随着时间的推移，De Novo帕金森病患者的自主神经功能障碍与情绪症状之间的关系。

IF 2.9 4区医学 Q2 CLINICAL NEUROLOGY

Journal of Geriatric Psychiatry and Neurology Pub Date : 2024-05-01 Epub Date: 2023-10-13 DOI:10.1177/08919887231204542

Adrianna M Ratajska, Connor B Etheridge, Francesca V Lopez, Lauren E Kenney, Katie Rodriguez, Rachel N Schade, Joshua Gertler, Dawn Bowers

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Multilevel modeling examined longitudinal relationships with total autonomic load.Results: Gastrointestinal symptoms were associated with both higher anxiety (b = 1.04, 95% CI [.55, 1.53], P < .001) and depression (b = .24, 95% CI [.11, .37], P = .012), as were thermoregulatory symptoms (anxiety: b = 1.06, 95% CI [.46, 1.65], P = .004; depression: b = .25, 95% CI [.09, .42], P = .013), while cardiovascular (b = .36, 95% CI [.10, .62], P = .012) and urinary symptoms (b = .10, 95% CI [.01, .20], P = .037) were associated only with depression. 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引用次数: 0

摘要

背景：自主功能障碍在帕金森病（PD）中普遍存在，并可能恶化生活质量。我们研究了：（a）特定的自主神经症状是否与帕金森病患者的焦虑或抑郁更密切相关；（b）总体自主神经功能障碍是否预测了5年内的情绪轨迹。方法：来自帕金森氏进展标记物倡议的新诊断的PD患者（N=414）每年完成抑郁、焦虑和自主神经症状的自我报告测量。横断面线性回归检验了特定自主亚结构域（胃肠道、心血管、体温调节等）与情绪之间的关系。多级建模检查了与总自主负荷的纵向关系。结果：胃肠道症状与较高的焦虑（b=1.04，95%CI[.55，1.53]，P<.001）和抑郁（b=0.24，95%CI[.11，.37]，P=.012）以及体温调节症状（焦虑：b=1.06，95%CI[.46，1.65]，P=.004；抑郁：b=0.25，95%CI[.09，.42]，P=.013）相关，而心血管（b=0.36，95%CI[.10，.62]，P=.012）和泌尿系统症状（b=0.10，95%CI[.01，.20]，P=.037）仅与抑郁症相关。从纵向上看，随着时间的推移，较高的总自主神经负荷与抑郁（b=.01，95%CI[.00，.02]，P=.015）和焦虑（b=.04，95%CI[.01，.06]，P<.001）的增加以及偶尔的波动（抑郁：b=.08，95%CI[0.05，.10]，P<.001；焦虑：b=.24，95%CI[15，.32]，P本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson's Disease Patients Over Time.

Background: Autonomic dysfunction is prevalent in Parkinson's disease (PD) and can worsen quality of life. We examined: (a) whether specific autonomic symptoms were more strongly associated with anxiety or depression in PD and (b) whether overall autonomic dysfunction predicted mood trajectories over a 5-year period.

Methods: Newly diagnosed individuals with PD (N = 414) from the Parkinson's Progression Markers Initiative completed self-report measures of depression, anxiety, and autonomic symptoms annually. Cross-sectional linear regressions examined relationships between specific autonomic subdomains (gastrointestinal, cardiovascular, thermoregulatory, etc.) and mood. Multilevel modeling examined longitudinal relationships with total autonomic load.

Results: Gastrointestinal symptoms were associated with both higher anxiety (b = 1.04, 95% CI [.55, 1.53], P < .001) and depression (b = .24, 95% CI [.11, .37], P = .012), as were thermoregulatory symptoms (anxiety: b = 1.06, 95% CI [.46, 1.65], P = .004; depression: b = .25, 95% CI [.09, .42], P = .013), while cardiovascular (b = .36, 95% CI [.10, .62], P = .012) and urinary symptoms (b = .10, 95% CI [.01, .20], P = .037) were associated only with depression. Longitudinally, higher total autonomic load was associated with increases in both depression (b = .01, 95% CI [.00, .02], P = .015) and anxiety (b = .04, 95% CI [.01, .06], P < .001) over time, as well as occasion-to-occasion fluctuations (depression: b = .08, 95% CI [.05, .10], P < .001; anxiety: b = .24, 95% CI [.15, .32], P < .001).

Conclusion: Findings suggest autonomic dysfunction, particularly gastrointestinal and thermoregulatory symptoms, may be an indicator for elevated anxiety/depression and a potential treatment target early on in PD.