Clinical characteristics of early Parkinson′s disease patients with emotional apathy and its relationship with other non-motor symptoms

Abstract

Objective To observe the characteristics of apathy in early Parkinson′s disease patients, analyze its relationship with other non-motor symptoms, and explore its impact on the quality of life. Methods Clinical data of 75 patients with Parkinson′s disease admitted to xingtai people′s hospital from August 2014 to August 2017 were selected.Unified Parkinson′s disease rating scale- III(UPDRS-III ), Modified apathy rating scale(MAES ), Montgomy-asberg Depression rating scale(MADRS ) and Simple mental state test(MMSE) were used to evaluate patients′ motor symptoms, indifference, depression and cognitive function.The relationship between apathy and other non-motor symptoms was analyzed by Parkinson′s disease non-motor symptom evaluation scale.Parkinson′s disease questionnaire-39(PDQ-39) was used to evaluate the quality of life.The patients were divided into the affective indifference group and the non-affective indifference group according to whether the patients were accompanied by affective indifference. Results 21.3%(16/75) of the patients were diagnosed with apathy.Emotional indifference group UPDRS score -Ⅲ (23.98±9.46), not apathy group(14.74±6.27). There was significant difference between the two groups (P<0.001). MMSE score of the indifferent group was (21.26±3.21), and that of the non-indifferent group was (26.57±3.42). There was significant difference between the two groups (P=0.038). PDQ-39 score of the emotionally indifferent group was (65.20±25.78), which was significantly higher than that of the non-emotionally indifferent group (34.86±25.42). There was significant difference between the two groups (P<0.001). In the comparison of Parkinson′s disease non-motor symptom evaluation scale, the fatigue symptom score of the emotionally indifferent group was (6.1±0.2) significantly higher than that of the non-indifferent group (2.3±0.7), and the difference was statistically significant (P=0.006). The score of lack of interest was (4.8±1.5) in the indifferent group and (1.3±0.8) in the non-indifferent group.The difference between the two groups was statistically significant (P=0.017). Conclusion Apathy has a high incidence in early Parkinson′s disease patients, often combined with fatigue and lack of interest symptoms.It has a serious impact on the quality of daily life in the future. Key words: Parkinson′s disease; Apathy; Unified Parkinson′s disease rating scale- III; Modified apathy evaluation scale; Montgomery-asberg depression rating scale; Mini-mental state examination; Non-motor symptom; Quality of life