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帕金森病患者认知功能与抑郁症状的动态相互作用

Dynamic interplay of cognitive functioning and depressive symptoms in patients with Parkinson's disease.

作者信息

Schroeders Ulrich, Zimmermann Johannes, Wicke Tamara, Schaumburg Martina, Lang Elisabeth, Trenkwalder Claudia, Mollenhauer Brit

机构信息

Department of Psychology, University of Kassel.

Paracelsus-Elena-Klinik.

出版信息

Neuropsychology. 2022 May;36(4):266-278. doi: 10.1037/neu0000795. Epub 2022 Feb 17.

DOI:10.1037/neu0000795
PMID:35175065
Abstract

OBJECTIVE

We examine the trajectories of and the dynamic interplay between cognitive functioning and depressive symptoms in patients with Parkinson's disease (PD) in comparison to healthy controls (HC) from an intraindividual perspective.

METHOD

The DeNoPa study is a single-center, observational, longitudinal study with biennial follow-ups over 8 years. The present analyses are based on 123 PD (79 male) and 107 HC (64 male) with a mean age of 64.1 years ( = 8.3). PD and HC completed a battery of neuropsychological tests and scales assessing depressive symptoms. We used a random-intercept cross-lagged panel model (RI-CLPM) to study their trajectories and the dynamic interplay.

RESULTS

Cognitive abilities of PD were on average = -0.67 worse at baseline and = -1.22 at 8-years follow-up in comparison to HC. Depressive symptoms in PD showed large variability and followed a -shaped trajectory. From an intraindividual perspective, greater impairments in cognitive abilities were subsequently associated with increased depressive symptoms ( = -0.60, p = .03), whereas the effect in the opposite direction was not significant.

CONCLUSIONS

We found indication that a decline on a global composite scale of cognition can be seen as a precursor of depressive symptoms in patients with PD. To counter cognitive losses and the subsequent mood deterioration, patient education and early cognitive (and behavioral) enrichment seem promising candidates for treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

我们从个体内部视角,对比帕金森病(PD)患者与健康对照(HC),研究认知功能与抑郁症状的轨迹及其动态相互作用。

方法

DeNoPa研究是一项单中心、观察性纵向研究,每两年随访一次,为期8年。目前的分析基于123名PD患者(79名男性)和107名HC(64名男性),平均年龄为64.1岁(标准差 = 8.3)。PD患者和HC完成了一系列评估抑郁症状的神经心理学测试和量表。我们使用随机截距交叉滞后面板模型(RI-CLPM)来研究它们的轨迹和动态相互作用。

结果

与HC相比,PD患者的认知能力在基线时平均低0.67,在8年随访时低1.22。PD患者的抑郁症状表现出很大的变异性,并呈U形轨迹。从个体内部视角来看,认知能力的更大损害随后与抑郁症状增加相关(β = -0.60,p = 0.03),而相反方向的影响不显著。

结论

我们发现有迹象表明,在PD患者中,认知的整体综合量表下降可被视为抑郁症状的先兆。为了对抗认知丧失和随后的情绪恶化,患者教育和早期认知(及行为)强化似乎是有前景的治疗选择。(PsycInfo数据库记录(c)2022美国心理学会,保留所有权利)

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J Neural Transm (Vienna). 2022 Dec;129(12):1397-1418. doi: 10.1007/s00702-022-02559-5. Epub 2022 Nov 2.
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