目的:探讨多系统萎缩(multiple system atrophy,MSA)患者睡眠质量与焦虑、抑郁及精神病性症状的相关性.方法:选取 185 例MSA患者,按照匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)评分分为MSA伴睡眠障碍组(MSA patients with sleep disorders,MSA-SD 组,PSQI>5 分)和MSA不伴睡眠障碍组(MSA patients without sleep disorders,MSA-NSD 组,PSQI≤5 分).采用简易智能状态检查量表(mini-mental state examination,MMSE)、额叶功能评定量表(frontal Assessment Battery,FAB)、汉密尔顿焦虑量表(hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(hamilton Depression Scale,HAMD)、神经精神量表(neuropsychiatric Inventory,NPI),轻度行为障碍清单(mild Behavioral Impairment Checklist,MBI-C)分别评估患者的整体认知功能、执行功能、焦虑和抑郁情绪以及精神行为状况,分析MSA患者睡眠质量与认知功能、焦虑和抑郁情绪及异常精神行为的相关性.结果:MSA患者睡眠障碍发生率为 48.11%,MSA合并睡眠障碍者的整体认知功能、执行功能比不合并睡眠障碍者差,焦虑和抑郁情绪、精神行为症状比不合并睡眠障碍者严重.单因素分析结果显示,PSQI总评分与年龄、MMSE、FAB均无显著关联,而与NPI总评分、HAMA评分、HAMD、MBI评分呈正相关.多重线性回归分析结果表明,抑郁和异常精神行为是MSA相关睡眠障碍的独立危险因素.结论:睡眠质量下降、焦虑和抑郁、精神行为异常是MSA患者常见的非运动症状,患者的抑郁情绪及精神病性症状是影响其睡眠质量的重要因素.
Objective:To explore the correlation between sleep quality and anxiety,depression,and psychiatric symptoms in multiple system atrophy(MSA)patients.Methods:total of 185 MSA patients were selected and divided into two groups based on their Pittsburgh Sleep Quality Index(PSQI)scores:MSA patients with sleep disorders(MSA-SD group,PSQI>5)and MSA patients without sleep disorders(MSA-NSD group,PSQI≤5).Cognitive function,executive function,anxiety,depression,neuropsychiatric symptoms,and mild behavioral impairment were assessed using the Mini-Mental State Examination(MMSE),Frontal Assessment Battery(FAB),HamiltoAn Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Neuropsychiatric Inventory(NPI-12),and Mild Behavioral Impairment Checklist(MBI-C),respectively.The correlation between sleep quality and cognitive function,anxiety,depression,and abnormal neuropsychiatric behavior was analyzed.Results:The prevalence of sleep disorders in MSA patients was 48.11%.MSA patients with comorbid sleep disorders had poorer overall cognitive function and executive function compared to those without sleep disorders.They also exhibited more severe anxiety,depression,and abnormal neuropsychiatric behavior.Univariate analysis showed that the PSQI total score was not significantly associated with age,MMSE,or FAB,but positively correlated with NPI total score,HAMA score,HAMD score,and MBI score.Multiple linear regression analysis revealed that depression and abnormal neuropsychiatric behavior were risk factors for sleep disorders in MSA patients.Conclusion:Sleep quality,anxiety,depression,and psychiatric behavioral abnormalities are common non-motor symptoms in MSA patients.Depression and psychiatric symptoms are important factors affecting sleep quality in these patients.