Institute of Health Sciences, Jan Kochanowski University, Collegium Medicum, Kielce, Poland.
Med Sci Monit. 2024 Oct 4;30:e943977. doi: 10.12659/MSM.943977.
BACKGROUND In patients with multiple sclerosis, depression and its associated symptoms are factors that reduce the health-related quality of life can affect the course of the disease and the patient's compliance with therapeutic recommendations, or may even increase the risk of suicide. This study aimed to determine the relationship between body composition, motor function of limbs, physical activity, and the occurrence of depressive symptoms in patients with multiple sclerosis. MATERIAL AND METHODS The study group included 110 patients - 84 women (76.4%) and 26 men (23.6%) - with multiple sclerosis and with or without depression. Disability status was assessed using the EDSS scale. Depressive symptoms were recognized based on the Beck Depression Inventory-II, while motor function was determined with the 9-Hole Peg Test and Timed 25-Foot Walk test. Accelerometers were used to evaluate physical activity of patients. Statistical analysis of collected data was performed using logistic regression. RESULTS Depressive symptoms (BDI-II score ≥14) were observed in 24.55% of the participants. MS patients with and without depression symptoms differed significantly in terms of fat mass, T25-FW, and 9-HPT-dominant hand. Multivariate regression analyses demonstrated that increased adiposity (OR=1.09; 95% CI=1.02-1.16; P=.008; and decreased motor ability of the upper limb, both dominant (OR=1.07; 95% CI=1.01-1.15; P=.043) and non-dominant one (OR=1.10 95% CI 1.01-1.18; P=.025) were associated with a higher risk of depression. The differences in physical activity and T25-FW between groups were statistically insignificant. CONCLUSIONS The severity of depression symptoms was related to higher body mass and decreased functional ability of the upper limbs in patients with MS. Thus, a detailed evaluation of the patient's upper-limb function should constitute an integral part of motor function assessment of patients with MS.
在多发性硬化症患者中，抑郁及其相关症状是降低健康相关生活质量的因素，会影响疾病进程和患者对治疗建议的依从性，甚至可能增加自杀风险。本研究旨在确定多发性硬化症患者的身体成分、四肢运动功能、身体活动与抑郁症状发生之间的关系。
研究组包括 110 名患者-84 名女性（76.4%）和 26 名男性（23.6%）-患有多发性硬化症，且伴有或不伴有抑郁。残疾状况采用 EDSS 量表评估。抑郁症状根据 Beck 抑郁量表 II 确定，运动功能通过 9 孔钉测试和定时 25 英尺步行测试确定。加速度计用于评估患者的身体活动。收集的数据进行了逻辑回归统计分析。
参与者中有 24.55%出现抑郁症状（BDI-II 评分≥14）。有和无抑郁症状的多发性硬化症患者在脂肪量、T25-FW 和 9-HPT 优势手方面存在显著差异。多变量回归分析表明，肥胖增加（OR=1.09；95%CI=1.02-1.16；P=.008）和上肢运动能力下降，包括优势手（OR=1.07；95%CI=1.01-1.15；P=.043）和非优势手（OR=1.10；95%CI=1.01-1.18；P=.025），与抑郁风险增加相关。组间身体活动和 T25-FW 的差异无统计学意义。
多发性硬化症患者抑郁症状的严重程度与体重增加和上肢功能下降有关。因此，对患者上肢功能的详细评估应构成多发性硬化症患者运动功能评估的一个组成部分。
