Tamaš Olivera, Kostić Milutin, Marić Gorica, Milovanović Andona, Janković Mladen, Salak Ðokić Biljana, Pekmezović Tatjana, Dragašević-Mišković Nataša
Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Institute of Mental Health, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Brain Sci. 2024 Oct 2;14(10):1003. doi: 10.3390/brainsci14101003.
BACKGROUND/OBJECTIVES: Degenerative cerebellar ataxias (DCA) present a group of complex neurological disorders primarily affecting the cerebellum and its pathways. Classic manifestations include motor symptoms of cerebellar ataxia. However, emerging evidence suggests that the cerebellum also plays a crucial role in various cognitive and emotional processes. The objective was to assess the psychiatric profile of a heterogeneous group of patients with degenerative cerebellar ataxia.
Our sample comprised 107 participants diagnosed with cerebellar degenerative ataxia. All patients were clinically evaluated using SARA, INAS, and different neuropsychiatric scales (ACE-R, HAMA, HAMD, AS, and GAF).
The majority of patients had autosomal dominant ataxia (38.3%) followed by sporadic ataxia (32.7%) with an average age at the moment of diagnosis of 35.3 ± 16.23 years, while the mean duration of disease at the study beginning was 12.1 ± 9.9 years. Psychiatric disorders were present in 40 patients (37.4%), with dysthymia (14.2%), major depressive disorder (9.4%), and MDD with melancholic features (7.6%). The presence of MDD with melancholic features was statistically significantly correlated with a lower ACE-R total score (r = -0.223; = 0.022), while dysthymia was statistically significantly associated with a shorter duration of the disease (r = -0.226; = 0.020) and older age (r = 0.197; = 0.043). Statistically significant differences were observed between MSA-C patients and those with sporadic ataxia (HDRS < 0.001, HARS < 0.001, Apathy Scale = 0.003, and GAF = 0.004).
Based on our findings, we can conclude that the degree of motor deficit has a significant impact on the development of psychiatric disorders, including depression, anxiety, and apathy. However, it is not the only factor, and the impact also depends on the type of DCA.
背景/目的：退行性小脑共济失调（DCA）是一组主要影响小脑及其传导通路的复杂神经系统疾病。典型表现包括小脑共济失调的运动症状。然而，新出现的证据表明，小脑在各种认知和情感过程中也起着关键作用。目的是评估一组异质性退行性小脑共济失调患者的精神状况。
我们的样本包括107名被诊断为小脑退行性共济失调的参与者。所有患者均使用SARA、INAS和不同的神经精神量表（ACE-R、HAMA、HAMD、AS和GAF）进行临床评估。
大多数患者为常染色体显性共济失调（38.3%），其次是散发性共济失调（32.7%），诊断时的平均年龄为35.3±16.23岁，而研究开始时的平均病程为12.1±9.9年。40名患者（37.4%）存在精神障碍，其中心境恶劣（14.2%）、重度抑郁症（9.4%）和伴有 melancholic 特征的重度抑郁症（7.6%）。伴有 melancholic 特征的重度抑郁症的存在与较低的ACE-R总分在统计学上显著相关（r = -0.223；P = 0.022），而心境恶劣与病程较短（r = -0.226；P = 0.020）和年龄较大（r = 0.197；P = 0.043）在统计学上显著相关。多系统萎缩-C型（MSA-C）患者与散发性共济失调患者之间观察到统计学上的显著差异（HDRS < 0.001，HARS < 0.001，淡漠量表 = 0.003，GAF = 0.004）。
根据我们的研究结果，我们可以得出结论，运动功能缺损程度对包括抑郁、焦虑和淡漠在内的精神障碍的发生发展有显著影响。然而，它不是唯一的因素，其影响还取决于DCA的类型。
