Castrioto A, Schmitt E, Anheim M, Meoni S, Klinger H, Sourd D, Pelissier P, Lhommée E, Bichon A, Tranchant C, Moro E, Fraix V, Thobois S, Krack P
Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Neurology Department, 38000, Grenoble, France.
Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
NPJ Parkinsons Dis. 2025 Apr 24;11(1):89. doi: 10.1038/s41531-025-00937-w.
Apathy is a disabling symptom in Parkinson's disease (PD). The effect of dopaminergic treatment on apathy is inconsistent, depending on the stage of the disease, the type of apathy and strongly influenced by placebo effect. Our study assessed the evolution of a cohort of 86 de novo, drug naive PD patients for 4 years, after dopaminergic treatment introduction. The main objective of the study was the change of apathy from baseline to follow-up and secondary outcomes were the change of other neuropsychiatric symptoms. At 4 years there was an improvement of apathy (p = 0.002), mainly driven by improvement of baseline apathy (p = 0.001). This was associated with an improvement of anxiety (p = 0.001), an increase in hyperdopaminergic behavior including nocturnal hyperactivity with consecutive diurnal sleepiness (p = 0.001 and p < 0.001), independently of the presence of apathy at baseline. These findings confirm, in a large real-life cohort, that dopaminergic treatment improves motivational apathy in early PD.
冷漠是帕金森病（PD）的一种致残症状。多巴胺能治疗对冷漠的效果并不一致，这取决于疾病阶段、冷漠类型，且受安慰剂效应的影响很大。我们的研究评估了86例初发、未接受过药物治疗的PD患者在开始多巴胺能治疗后4年的病情演变。该研究的主要目标是从基线到随访期间冷漠症状的变化，次要结果是其他神经精神症状的变化。4年后，冷漠症状有所改善（p = 0.002），主要是由于基线冷漠症状的改善（p = 0.001）。这与焦虑症状的改善（p = 0.001）以及多巴胺能亢进行为的增加有关，包括夜间多动及随之而来的日间嗜睡（p = 0.001和p < 0.001），且与基线时是否存在冷漠无关。这些发现在一个大型现实生活队列中证实，多巴胺能治疗可改善早期PD患者的动机性冷漠。
Zotero 插件