Kenangil Gulay, Demir Mehmet, Tur Esma, Domac Fusun
Department of Neurology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
Department of Neurology, Agri Dr. Yasar Eryılmaz Dogubeyazıt State Hospital, Agri, Turkey.
Acta Neurol Belg. 2023 Feb;123(1):85-91. doi: 10.1007/s13760-020-01581-2. Epub 2021 Jan 16.
Basal ganglia are connected to dorsal prefrontal and orbitofrontal structures, which have an important role in emotional experience. Alexithymia is defined as the inability to recognize and verbalize emotions. There is little known about alexithymia and cognitive dysfunction and its relationship with depression. In this study, we examined the relation of alexithymia with cognition and depression in non-demented patients with Parkinson's disease (PD).
Fort-two consecutive non-demented patients PD and 40 healthy controls were enrolled in the study. The Turkish version of the Montreal Cognitive Assessment scale (MOCA-TR), 20-item Toronto Alexithymia Scale (TAS-20) (F1, F2, F3 subgroups), and Beck Depression Inventory (BDI-I) were used to evaluate cognitive functions, alexithymia, and depression, respectively, in both groups.
The total TAS-20 score was 55.71 ± 19 in the PD group and 46.33 ± 8.21 in the control group. There was a statistically significant difference in the total TAS-20 scores between the groups (p < 0.001). In subgroups of alexithymia, all mean scores of F1, F2, and F3 were higher in the PD group (p = 0.019, p < 0.001, and p = 0.005, respectively). In the MOCA-TR test, the mean scores in visuospatial and delayed recall of patients with PD were statistically lower than in the control group (p = 0.044 and p = 0.04, respectively). The MOCA-TR and BDI total scores were significantly correlated with TAS-20 total scores. In subgroup analysis, we only found an association between the visuospatial domain of MOCA-TR and the F3 subgroup of TAS-20 (r = - 0.22, p = 0.03). There was no relation between alexithymia and disease duration or total levodopa dose (p < 0.05).
Alexithymia is not a rare symptom in PD. It should be accepted as an independent non-motor symptom, and patients should be interrogated accordingly.
基底神经节与背侧前额叶和眶额叶结构相连，这些结构在情感体验中起重要作用。述情障碍被定义为无法识别和表达情感。关于述情障碍与认知功能障碍及其与抑郁症的关系知之甚少。在本研究中，我们研究了非痴呆帕金森病（PD）患者的述情障碍与认知及抑郁之间的关系。
连续纳入42例非痴呆PD患者和40例健康对照者。分别使用蒙特利尔认知评估量表土耳其版（MOCA-TR）、20项多伦多述情障碍量表（TAS-20）（F1、F2、F3亚组）和贝克抑郁量表（BDI-I）评估两组的认知功能、述情障碍和抑郁情况。
PD组TAS-20总分平均为55.71±19，对照组为46.33±8.21。两组间TAS-20总分差异有统计学意义（p<0.001）。在述情障碍亚组中，PD组F1、F2和F3的所有平均得分均较高（分别为p=0.019、p<0.001和p=0.005）。在MOCA-TR测试中，PD患者的视觉空间和延迟回忆平均得分在统计学上低于对照组（分别为p=0.044和p=0.04）。MOCA-TR和BDI总分与TAS-20总分显著相关。在亚组分析中，我们仅发现MOCA-TR的视觉空间领域与TAS-20的F3亚组之间存在关联（r=-0.22，p=0.03）。述情障碍与病程或左旋多巴总剂量之间无相关性（p>0.05）。
述情障碍在PD中并非罕见症状。应将其视为一种独立的非运动症状，并相应地对患者进行询问。
