The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease
The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease
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DOI：
10.1136/jnnp.2008.166959
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发表时间：
2009-08-01
影响因子：
11
通讯作者：
Larsen, J. P.
中科院分区：
文献类型：
--
作者：
Aarsland, D.;Bronnick, K.;Larsen, J. P.
背景资料：神经精神症状在帕金森病（PD）中很常见，对患者、护理人员和社会都有重要的临床后果。少数研究的神经精神症状在早期未经治疗的PD existing.Objective：探讨的范围，聚类和相关的神经精神症状的发病率队列中未经治疗的受试者与PD.Methods：在22个月期间确定的事件PD在挪威西部和南部的四个县的所有病例。使用标准化标准诊断PD。对175名PD和166名年龄和性别分布相似的健康对照者进行神经精神量表（NPI）。结果：PD组有NPI症状者占56%，明显高于对照组的22%（P < 0.001）。抑郁（37%）、冷漠（27%）、睡眠障碍（18%）和焦虑（17%）是最常见的症状。有临床意义的症状在PD组中的发生率为27%，而在对照组中仅为3%（p <0.001）。具有临床显著神经精神症状的受试者比没有症状的受试者有更严重的帕金森综合征。确定了两个神经精神集群，一个特点是情绪症状和一个由apathy.Conclusions：虽然大多数早期未经治疗的PD患者没有临床显着的神经精神症状，这些症状是更常见的患者比没有PD的人。与PD相关的心理压力和大脑变化都可能导致更高的频率。
Background: Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have important clinical consequences for patients, caregivers and society. Few studies of neuropsychiatric symptoms in early untreated PD exist.Objective: To explore the range, clustering and correlates of neuropsychiatric symptoms in an incidence cohort of untreated subjects with PD.Methods: All cases with incident PD identified during a 22 month period in four counties of Western and Southern Norway were included. Standardised criteria were used to diagnose PD. The Neuropsychiatric Inventory (NPI) was administered to 175 PD and 166 healthy control subjects with similar age and sex distributions. Cluster analysis was used to investigate the interrelationship of NPI items.Results: The proportion with any NPI symptoms was higher in PD (56%) than in controls (22%) (p < 0.001). Depression (37%), apathy (27%), sleep disturbance (18%) and anxiety (17%) were the most common symptoms. Clinically significant symptoms occurred in 27% of the PD group compared with only 3% in the control group (p < .001). Subjects with clinically significant neuropsychiatric symptoms had more severe parkinsonism than those without. Two neuropsychiatric clusters were identified, one characterised by mood symptoms and one by apathy.Conclusions: Although the majority of patients with early untreated PD do not have clinical significant neuropsychiatric symptoms, these symptoms are more common in patients than in people without PD. Both psychological stress and brain changes associated with PD are likely to contribute to the higher frequencies.