Mood and motor trajectories in Parkinson's disease: multivariate latent growth curve modeling.
Mood and motor trajectories in Parkinson's disease: multivariate latent growth curve modeling.
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DOI：
10.1037/a0025119
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发表时间：
2012-01
期刊：
影响因子：
2.4
通讯作者：
Bowers D
中科院分区：
文献类型：
--
作者：
Zahodne LB;Marsiske M;Okun MS;Rodriguez RL;Malaty I;Bowers D
冷漠是帕金森病（PD）的一个常见特征，可以独立于抑郁症表现出来，但对其在医疗管理患者中的自然进展知之甚少。本研究旨在描述和比较PD患者在18个月内的冷漠、抑郁和运动症状的轨迹。从临床研究数据库中获得了来自佛罗里达大学运动障碍中心的186例PD患者（平均疾病持续时间为8.2年）的数据。在结构方程模型框架中分析三个时间点（基线、6个月、18个月）的统一帕金森病评定量表（运动部分）、冷漠量表和贝克抑郁量表评分。一个控制年龄、性别、教育和病程的多变量增长模型确定了冷漠（斜率估计= 0.73; p <0.001）和运动症状（斜率估计= 1.51; p <0.001）的线性恶化，以及抑郁症的二次变化（斜率估计= 1.18; p = 0.07）。所有症状均呈正相关。高等教育与较低的冷漠，抑郁和运动严重程度相关。高龄与更大的运动和冷漠的严重程度。女性和较长的病程与运动恶化减弱相关。抗抑郁药的使用仅与抑郁评分相关。这些纵向结果支持PD患者冷漠和抑郁的区分。与运动进展一样，冷漠进展可能至少部分与多巴胺能神经变性有关。需要经验支持的PD冷漠治疗。
Apathy is a common feature of Parkinson's disease (PD) that can manifest independently of depression, but little is known about its natural progression in medically-managed patients. The present study sought to characterize and compare trajectories of apathy, depression, and motor symptoms in PD over 18 months. Data from a sample of 186 PD patients (mean disease duration of 8.2 years) followed by the University of Florida Movement Disorders Center were obtained from a clinical research database. Scores on the Unified Parkinson's Disease Rating Scale (motor portion), Apathy Scale, and Beck Depression Inventory at three time-points (baseline, 6 months, 18 months) were analyzed in a structural equation modeling framework. A multivariate growth model controlling for age, sex, education, and disease duration identified linear worsening of both apathy (slope estimate = 0.73; p <.001) and motor symptoms (slope estimate = 1.51; p <.001), and quadratic changes in depression (slope estimate = 1.18; p = .07). All symptoms were positively correlated. Higher education was associated with lower apathy, depression, and motor severity. Advanced age was associated with greater motor and apathy severity. Female sex and longer disease duration were associated with attenuated motor worsening. Antidepressant use was associated only with depression scores. These longitudinal results support the differentiation of apathy and depression in PD. Like motor progression, apathy progression may be linked at least partially to dopaminergic neurodegeneration. Empirically-supported treatments for apathy in PD are needed.
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影响因子：
2.6
作者：
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通讯作者：
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作者：
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通讯作者：
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