执行组合或认知任务时，所有三种步态参数的变异性均显著升高，而在 PD-Dep 组患者中这种影响更为明显。
PD 中的抑郁与摆动时间变异性相关，而在执行双重任务时，这种影响更为明显。
诊断和治疗 PD 中的抑郁可能对改善 PD 患者的步态和减少跌倒非常重要。
