中晚期帕金森病患者社交回避与认知功能的相关性研究

Relationship between social avoidance and multi-cognitive dysfunctions in advanced Parkinson’s disease

目的探讨社交回避状况与中晚期帕金森病(PD)患者的不同认知领域功能的相关性。方法选取2023年3~12月在安徽医科大学第一附属医院神经内科就诊的58例中晚期原发性帕金森病患者为研究对象,进行社交回避及苦恼量表(SAD)评估,并按SAD得分将所有受试者分为PD伴社交回避及苦恼组(SAD组,n=29)和PD不伴社交回避及苦恼组(NSAD组,n=29)。采用简易智力状况检查量表(MMSE)、中文听觉词语学习测验(AVLT)、数字广度测验(DST)和综合连线测验A(TMA)、测验B(TMB)、额叶功能评价量表(FAB)、语义流畅性(CVF)和语音流畅性(PVF)对所有受试者进行认知功能测验。分别比较SAD组和NSAD组以上认知功能测验的差异性,分析各项认知测验得分与SAD量表得分的相关性,并采用多元线性回归分析认知功能的影响因素。结果SAD组受试者的MMSE、DST逆序、TMA、TMB、FAB得分显著差于NSAD组(P<0.05)。Spearman相关分析提示,SAD得分与MMSE、AVLT-8得分、DST逆序、FAB得分呈负相关(r=-0.502、-0.350、-0.542、-0.432,P<0.05),与TMA、TMB用时呈正相关(r=0.543、0.626,P<0.05)。回归分析提示,SAD得分、受教育年限是不同认知测评得分的影响因素(P<0.05)。结论在中晚期帕金森病患者中,社交回避状况是认知水平下降的风险因素,且突出表现在注意、执行能力下降方面。

Objective To explore the correlation between social avoidance and multi-cognitive dysfunctions in patients with advanced Parkinson’s disease.Methods From March 2023 to December 2023,58 patients with advanced Parkinson’s disease from the Department of Neurology,the First Affiliated Hospital of Anhui Medical University,were involved.The scores of social avoidance scale and distress scale were performed.All participants were divided into the PD group with social avoidance and distress(SAD group,n=29 cases)and the PD group without social avoidance and distress(NSAD group,n=29 cases)according to the social avoidance and distress scale.The cognitive functions of all subjects was assessed using the Mini-mental State Examination(MMSE),Auditory Verbal Learning Test(AVLT),Digital Span Test(DST),Trail Making Test A(TMA),Test B(TMB),Frontal Assessment Battery(FAB),Category Verbal Fluency(CVF)and Phonemic Verbal Fluency(PVF).The differences in MMSE,AVLT,DST,TMA,TMB,FAB,CVF and PVF between SAD group and NSAD group were compared respectively.The Spearman rank correlation analysis of cognitive function scores with scores of social avoidance and distress scale was conducted subsequently.The multiple linear regression was conducted to explore risk factors for recognitive impairments.Results The scores of MMSE,DST reverse order,TMA,TMB and FAB of the SAD group were significantly worse than those of the NSAD group(P<0.05).The Spearman correlation analysis further showed that the score of social avoidance and distress scale had negative correlation with scores of MMSE,AVLT-8,DST reverse and FAB(r=-0.502,-0.350,-0.542,-0.432,P<0.05),and positive correlation with TMA and TMB scores(r=0.543,0.626,P<0.05).Multiple linear regression found that the score of social avoidance and distress scale and years of schooling were risk factors for different fields of cognitive impairments(P<0.05).Conclusion In patients with advanced Parkinson′s disease,social avoidance is associated with the decline of overall cognition,and especially with the decline of attention and executive ability.