Zhu Xiaobo, Gan Jing, Wu Na, Zhang Yu, Liu Zhenguo
Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Front Psychiatry. 2024 Feb 9;15:1345280. doi: 10.3389/fpsyt.2024.1345280. eCollection 2024.
Parkinson's disease (PD) is marked not only by motor symptoms but also by neuropsychiatric manifestations, including demoralization, apathy, and depression. Understanding the clinical distribution and characteristics of these co-occurring symptoms is crucial for improving quality of life of PD patients.
This study enrolled 195 Chinese PD patients from Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine. The study involved analyzing the clinical characteristics related to the simultaneous presence of demoralization, apathy, and depression in PD patients. Linear regression was employed to elucidate the linear trend between the quantity of negative neuropsychiatric symptoms and cognitive function, as well as motor symptoms and motor complications. SPSS mediation models were utilized to investigate whether the severity of cognitive function mediated the connection between multiple negative neuropsychiatric symptoms and motor symptoms.
Among PD patients, a notable 57.5% experience the presence of multiple concurrent negative neuropsychiatric symptoms. Our investigation unveiled a correlation where patients with more negative neuropsychiatric symptoms displayed heightened cognitive impairment (P=0.048) and more severe motor symptoms (P=0.024), following a linear trend with increasing symptom numbers. Additionally, cognitive impairment played a partial mediating role in the impact of multiple negative neuropsychiatric symptoms on motor symptoms (β=0.747; 95% bootstrap confidence interval: 0.195 to 1.532).
The co-occurrence of these negative neuropsychiatric symptoms has the potential to worsen cognitive function and motor symptoms in PD patients. Moreover, cognitive impairment was identified as playing a partial mediating role in the relationship between multiple negative neuropsychiatric symptoms and motor symptoms.
帕金森病（PD）不仅以运动症状为特征，还伴有神经精神症状，包括意志消沉、淡漠和抑郁。了解这些共发症状的临床分布和特征对于提高PD患者的生活质量至关重要。
本研究纳入了上海交通大学医学院附属新华医院的195例中国PD患者。该研究分析了与PD患者同时存在意志消沉、淡漠和抑郁相关的临床特征。采用线性回归来阐明阴性神经精神症状数量与认知功能、运动症状及运动并发症之间的线性趋势。利用SPSS中介模型研究认知功能严重程度是否介导了多种阴性神经精神症状与运动症状之间的联系。
在PD患者中，显著有57.5%的患者存在多种并发的阴性神经精神症状。我们的调查发现，阴性神经精神症状越多的患者，认知障碍越严重（P = 0.048），运动症状越严重（P = 0.024），且随着症状数量的增加呈线性趋势。此外，认知障碍在多种阴性神经精神症状对运动症状的影响中起部分中介作用（β = 0.747；95%自抽样置信区间：0.195至1.532）。
这些阴性神经精神症状的共发有可能使PD患者的认知功能和运动症状恶化。此外，认知障碍被确定在多种阴性神经精神症状与运动症状之间的关系中起部分中介作用。
