Department of Neurology, Bashkir State Medical University, Ufa, Russia.
Brain & Mind Centre, University of Sydney, Sydney, Australia.
Amyotroph Lateral Scler Frontotemporal Degener. 2023 Feb;24(1-2):14-23. doi: 10.1080/21678421.2022.2053721. Epub 2022 Mar 30.
: To determine the frequency and correlates of apathy in amyotrophic lateral sclerosis (ALS) and its influence on the prognosis of the disease.: Three databases were searched: MEDLINE, PubMed, and Google Scholar. Quantitative synthesis of the frequency of apathy in ALS was conducted using random effects in Stata (College Station, TX). Meta-regression and subgroup analyses were conducted to investigate the association between frequency of apathy in ALS and different covariates.: Fifty-two studies (51 cohorts) were included in the analysis. The pooled frequency of apathy in ALS was 25% (95% confidence interval (CI) 14-35%) according to the studies that used self-rated tools and 34% (95% CI 27-41%) according to studies that used informant-rated tools. The emergence of apathy was associated with cognitive decline and bulbar onset of the disease. There was no consistent relationship between apathy and disease stage or the severity of depression. Structural brain imaging studies established that ALS patients with apathy exhibited more prominent changes with structural and functional brain imaging particularly involving fronto-subcortical regions of the brain. Overall, apathy worsened the long-term prognosis of ALS.: Apathy affects up to a third of ALS patients аnd develops in the context of progressive neurodegeneration. Increased awareness and understanding of non-motor symptoms in ALS highlights the potential utility of apathy as an outcome measure in future clinical trial design.
: 目的：确定肌萎缩侧索硬化症（ALS）患者中淡漠的发生频率及其相关因素，以及其对疾病预后的影响。: 方法：检索了 MEDLINE、PubMed 和 Google Scholar 这 3 个数据库。使用 Stata（德克萨斯州学院站）中的随机效应进行 ALS 患者淡漠发生率的定量综合分析。进行了荟萃回归和亚组分析，以调查 ALS 患者淡漠发生率与不同协变量之间的关系。: 结果：共纳入了 52 项研究（51 个队列）。根据使用自我评估工具的研究，ALS 患者淡漠的总发生率为 25%（95%置信区间[CI] 14-35%），根据使用知情者评估工具的研究，这一比例为 34%（95%CI 27-41%）。淡漠的出现与认知功能下降和延髓起病有关。淡漠与疾病分期或抑郁严重程度之间没有一致的关系。结构性脑影像学研究表明，患有淡漠的 ALS 患者的大脑结构和功能影像学上显示出更明显的变化，特别是涉及大脑额-皮质下区域。总体而言，淡漠会使 ALS 的长期预后恶化。: 结论：淡漠影响了多达三分之一的 ALS 患者，并在进行性神经退行性变的背景下发生。提高对 ALS 中非运动症状的认识和理解，凸显了淡漠作为未来临床试验设计中结局指标的潜在效用。
