Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad 26, Holguín, Cuba.
National Institute of Neurology and Neurosurgery "Rafael Estrada", 29th Street 139, Vedado, Plaza de la Revolución, Havana, Cuba.
Cerebellum. 2021 Dec;20(6):896-903. doi: 10.1007/s12311-021-01260-9. Epub 2021 Mar 25.
Although there are no convincing evidences of detrimental effect of SARS-CoV2 infection on the cerebellum, the COVID-19 pandemic could impact the life quality of patients with cerebellar ataxias, but few studies have addressed this concern. To assess the motor and mental health changes caused by the COVID-19 pandemics in Cuban patients with cerebellar ataxias, three hundred four patients with cerebellar ataxias and 167 healthy controls were interviewed for risks of exposure to COVID-19, and the self-perception of the pandemics' impact on the disease progression and on the mental health. All subjects underwent the Hospital Anxiety and Depression Scale. The patients reported low exposition to SARS-CoV2 infection, but one case was confirmed with a mild COVID-19. Overall, depressive and anxiety symptoms were significantly and marginally increased in patients, respectively, with higher scores in cases with severe and moderate ataxia. Positive patient's impression of psychopathological changes was associated to increased age, age at onset, and anxiety. Sixty-seven patients had a positive self-perception of ataxia progression, which was mainly influenced by higher anxiety scores but not by the adherence to at-home exercise programs. However, the practice of physical exercise was related with lower depression and anxiety scores, but this therapeutical effect was not significantly influenced by the disease stage. We demonstrated the negative effect of the COVID-19 pandemic on the mental and motor deficits in Cuban patients with cerebellar ataxias and the positive effect of the at-home physical exercise programs on their mental well-being. These findings give rationales to develop tele-medicine approaches to minimize these health impacts and to study the long-term effects of such sequelae and accordingly define their treatments.
虽然没有令人信服的证据表明 SARS-CoV2 感染对小脑有不利影响，但 COVID-19 大流行可能会影响小脑共济失调患者的生活质量，但很少有研究关注这一问题。为了评估 COVID-19 大流行对古巴小脑共济失调患者的运动和心理健康的影响，对 304 例小脑共济失调患者和 167 例健康对照者进行了采访，以了解他们接触 COVID-19 的风险，并了解他们对大流行对疾病进展和心理健康影响的自我认知。所有受试者均接受了医院焦虑和抑郁量表的评估。患者报告接触 SARS-CoV2 感染的风险较低，但有 1 例确诊为轻度 COVID-19。总体而言，患者的抑郁和焦虑症状显著且略有增加，严重和中度共济失调患者的评分更高。患者对心理病理变化的正面印象与年龄、发病年龄和焦虑有关。67 例患者对共济失调进展有积极的自我认知，这主要与更高的焦虑评分有关，但与在家锻炼计划的依从性无关。然而，体育锻炼的实践与较低的抑郁和焦虑评分有关，但这种治疗效果不受疾病阶段的显著影响。我们证明了 COVID-19 大流行对古巴小脑共济失调患者的心理和运动缺陷的负面影响，以及在家进行体育锻炼对其心理健康的积极影响。这些发现为开发远程医疗方法提供了依据，以尽量减少这些健康影响，并研究这些后遗症的长期影响，从而相应地确定其治疗方法。
