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Neurology:小脑性共济失调和帕金森病患者的冲动性特征

2022-05-27 Naomi MedSci原创

患有小脑性共济失调(CA)的人会出现冲动的行为症状。不同于帕金森患者,CA患者的冲动由非计划性特征驱动。这表明小脑和基底节可能以不同的方式控制冲动行为,小脑以一种特定领域的方式参与冲动的大脑回路。

患有小脑性共济失调(CA)的人会出现冲动的行为症状,通常会导致负面的人际关系后果,对他们的生活质量产生不利影响。关于CA的冲动及其相关的行为改变,目前存在的证据有限。近日,有研究人员使用Barratt冲动性来评估CA的冲动性特征采用抑郁自评量表(BIS-11),并与帕金森病(PD)患者进行比较,以探讨CA与PD在冲动特质方面的差异。

研究人员对分别来自哥伦比亚大学医学中心和范德比尔特大学医学中心的运动障碍门诊的CA和PD受试者进行了一项双中心横断面研究。在各自的机构招募了年龄匹配的对照组。如果参与者之前或同时患有已知与冲动有关的神经和精神疾病,则被排除在外。所有受试者都完成了BIS-11问卷,作为冲动特质的测量工具。使用一般线性模型和最小绝对收缩和选择操作回归来比较不同组间BIS-11的总分、分量表和单项得分。亚组分析是为了从小脑外病理和多巴胺能障碍或药物的潜在影响中分离出小脑对冲动的贡献。

  • 共有190名参与者:90名年龄匹配的对照组、50名CA和50名PD参与者完成了评估。
  • CA患者报告的BIS11得分比对照组高9.7%(p<0.001),而PD患者报告的BIS11得分比对照组高24.9%(p<0.001)。
  • 在CA中,受冲动影响最大的领域是非计划性。相反,帕金森病患者注意到在非计划领域、注意力领域和运动领域有更大的冲动。

与帕金森病患者不同,CA患者的冲动是由非计划性特征驱动的。这表明,小脑和基底节可能以不同的方式控制冲动行为,小脑以一种特定领域的方式参与冲动的大脑回路。

文献来源:Chen TX, Roy Lin CY, Aumann MA, et al. Impulsivity Trait Profiles in Patients With Cerebellar Ataxia and Parkinson Disease [published online ahead of print, 2022 Apr 15]. Neurology. 2022;10.1212/WNL.0000000000200349. doi:10.1212/WNL.0000000000200349

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