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亨廷顿病患者生活质量下降与大脑、认知和身体残疾的相关性。

Brain, cognitive, and physical disability correlates of decreased quality of life in patients with Huntington's disease.

机构信息

Universidad de los Andes, Bogotá, Colombia.

Universidad Autónoma del Caribe, Barranquilla, Colombia.

出版信息

Qual Life Res. 2023 Jan;32(1):171-182. doi: 10.1007/s11136-022-03220-0. Epub 2022 Aug 17.

Abstract

PURPOSE

Following a case-control design, as a primary objective, this study aimed to explore the relationship between quality of life (QoL) scores and gray matter (GM) volumes in patients with Huntington's disease (HD). As a secondary objective, we assessed the relationship between QoL scores and other important behavioral, clinical and demographical variables in patients with HD and HD patients' caregivers.

METHODS

We recruited 75 participants (25 HD patients, 25 caregivers, and 25 controls) and assessed their QoL using the World Health Organization Quality of Life scale-Brief Version (WHOQOL-BREF). Participants were also assessed with general cognitive functioning tests and clinical scales. In addition, we acquired MRI scans from all participants.

RESULTS

Our results showed that patients exhibited significantly lower scores in all four QoL domains (physical health, psychological wellbeing, social relationships, and relationship with the environment) compared to caregivers and controls. Caregivers showed lower scores than controls in the physical health and the environmental domains. In HD patients, lower scores in QoL domains were associated with lower GM volumes, mainly in the precuneus and the cerebellum. Moreover, in HD patients, physical disability and GM volume reduction were significant predictors of QoL decrease in all domains. For caregivers, years of formal education was the most important predictor of QoL.

CONCLUSIONS

HD patients exhibit greater GM volume loss as well as lower QoL scores compared to caregivers and controls. However, caregivers displayed lower scores in QoL scores than controls, with years of education being a significant predictor. Our results reflect a first attempt to investigate the relationships among QoL, GM volumes, and other important factors in an HD and HD caregiver sample.

摘要

目的

采用病例对照设计,作为主要目标,本研究旨在探讨亨廷顿病(HD)患者生活质量(QoL)评分与灰质(GM)体积之间的关系。作为次要目标,我们评估了 HD 患者和 HD 患者照顾者的 QoL 评分与其他重要行为、临床和人口统计学变量之间的关系。

方法

我们招募了 75 名参与者(25 名 HD 患者、25 名照顾者和 25 名对照者),并使用世界卫生组织生活质量量表-简短版(WHOQOL-BREF)评估了他们的 QoL。参与者还接受了一般认知功能测试和临床量表评估。此外,我们从所有参与者中获取了 MRI 扫描。

结果

我们的结果表明,与照顾者和对照组相比,患者在所有四个 QoL 领域(身体健康、心理幸福感、社会关系和与环境的关系)的得分明显较低。照顾者在身体健康和环境领域的得分低于对照组。在 HD 患者中,QoL 领域的得分较低与 GM 体积减少有关,主要与后扣带回和小脑有关。此外,在 HD 患者中,身体残疾和 GM 体积减少是所有领域 QoL 下降的重要预测因素。对于照顾者,正规教育年限是 QoL 的最重要预测因素。

结论

与对照组相比,HD 患者表现出更大的 GM 体积损失和较低的 QoL 评分。然而,与对照组相比,照顾者的 QoL 评分较低,教育年限是一个重要的预测因素。我们的结果反映了首次尝试在 HD 和 HD 照顾者样本中研究 QoL、GM 体积和其他重要因素之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c0c/9829572/66e0d426e0e1/11136_2022_3220_Fig1_HTML.jpg

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