老年脑小血管病患者淡漠症状的体动分析研究

Actigraphy of apathy in aged patients with cerebral small vessel disease

目的探究脑小血管病(CSVD)患者淡漠症状及其与体动分析设备在昼间和夜间采集数据的相关性。方法选择2021年11月至2022年4月解放军总医院第七医学中心神经内科住院的老年CSVD患者56例,根据神经精神问卷淡漠分量表评分分为淡漠组21例,非淡漠组35例。又根据CSVD负荷评分分为高负荷组40例(CSVD负荷评分≥2分)和低负荷组16例(CSVD负荷评分≤1分)。采用头颅MRI检查评定腔隙、脑白质高信号、脑微出血、扩大的血管周围间隙。体动分析设备佩戴于非惯用手,采集连续7 d的数据,得到昼间矢量和以及睡眠治疗参数。结果与非淡漠组比较,淡漠组腔隙、脑微出血、Fazekas量表评分、CSVD负荷评分更高(P<0.05,P<0.01)。与低负荷组比较,高负荷组表现出更低的昼间矢量和[(885.97±410.04)次vs(1369.27±411.28)次,P<0.01]。淡漠严重程度与昼间矢量和(r=-0.811,P=0.000)及卧床总时间(r=-0.349,P=0.030)呈负相关。结论体动分析是CSVD患者淡漠严重程度的理想方法。

Objective To investigate apathy in patients with CSVD,and explore the correlation between apathy and actigraphic data sampled from diurnal and nocturnal periods.Methods A total of 56 elderly CSVD patients hospitalized in our department from November 2021 to April 2022 were enrolled in the study.According to the score of Neuropsychiatric Inventory-Apathy Subscale,they were divided into 21 cases in the apathy group and 35 cases in the non-apathy group.Besides,CSVD burden score was employed to divide the subjects into severe burden group(CSVD burden score≥2,n=40)and low burden group(score≤1,n=16).MRI images were observed to identify the presences of lacunes,WMH,CMB,and PVS.Actigraph devices were worn in the nondominant hand of each subject for 7 consecutive days to sample raw data,and diurnal vector magnitudes(VM)as well as sleep quality variables were obtained.Results The patients of the apathy group showed more lacunes and CMB and higher Fazekas score and CSVD burden score in comparison to those from the non-apathy group(P<0.05,P<0.01).Compared with the low burden load group,the severe burden group had significantly lower diurnal VM(885.97±410.04 vs 1369.27±411.28,P<0.01).The apathy severity was negatively correlated with diurnal VM(r=-0.811,P=0.000)and total time in bed(r=-0.349,P=0.030)in the CSVD patients.Conclusion Actigraphy is an optimal choice to evaluate the severity of apathy in CSVD patients.