睡眠质量、白天过度嗜睡、昼夜节律特征和运动亚型对帕金森病患者抑郁症状的影响。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-11-15 DOI:10.1016/j.sleep.2024.11.024

Anastasiia D. Shkodina , Kateryna A. Tarianyk , Mykhaylo Yu Delva , Azmat Ali Khan , Abdul Malik , Sabiha Fatima , Athanasios Alexiou , Md. Habibur Rahman , Marios Papadakis

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引用次数: 0

摘要

目的：帕金森病（PD）的诊断主要基于运动症状的评估，尽管非运动症状对患者残疾的影响有时可能比疾病的主要临床症状更为显著。众所周知，姿势不稳和步态障碍的主要亚型与帕金森病更严重的非运动症状有关。然而，运动亚型与特定情绪症状之间的关系仍未得到充分研究。本研究旨在分析帕金森病患者的睡眠和时间型体征、运动亚型与抑郁症状严重程度之间的关系：我们在临床研究中纳入了 64 名患者。研究对象分为以下几组：PIGD组--以姿势不稳和步态障碍为主的帕金森病患者；非PIGD组--以震颤或中等运动亚型为主的帕金森病患者。我们使用了统一帕金森病评分量表、贝克抑郁量表、匹兹堡睡眠质量指数、爱普沃斯嗜睡量表和慕尼黑时间型问卷：结果：PIGD亚型患者的抑郁症状和白天过度嗜睡程度较高，睡眠质量较差，睡眠开始和睡眠中期较晚，睡眠潜伏期较长，且有睡眠惰性。PIGD 运动亚型（P 结论：睡眠质量差和睡眠中期较晚可能是预测帕金森病患者抑郁症状更严重的因素。

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Influence of sleep quality, excessive daytime sleepiness, circadian features and motor subtypes on depressive symptoms in Parkinson's disease

Objectives

The diagnosis of Parkinson's disease (PD) is mainly based on the assessment of motor symptoms, although the influence of non-motor symptoms sometimes may be more significant on the patient's disability than the cardinal clinical signs of the disease. The predominant subtype of postural instability and gait disturbance is known to be associated with more severe non-motor symptoms of Parkinson's disease. Yet, the association between motor subtypes and specific mood symptoms remains understudied. The study aimed to analyze an association between sleep and chronotype signs, motor subtypes, with the severity of depressive symptoms in PD patients.

Methods

We have included 64 patients in the clinical study. The studied population was divided into the following groups: PIGD group – patients with PD and dominance of postural instability and gait disorders; non-PIGD group – patients with PD and dominance of tremor or intermediate motor subtype. We used the Unified Parkinson's Disease Rating Scale, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Munich Chronotype Questionnaire.

Results

Patients with the PIGD subtype have higher levels of depressive symptoms and excessive daytime sleepiness, poorer sleep quality, later sleep onset and mid-sleep, longer sleep latency, and sleep inertia. PIGD motor subtype (p < 0.001), poor sleep quality (p < 0.001), mid-sleep (p = 0.016), and sleep latency (p = 0.025) had a significant impact on the level of depression in univariate regression analysis. Still, only mid-sleep (p = 0.019) and poor sleep quality (p = 0.003) increased the probability of higher severity of depression in the multivariate model.

Conclusion

Poor sleep quality and later mid-sleep may be predictors of more severe depressive symptoms in PD.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.