Neurology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France.
J Parkinsons Dis. 2022;12(5):1665-1676. doi: 10.3233/JPD-213070.
Previous studies described a parkinsonian personality characterized as rigid, introverted, and cautious; however, little is known about personality traits in de novo Parkinson's disease (PD) patients and their relationships with motor and neuropsychiatric symptoms.
To investigate personality in de novo PD and explore its relationship with PD symptoms.
Using Cloninger's biosocial model, we assessed personality in 193 de novo PD patients. Motor and non-motor symptoms were measured using several validated scales. Cluster analysis was conducted to investigate the interrelationship of personality traits, motor, and non-motor symptoms.
PD patients showed low novelty seeking, high harm avoidance, and normal reward dependence and persistence scores. Harm avoidance was positively correlated with the severity of depression, anxiety, and apathy (rs = [0.435, 0.676], p < 0.001) and negatively correlated with quality of life (rs = -0.492, p < 0.001). Novelty seeking, reward dependence, and persistence were negatively correlated with apathy (rs = [-0.274, -0.375], p < 0.001). Classification of patients according to personality and PD symptoms revealed 3 distinct clusters: i) neuropsychiatric phenotype (with high harm avoidance and low novelty seeking, hypodopaminergic neuropsychiatric symptoms and higher impulsivity), ii) motor phenotype (with low novelty seeking and higher motor severity), iii) benign phenotype (with low harm avoidance and high novelty seeking, reward dependence, and persistence traits clustered with lower symptoms severity and low impulsivity).
Personality in early PD patients allows us to recognize 3 patients' phenotypes. Identification of such subgroups may help to better understand their natural history. Their longitudinal follow-up will allow confirming whether some personality features might influence disease evolution and treatment.
先前的研究描述了一种帕金森病人格，其特征为刻板、内向和谨慎；然而，对于初发帕金森病（PD）患者的人格特征及其与运动和神经精神症状的关系知之甚少。
探讨初发 PD 患者的人格特征，并探讨其与 PD 症状的关系。
使用 Cloninger 的生物社会模型，我们评估了 193 例初发 PD 患者的人格。使用多个经过验证的量表评估运动和非运动症状。进行聚类分析以研究人格特质、运动和非运动症状之间的相互关系。
PD 患者的新奇寻求、高回避和正常的奖赏依赖和坚持得分较低。回避与抑郁、焦虑和淡漠的严重程度呈正相关（rs= [0.435, 0.676]，p< 0.001），与生活质量呈负相关（rs= -0.492，p< 0.001）。新奇寻求、奖赏依赖和坚持与淡漠呈负相关（rs= [-0.274, -0.375]，p< 0.001）。根据人格和 PD 症状对患者进行分类，发现 3 种不同的聚类：i）神经精神表型（具有高回避和低新奇寻求、低多巴胺能神经精神症状和更高的冲动性），ii）运动表型（具有低新奇寻求和更高的运动严重程度），iii）良性表型（具有低回避和高新奇寻求、奖赏依赖和坚持特质，与较低的症状严重程度和低冲动性聚类）。
初发 PD 患者的人格特征使我们能够识别 3 种患者表型。识别这些亚组可能有助于更好地了解他们的自然史。对他们进行纵向随访将能够确认某些人格特征是否可能影响疾病的演变和治疗。
