Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
National Neuroscience Institute, Singapore.
Parkinsonism Relat Disord. 2021 Jan;82:24-28. doi: 10.1016/j.parkreldis.2020.11.013. Epub 2020 Nov 17.
Subjective cognitive complaints (SCC) and affective symptoms are highly prevalent in Parkinson's Disease (PD). In early PD, SCC prevalence and its affective correlates, using recommended Movement Disorders Society (MDS) Level II Criteria to define the underlying cognitive impairment, has not been previously explored.
We recruited 121 participants with early PD from two tertiary hospitals in Singapore. The presence of SCC was defined using a Non-Motor Symptoms Scale Domain-5 Score ≥1. Comprehensive neuropsychological testing was conducted with Mild Cognitive Impairment (PD-MCI) defined using recommended MDS Level II Criteria. Affective symptoms were assessed using the Hospital Anxiety Depression Scale (HADS), Geriatric Depression Scale (GDS) and Apathy Scale (AS). Analysis using multivariable linear regression model was performed.
In our early PD cohort, SCC prevalence independent of underlying cognitive status was 38.8%. Prevalence of SCC in cognitively impaired and cognitively normal participants was 10.7% and 28.1% respectively (р = 0.241). In cognitively normal PD participants, multivariable linear regression analysis revealed that SCC was significantly associated with anxiety (β = 0.28, 95% CI = 0.09-0.79, p = 0.014), depression (β = 0.31, 95% CI = 0.10-0.59, p = 0.006) and apathy (β = 0.32, 95% CI = 1.15-5.98, p = 0.004). Such an association was not found in cognitively impaired PD participants.
SCC is highly prevalent even in early PD. Its implications in early PD differ depending on underlying cognitive status. SCC in cognitively impaired participants underestimates the true prevalence of PD-MCI. In contrast, SCC in cognitively normal participants is suggestive of an underlying affective disorder.
主观认知主诉（SCC）和情感症状在帕金森病（PD）中非常普遍。在早期 PD 中，使用推荐的运动障碍协会（MDS）二级标准来定义潜在认知障碍，尚未探讨 SCC 的患病率及其情感相关性。
我们从新加坡的两家三级医院招募了 121 名早期 PD 患者。使用非运动症状量表域 5 评分≥1 来定义 SCC 的存在。使用推荐的 MDS 二级标准定义轻度认知障碍（PD-MCI）进行全面的神经心理学测试。使用医院焦虑抑郁量表（HADS）、老年抑郁量表（GDS）和淡漠量表（AS）评估情感症状。使用多变量线性回归模型进行分析。
在我们的早期 PD 队列中，独立于潜在认知状态的 SCC 患病率为 38.8%。认知障碍和认知正常参与者中 SCC 的患病率分别为 10.7%和 28.1%（p=0.241）。在认知正常的 PD 参与者中，多变量线性回归分析表明 SCC 与焦虑（β=0.28，95%CI=0.09-0.79，p=0.014）、抑郁（β=0.31，95%CI=0.10-0.59，p=0.006）和淡漠（β=0.32，95%CI=1.15-5.98，p=0.004）显著相关。在认知障碍的 PD 参与者中没有发现这种关联。
即使在早期 PD 中，SCC 的患病率也很高。其在早期 PD 中的意义取决于潜在的认知状态。在认知障碍的参与者中，SCC 低估了 PD-MCI 的真实患病率。相比之下，在认知正常的参与者中，SCC 提示存在潜在的情感障碍。
