UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Building 71/918 Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, 4029, Australia.
School of Psychology, The University of Queensland, Brisbane, Australia.
J Neurol. 2022 Mar;269(3):1600-1609. doi: 10.1007/s00415-021-10736-x. Epub 2021 Aug 4.
Preliminary evidence has demonstrated a link between anxiety and memory impairment in Parkinson's disease (PD). This study further investigated this association using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for anxiety disorders and a standardized cognitive test battery.
A convenience sample of 89 PD patients without dementia was recruited from neurology outpatient clinics. A cross-sectional design was applied. Participants completed two semi-structured interviews. The first interview diagnosed DSM-5 anxiety disorders, unspecified anxiety disorder, and no anxiety. The second interview applied a neurocognitive test battery comprising two tests for each domain. Logistic regression models compared cognitive characteristics associated with anxiety disorders to no anxiety.
Clinically significant anxiety was associated with immediate verbal memory impairment compared to the no anxiety group (OR, 95% CI 0.52, 0.30-0.89; p = 0.018), controlling for sex and age. The anxiety disorders group demonstrated immediate (OR, 95% CI 0.46, 0.26-0.83; p = 0.010) and delayed (OR, 95% CI 0.63, 0.40-0.99; p = 0.047) verbal memory impairments compared to those without anxiety, controlling for sex and age. This association remained for immediate (OR, 95% CI 0.43, 0.22-0.84; p = 0.013), but not delayed verbal memory impairment (OR, 95% CI 0.65, 0.39-1.06; p = 0.081) when additionally controlling for disease severity, education and levodopa dose.
These findings present first evidence that anxiety disorders are associated with verbal memory impairment in PD and have implications for the management and treatment of anxiety in PD.
初步证据表明,帕金森病(PD)患者的焦虑与记忆障碍之间存在关联。本研究进一步使用精神障碍诊断与统计手册(DSM-5)焦虑障碍标准和标准化认知测试组合来研究这种关联。
从神经病学门诊招募了 89 名无痴呆的 PD 患者作为便利样本。采用横断面设计。参与者完成了两次半结构化访谈。第一次访谈诊断了 DSM-5 焦虑障碍、未指定的焦虑障碍和无焦虑。第二次访谈采用了包含每个领域两个测试的神经认知测试组合。逻辑回归模型比较了与焦虑障碍相关的认知特征与无焦虑的认知特征。
与无焦虑组相比,临床显著焦虑与即时言语记忆障碍相关(OR,95%CI 0.52,0.30-0.89;p=0.018),控制了性别和年龄。与无焦虑相比,焦虑障碍组在即时(OR,95%CI 0.46,0.26-0.83;p=0.010)和延迟(OR,95%CI 0.63,0.40-0.99;p=0.047)言语记忆障碍方面存在差异,控制了性别和年龄。当进一步控制疾病严重程度、教育程度和左旋多巴剂量时,这种关联仍然存在于即时记忆障碍(OR,95%CI 0.43,0.22-0.84;p=0.013),但不存在于延迟言语记忆障碍(OR,95%CI 0.65,0.39-1.06;p=0.081)。
这些发现首次提供了证据表明,焦虑障碍与 PD 中的言语记忆障碍有关,这对 PD 中焦虑的管理和治疗具有启示意义。