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运动不能性僵直型帕金森病中的内向性和神经质:与额叶执行功能障碍的关联。

Introversion and Neuroticism in Akinetic-Rigid Parkinson's Disease: Association With Frontal-Executive Dysfunction.

机构信息

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples (De Lucia, De Rosa, Perillo, De Michele, Maldonato); Postgraduate School of Integrated Gestalt Psychotherapy, Torre Annunziata, Italy (Sperandeo).

出版信息

J Neuropsychiatry Clin Neurosci. 2023 Summer;35(3):228-235. doi: 10.1176/appi.neuropsych.20220115. Epub 2023 Mar 31.

Abstract

OBJECTIVE

Personality changes have often been reported among people with Parkinson's disease (PD); however, no studies have investigated the associations between personality traits, cognitive function, and specific motor symptoms. In this study, the investigators assessed whether particular personality traits were associated with specific motor subtypes of PD (e.g., tremor-dominant and akinetic-rigid phenotypes) and whether frontal-executive functions were associated with personality traits among patients with a specific motor phenotype.

METHODS

Forty-one people with PD and 40 healthy control participants were enrolled in the study. All participants underwent assessments of cognitive and psychological function and personality traits. The study was conducted in Italy.

RESULTS

Tremor-dominant symptoms occurred among 20 (48.8%) people with PD, whereas 21 (51.2%) patients exhibited akinetic-rigid symptoms. Multivariate analyses of variance revealed that participants with akinetic-rigid PD demonstrated significantly poorer performance on frontal-executive tests compared with those with tremor-dominant PD. Moreover, those with akinetic-rigid PD exhibited more psychopathological symptoms and higher neuroticism and introversion compared with those with tremor-dominant PD. Correlations revealed that among participants with akinetic-rigid PD, psychopathological symptoms and neuroticism and introversion personality traits were associated with frontal-executive dysfunction, whereas among those with tremor-dominant PD, no significant associations were found between personality traits and cognitive abilities.

CONCLUSIONS

These findings suggest that specific personality and frontal-executive profiles are associated with the akinetic-rigid motor subtype of PD, thus helping to refine the different clinical manifestations of PD. A better understanding of the psychological, personality, and cognitive mechanisms in PD could also help to develop more targeted treatments.

摘要

目的

帕金森病(PD)患者常出现人格改变;然而,尚无研究调查人格特质与认知功能和特定运动症状之间的关系。本研究评估了特定人格特质是否与 PD 的特定运动亚型(如震颤主导型和无动-僵硬型表型)相关,以及特定运动表型患者的额叶执行功能是否与人格特质相关。

方法

本研究纳入了 41 名 PD 患者和 40 名健康对照者。所有参与者均接受认知和心理功能以及人格特质评估。本研究在意大利进行。

结果

20 名(48.8%)PD 患者出现震颤主导症状,21 名(51.2%)患者表现出无动-僵硬症状。多变量方差分析显示,无动-僵硬型 PD 患者在额叶执行功能测试中的表现明显差于震颤主导型 PD 患者。此外,无动-僵硬型 PD 患者表现出更多的精神病理学症状以及更高的神经质和内向性,与震颤主导型 PD 患者相比。相关性分析显示,在无动-僵硬型 PD 患者中,精神病理学症状、神经质和内向性人格特质与额叶执行功能障碍相关,而在震颤主导型 PD 患者中,人格特质与认知能力之间无显著相关性。

结论

这些发现表明,特定的人格和额叶执行特征与无动-僵硬型 PD 运动亚型相关,从而有助于细化 PD 的不同临床表现。更好地理解 PD 中的心理、人格和认知机制,也有助于开发更有针对性的治疗方法。

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