Involuntary emotional expression disorder (IEED) in Parkinson's disease.
Involuntary emotional expression disorder (IEED) in Parkinson's disease.
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帕金森病中的非自愿情绪表达障碍（IEED）。
DOI：
10.1016/j.parkreldis.2009.01.001
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发表时间：
2009
影响因子：
4.1
通讯作者：
Weintraub,Daniel
中科院分区：
文献类型：
--
作者：
Phuong,Lisa;Garg,Shalini;Duda,JohnE;Stern,MatthewB;Weintraub,Daniel
目的利用神经学研究中心-不稳定性量表（CNS-LS）和最近提出的不自主情绪表达障碍（IEED）诊断标准，评估帕金森病（PD）中不自主情绪表达障碍（IEED）的频率及其相关因素。背景：dieed的特征是无法控制的情绪发作，通常与潜在情绪无关或超过潜在情绪，在很少或没有刺激的情况下发生。据报道，IEED在许多神经系统疾病和神经退行性疾病中都有发生，但其在PD中的患病率及其相关性尚未得到很好的研究。此外，没有发表的研究使用最近提出的IEED诊断标准在任何人群中。方法采用神经精神病学量表对193例特发性PD患者进行评估，包括CNS-LS和15项老年抑郁量表（GDS-15）。一个子集（N=100）也接受了一个盲法评分者的诊断访谈，该评分者应用了IEED和精神障碍诊断与统计手册（DSM-IV-TR）抑郁症的标准。结果应用正式诊断标准，7.0%的患者被诊断为IEED，另有7.0%的患者有IEED亚综合征症状。应用其他人群推荐的CNS-LS分值，42.5%（分值≥13）或16.6%（分值≥17）筛查出IEED阳性。抑郁症状与较高的CNS-LS评分相关（B[SE]=0.27）。[08]， P=.001)，但与诊断为IEED无关（优势比=1.1,[95% CI= 1.0-1.3]， P=.16）。CNS-LS诊断IEED的判别效度较差（AUC= 0.79，无截断值，敏感性和特异性均为60%左右）。结论抑郁与抑郁是帕金森病的双重障碍。多达15%的PD患者可能出现IEED症状，但其中只有一半患者出现疾病，这表明IEED症状在这一人群中通常没有临床意义。CNS-LS似乎不是PD患者IEED的良好筛查工具，部分原因是它与抑郁症状高度相关。
OBJECTIVETo estimate the frequency and correlates of involuntary emotional expression disorder (IEED) in Parkinson's disease (PD) using the Center for Neurological Study-Lability Scale (CNS-LS) and recently-proposed diagnostic criteria for IEED.BACKGROUNDIEED is characterized by uncontrollable emotional episodes, typically unrelated to or in excess of the underlying mood, and occurring with minimal or no stimulus. IEED has been reported to occur in many neurological disorders and neurodegenerative diseases, but its prevalence and correlates in PD have not been well studied. Additionally, there is no published research using recently-proposed IEED diagnostic criteria in any population.METHODS193 Patients with idiopathic PD were assessed with a neuropsychiatric battery, including the CNS-LS and the 15-item Geriatric Depression Scale (GDS-15). A subset (N=100) was also administered a diagnostic interview by a blinded rater that applied criteria for both IEED and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) depressive disorders.RESULTSApplying formal diagnostic criteria, 7.0% of patients were diagnosed with IEED, and an additional 7.0% had subsyndromal IEED symptoms. Applying recommended CNS-LS cutoff scores from other populations, either 42.5% (cutoff ≥13) or 16.6% (cutoff ≥17) screened positive for IEED. Depressive symptoms were associated with higher CNS-LS scores (B[SE]=0.27[.08], P=.001) but not with a diagnosis of IEED (odds ratio=1.1, [95% CI=1.0–1.3], P=.16). The CNS-LS had poor discriminant validity for an IEED diagnosis (AUC=.79, no cutoff value with sensitivity and specificity both >60%).CONCLUSIONSIEED and depression are overlapping but distinct disorders in PD. IEED symptoms may occur in up to 15% of PD patients, but a disorder occurs in only half of those, suggesting that often IEED symptoms are not clinically significant in this population. The CNS-LS does not appear to be a good screening instrument for IEED in PD, in part due to its high correlation with depressive symptoms.