Department of Parkinson's Disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital-Gravedona ed Uniti, Como, Italy.
Department of Human and Social Sciences, University of Bergamo, Italy.
Behav Neurol. 2020 Nov 26;2020:5139237. doi: 10.1155/2020/5139237. eCollection 2020.
The field related to mood disorders in Parkinson's disease (PD) is fragmented. The aim of this cohort observational study was to evaluate whether the episodes of mood alteration could appear in different disease stages and to verify how nonmotor symptoms were led off into different stages. We enrolled 93 PD outpatients (three groups: drug naive-DN; not exhibiting motor fluctuations-n-MF; and exhibiting motor fluctuations-MF) and 50 healthy controls. Mood state was assessed through the Internal State Scale (ISS) while depressive symptoms were evaluated through the Beck Depression Inventory-II (BDI-II), nonmotor symptoms by means of the Non-Motor Symptoms Scale (NMSS), and the presence of impulse control disorders (ICDs) with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). Clinical and pharmacological data have also been recorded. No significant differences in mood state distribution between groups were observed. Nevertheless, as regards the mood state distribution within groups, in n-MF (47.6%) and MF patients (50%), (hypo)mania presence was significantly higher than other symptoms. In DN patients, hypomania showed a prevalence of 38.1% although it was not significant. At least one ICD was reported in 29.3% of n-MF and 50% of MF patients. In the MF group, a moderate positive correlation between ISS ACTivation subscale scores and the presence of ICDs and compulsive medication use emerged. Finally, MF patients reported higher BDI-II total scores than DN. Our results show that mood alterations in PD, considering both depressive symptoms and mood elevation, are related to the advanced stages of the disease as well as the presence of ICDs, and dopaminergic therapy would not always be able to restore a normal mood condition.
帕金森病（PD）相关心境障碍领域的研究较为分散。本队列观察性研究旨在评估心境改变是否可能出现在不同的疾病阶段，并验证非运动症状如何演变为不同的阶段。我们招募了 93 名 PD 门诊患者（三组：未接受药物治疗的患者-DN；无运动波动的患者-n-MF；有运动波动的患者-MF）和 50 名健康对照者。通过内部状态量表（ISS）评估心境状态，通过贝克抑郁量表-II（BDI-II）评估抑郁症状，通过非运动症状量表（NMSS）评估非运动症状，通过帕金森病冲动控制障碍问卷（QUIP）评估冲动控制障碍（ICD）的存在。还记录了临床和药物治疗数据。但在组间的心境状态分布上没有观察到显著差异。然而，就组内的心境状态分布而言，在 n-MF（47.6%）和 MF 患者（50%）中，（轻躁狂）的出现显著高于其他症状。在 DN 患者中，尽管无统计学意义，但轻躁狂的患病率为 38.1%。n-MF 和 MF 患者中分别有 29.3%和 50%报告至少有一种 ICD。在 MF 组中，ISS 激活子量表评分与 ICD 和强迫用药的存在之间存在中度正相关。最后，MF 患者的 BDI-II 总分高于 DN 患者。我们的研究结果表明，PD 患者的心境改变，包括抑郁症状和心境升高，与疾病的晚期以及 ICD 的存在有关，而多巴胺能治疗并不总能恢复正常的心境状态。
