抑郁症中的认知和运动障碍:综合行为评估的见解
Cognitive and motor disturbances in depression: insights from comprehensive behavioral assessments.
作者信息
Douka Ioanna, Ruitenberg Marit F L, Weischedel Kamile, Phouthavongsay Carlos, Weisenbach Sara L, van der Geest Jos N, Mickey Brian J, Koppelmans Vincent
机构信息
Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, United States.
Department of Health, Medical and Neuropsychology, Leiden University, Leiden, Netherlands.
出版信息
Front Psychiatry. 2025 Jul 29;16:1624776. doi: 10.3389/fpsyt.2025.1624776. eCollection 2025.
BACKGROUND
Depression affects not only mood and reward processing, but also motor and cognitive functioning, leading to psychomotor disturbances crucial for diagnosis, prognosis, and treatment. Patients with severe psychomotor retardation often respond poorly to SSRIs but benefit from neurostimulation like ECT. However, comprehensive assessments of cognitive and motor domains in the same depression sample are rare.
METHODS
This pilot study compared 20 depressed patients and 22 controls across multiple tests of cognitive and motor functions. We examined executive function and processing speed (Symbol Digit Modalities Test (SDMT), D-KEFS Color-Word Interference Test), verbal and visual learning and memory (Hopkins Verbal Learning Test (HVLT-R), and Brief Visuospatial Test (BVMT-R), gait (2-minute walking, 4-meter walking and walking while talking (WWT) tests), sarcopenia (grip strength ftest, knee extension test), and fine motor function (Archimedes Spiral Test, 9 Hole Peg Test). Associations between depression severity and behavioral performance were also explored.
RESULTS
Depressed participants performed significantly worse on the color naming and interference conditions within the D-KEFS Color-Word Interference Test and on the HVLT's delayed recall. They were slower on the 9 Hole Peg Test with both their dominant and nondominant hands, while no differences were noted in gait or sarcopenia. Greater depression severity correlated with poorer performance on the WWT dual cognitive-motor task and quicker movement on the Archimedes Spiral task.
CONCLUSIONS
These findings reveal decrements in cognitive and motor domains in depressed individuals, which could impact daily functioning. Overall, results from this pilot study suggest that examining motor disturbances alongside cognitive disturbances could serve as a marker of disease progression and a potential target for intervention.
背景
抑郁症不仅影响情绪和奖赏处理,还会影响运动和认知功能,导致对诊断、预后和治疗至关重要的精神运动障碍。重度精神运动迟缓的患者对选择性5-羟色胺再摄取抑制剂(SSRI)反应通常较差,但能从电休克疗法(ECT)等神经刺激中获益。然而,在同一抑郁症样本中对认知和运动领域进行全面评估的情况很少见。
方法
这项初步研究对20名抑郁症患者和22名对照者进行了多项认知和运动功能测试。我们检查了执行功能和处理速度(符号数字模态测试(SDMT)、D-KEFS颜色-词语干扰测试)、言语和视觉学习与记忆(霍普金斯言语学习测试(HVLT-R)和简易视觉空间测试(BVMT-R))、步态(2分钟步行、4米步行和边说话边步行(WWT)测试)、肌肉减少症(握力测试、膝关节伸展测试)以及精细运动功能(阿基米德螺旋测试、9孔插钉测试)。还探讨了抑郁严重程度与行为表现之间的关联。
结果
抑郁症参与者在D-KEFS颜色-词语干扰测试的颜色命名和干扰条件以及HVLT的延迟回忆方面表现明显更差。他们用优势手和非优势手进行9孔插钉测试时速度较慢,而在步态或肌肉减少症方面未发现差异。抑郁严重程度越高,在WWT双重认知-运动任务中的表现越差,在阿基米德螺旋任务中的动作越快。
结论
这些发现揭示了抑郁症患者认知和运动领域的减退,这可能会影响日常功能。总体而言,这项初步研究的结果表明,将运动障碍与认知障碍一起检查可作为疾病进展的标志物和潜在的干预靶点来源。