Apathy predicts rate of cognitive decline over 24 months in premanifest Huntington's disease
Apathy predicts rate of cognitive decline over 24 months in premanifest Huntington's disease
复制标题
DOI：
10.1017/s0033291720000094
复制
发表时间：
2021-06-01
影响因子：
6.9
通讯作者：
Stout, J. C.
中科院分区：
文献类型：
--
作者：
Andrews, S. C.;Langbehn, D. R.;Stout, J. C.
背景认知障碍是亨廷顿舞蹈病（HD）的核心特征，然而，认知能力下降的发作和速度变化很大。冷漠是 HD 最常见的神经精神症状，与认知障碍有关。本研究的目的是采用前瞻性纵向设计，探讨冷漠作为 HD 前期和早期 HD 患者 2 年内认知能力下降的预测因素。方法 多中心TRACK-HD研究共纳入118例HD前期基因携带者、111例早期HD和118例健康对照受试者。使用短期问题行为评估中的冷漠严重程度评级来评估冷漠症状。使用来自 9 项认知任务的 12 项结果测量的组合来评估基线和 24 个月后的认知功能。结果在前期组中，在控制年龄、抑郁和运动体征后，更多的冷漠症状预示着两年内认知能力下降更快。相比之下，在早期HD组中，更多的运动迹象（而不是冷漠）预示着随后的认知衰退更快。在对照组中，只有年龄较大才能预测认知能力下降。结论 我们的研究结果表明，在 HD 前期，冷漠是认知能力下降的先兆。相比之下，在早期诊断的 HD 中，运动发作后，运动症状的严重程度更能预测认知能力下降的速度。
Background Cognitive impairment is a core feature of Huntington's disease (HD), however, the onset and rate of cognitive decline is highly variable. Apathy is the most common neuropsychiatric symptom of HD, and is associated with cognitive impairment. The aim of this study was to investigate apathy as a predictor of subsequent cognitive decline over 2 years in premanifest and early HD, using a prospective, longitudinal design. Methods A total of 118 premanifest HD gene carriers, 111 early HD and 118 healthy control participants from the multi-centre TRACK-HD study were included. Apathy symptoms were assessed at baseline using the apathy severity rating from the Short Problem Behaviours Assessment. A composite of 12 outcome measures from nine cognitive tasks was used to assess cognitive function at baseline and after 24 months. Results In the premanifest group, after controlling for age, depression and motor signs, more apathy symptoms predicted faster cognitive decline over 2 years. In contrast, in the early HD group, more motor signs, but not apathy, predicted faster subsequent cognitive decline. In the control group, only older age predicted cognitive decline. Conclusions Our findings indicate that in premanifest HD, apathy is a harbinger for cognitive decline. In contrast, after motor onset, in early diagnosed HD, motor symptom severity more strongly predicts the rate of cognitive decline.