冷漠与快感缺乏：罗马尼亚队列的临床与神经生理学评估
Apathy and Anhedonia: Clinical and Neurophysiological Assessment of a Romanian Cohort.
作者信息
Sipos-Lascu Diana, Vesa Ștefan-Cristian, Perju-Dumbravă Lăcrămioara
机构信息
Department of Neurosciences, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Neurology I Clinic, Cluj-Napoca Emergency Clinical County Hospital, 400012 Cluj-Napoca, Romania.
出版信息
Brain Sci. 2021 May 31;11(6):729. doi: 10.3390/brainsci11060729.
BACKGROUND
Patients with Parkinson's disease (PD) often have, besides the characteristic motor manifestations, a wide variety of non-motor symptoms. These include apathy and anhedonia, common issues in PD, which can be quantified with the help of evaluation scales recommended by the literature. There are sensory non-motor manifestations of PD, some of which are easy to detect through electrophysiological studies. Our aim was to investigate the possible association of apathy and anhedonia with the severity of the motor status in a sample of PD patients in Romania. We also examined the prevalence of latency changes in the P100 wave of visual evoked potentials (VEPs) and how they correlated with motor status, apathy, and anhedonia in PD patients.
METHODS
Thirty-four patients with PD participated in this study. All were assessed for motor status using the Unified Parkinson's Disease Rating Scale (UPDRS) and were rated on the Hoehn and Yahr scales. The presence and severity of apathy and anhedonia were assessed using the Apathy Evaluation Scale (AES), the Dimensional Apathy Scale (DAS), the Lille Apathy Rating Scale (LARS), and the Snaith-Hamilton Pleasure Scale (SHAPS). The latency of the P100 wave of the VEP was measured in all the patients.
RESULTS
Apathy and anhedonia were common among the patients with PD (35% and 58.8%, respectively). The presence of apathy/anhedonia was correlated with the severity of motor symptoms, as assessed using the UPDRS scale ( < 0.001), and with the stage of the disease according to the Hoehn and Yahr scale ( < 0.001). A prolonged latency of the P100 wave of the VEP was observed among apathetic ( < 0.001)/anhedonic ( < 0.01) patients and those with increased disease severity ( < 0.001).
CONCLUSION
Apathy and anhedonia are common in PD and may correlate with the severity of motor symptoms. There may be visual impairment in these patients, evidenced by a prolonged P100 latency, which correlates with the severity of disease.
SIGNIFICANCE
Scales for assessing apathy and anhedonia, as well as measuring VEP latency, could be useful in assessing the severity of disease.
背景
帕金森病（PD）患者除了有典型的运动表现外，通常还伴有多种非运动症状。这些症状包括冷漠和快感缺乏，这是PD患者常见的问题，可借助文献推荐的评估量表进行量化。PD存在感觉方面的非运动表现，其中一些可通过电生理研究轻易检测到。我们的目的是在罗马尼亚的一组PD患者样本中，研究冷漠和快感缺乏与运动状态严重程度之间可能存在的关联。我们还检查了视觉诱发电位（VEP）P100波潜伏期变化的发生率，以及它们与PD患者的运动状态、冷漠和快感缺乏之间的相关性。
方法
34例PD患者参与了本研究。所有患者均使用统一帕金森病评定量表（UPDRS）评估运动状态，并根据Hoehn和Yahr量表进行分级。使用冷漠评估量表（AES）、维度冷漠量表（DAS）、里尔冷漠评定量表（LARS）和斯奈斯 - 汉密尔顿快感量表（SHAPS）评估冷漠和快感缺乏的存在及严重程度。对所有患者测量VEP的P100波潜伏期。
结果
冷漠和快感缺乏在PD患者中很常见（分别为35%和58.8%）。使用UPDRS量表评估时，冷漠/快感缺乏的存在与运动症状的严重程度相关（<0.001），并且根据Hoehn和Yahr量表与疾病阶段相关（<0.001）。在冷漠（<0.001）/快感缺乏（<0.01）患者以及疾病严重程度增加的患者中观察到VEP的P100波潜伏期延长（<0.001）。
结论
冷漠和快感缺乏在PD中很常见，可能与运动症状的严重程度相关。这些患者可能存在视力损害，表现为P100潜伏期延长，这与疾病严重程度相关。
意义
评估冷漠和快感缺乏的量表以及测量VEP潜伏期，可能有助于评估疾病的严重程度。
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