Changes in Motor, Cognitive, and Behavioral Symptoms in Parkinson's Disease and Mild Cognitive Impairment During the COVID-19 Lockdown.
Changes in Motor, Cognitive, and Behavioral Symptoms in Parkinson's Disease and Mild Cognitive Impairment During the COVID-19 Lockdown.
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DOI：
10.3389/fpsyt.2020.590134
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发表时间：
2020
影响因子：
4.7
通讯作者：
Monastero R
中科院分区：
文献类型：
--
作者：
Baschi R;Luca A;Nicoletti A;Caccamo M;Cicero CE;D'Agate C;Di Giorgi L;La Bianca G;Lo Castro T;Zappia M;Monastero R
目的：COVID-19 封锁对痴呆前驱期受试者的影响尚不清楚。本研究的目的是评估意大利 COVID-19 封锁期间患有或不患有轻度认知障碍的帕金森病 (PD) 患者（PD-MCI 和 PD-NC）以及与 PD 无关的 MCI 患者 (MCInoPD) 的运动、认知和行为变化。方法：在意大利 COVID-19 封锁 10 周后，对 34 名 PD-NC、31 名 PD-MCI 和 31 名 MCInoPD 患者及其护理人员进行了访谈，并检查了认知、行为和运动症状的变化。采用修改后的标准化量表，包括神经精神量表 (NPI) 和运动障碍协会、统一帕金森病评定量表 (MDS-UPDRS) 第 I 部分和第 II 部分。通过比较 PD-NC 与 PD-MCI 以及 MCInoPD 与 PD-MCI，使用多变量逻辑回归来评估相关协变量。结果：在 COVID-19 封锁期间，所有群体的认知（39.6%）、已有的（37.5%）和新的（26%）行为症状以及运动症状（35.4%）均出现恶化，导致 26% 的病例的护理负担增加。经过多变量分析，与 PD-NC 相比，PD-MCI 与隔离期间 IADL 丢失呈显着正相关（OR 3.9，CI 1.61-9.58）。在 MCInoPD 与 PD-MCI 的分析中，后者的运动症状比 MCInoPD 显着恶化（OR 7.4，CI 1.09-45.44）。关于 NPI 项目，MCInoPD 与 PD-MCI 的夜间行为存在统计差异（16.1% vs. 48.4%，p = 0.007）。 MDS-UPDRS 第 I 和 II 部分显示，与 PD-NC 相比，PD-MCI 表现出认知障碍 (p = 0.034)、疲劳 (p = 0.036) 和言语 (p = 0.013) 的频率显着更高。相反，与 MCInoPD 相比，PD-MCI 在多个 MDS-UPDRS 项目中显示出显着更高的频率，特别是在疼痛 (p = 0.001)、床上翻身 (p = 0.006)、起床 (p = 0.001) 以及行走和平衡 (p = 0.003) 方面。结论：COVID-19 隔离与 PD 和 MCI 患者的认知、行为和运动症状恶化有关，尤其是 PD-MCI。需要实施具体策略来控制隔离对帕金森病和认知障碍患者及其护理人员的影响。
Objective: The effects of the COVID-19 lockdown on subjects with prodromal phases of dementia are unknown. The aim of this study was to evaluate the motor, cognitive, and behavioral changes during the COVID-19 lockdown in Italy in patients with Parkinson's disease (PD) with and without mild cognitive impairment (PD-MCI and PD-NC) and in patients with MCI not associated with PD (MCInoPD). Methods: A total of 34 patients with PD-NC, 31 PD-MCI, and 31 MCInoPD and their caregivers were interviewed 10 weeks after the COVID-19 lockdown in Italy, and changes in cognitive, behavioral, and motor symptoms were examined. Modified standardized scales, including the Neuropsychiatric Inventory (NPI) and the Movement Disorder Society, Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts I and II, were administered. Multivariate logistic regression was used to evaluate associated covariates by comparing PD-NC vs. PD-MCI and MCInoPD vs. PD-MCI. Results: All groups showed a worsening of cognitive (39.6%), pre-existing (37.5%), and new (26%) behavioral symptoms, and motor symptoms (35.4%) during the COVID-19 lockdown, resulting in an increased caregiver burden in 26% of cases. After multivariate analysis, PD-MCI was significantly and positively associated with the IADL lost during quarantine (OR 3.9, CI 1.61–9.58), when compared to PD-NC. In the analysis of MCInoPD vs. PD-MCI, the latter showed a statistically significant worsening of motor symptoms than MCInoPD (OR 7.4, CI 1.09–45.44). Regarding NPI items, nighttime behaviors statistically differed in MCInoPD vs. PD-MCI (16.1% vs. 48.4%, p = 0.007). MDS-UPDRS parts I and II revealed that PD-MCI showed a significantly higher frequency of cognitive impairment (p = 0.034), fatigue (p = 0.036), and speech (p = 0.013) than PD-NC. On the contrary, PD-MCI showed significantly higher frequencies in several MDS-UPDRS items compared to MCInoPD, particularly regarding pain (p = 0.001), turning in bed (p = 0.006), getting out of bed (p = 0.001), and walking and balance (p = 0.003). Conclusion: The COVID-19 quarantine is associated with the worsening of cognitive, behavioral, and motor symptoms in subjects with PD and MCI, particularly in PD-MCI. There is a need to implement specific strategies to contain the effects of quarantine in patients with PD and cognitive impairment and their caregivers.
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影响因子：
4
作者：
Panzarella, Vera;Mauceri, Rodolfo;Baschi, Roberta;Maniscalco, Laura;Campisi, Giuseppina;Monastero, Roberto
通讯作者：
Monastero, Roberto
影响因子：
6.7
作者：
Cheng ST
通讯作者：
Cheng ST
影响因子：
168.9
作者：
Kalia, Lorraine V.;Lang, Anthony E.
通讯作者：
Lang, Anthony E.
影响因子：
11.1
作者：
Petersen RC;Caracciolo B;Brayne C;Gauthier S;Jelic V;Fratiglioni L
通讯作者：
Fratiglioni L
影响因子：
8.6
作者：
Cilia, Roberto;Bonvegna, Salvatore;Eleopra, Roberto
通讯作者：
Eleopra, Roberto