Publication: Estudio del rendimiento cognitivo en pacientes con temblor esencial: comparación con controles y enfermedad de Parkinson
Loading...
Files
Official URL
Full text at PDC
Publication Date
2016-05-06
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
El temblor esencial es la segunda enfermedad neurológica más frecuente, y en población anciana una de las más incapacitantes. En la actualidad ha crecido el debate sobre los problemas no motores asociados al temblor esencial, y han sido varios los estudios que han encontrado un rendimiento cognitivo bajo en los sujetos con temblor esencial en comparación con datos normativos y con controles. Pero estos estudios tienen un tamaño muestral pequeño o utilizan protocolos cognitivos breves. En este trabajo utilizamos una muestra mayor de sujetos con temblor esencial comparando su rendimiento cognitivo, su perfil de personalidad y puntuación en depresión con un grupo de sujetos sanos y con un grupo de enfermos de Parkinson, entidad que tiene características comunes con el temblor esencial. Los objetivos del presente estudio son describir el perfil cognitivo de los pacientes con temblor esencial, estudiar las variables de personalidad y los síntomas depresivos en comparación con el grupo control y el grupo de pacientes con Parkinson. Seleccionamos 96 sujetos, donde 32 sufren temblor esencial, 32 enfermedad de Parkinson y 32 sujetos sanos, homogéneos en edad, sexo y nivel educativo. Recogimos datos de diferentes variables médicas. Aplicamos una batería neuropsicológica completa que evaluaba funciones atencionales, visuoespaciales y ejecutivas, memoria verbal y visual y lenguaje, además de pasar un test de evaluación de alteraciones emocionales y de personalidad. Para los análisis estadísticos utilizamos el análisis de varianza para comparar entre grupos en las variables cuantitativas y el chi-cuadrado para las cualitativas. Aplicamos correlaciones para estudiar la relación de la gravedad y evolución de la enfermedad con los diferentes test. Y realizamos un modelo de regresión con los test como variable dependiente y las diferentes variables sociodemográficas como independientes. El resultado del estudio es que sí existen diferencias cognitivas entre los temblores esenciales y el grupo control, en diferentes dominios cognitivos: atención, funciones ejecutivas, memoria verbal y lenguaje. Pero no se observan diferencias en el rendimiento cognitivo al compararse con los sujetos con Parkinson. La puntuación del test de depresión no existen diferencias entre los grupos. En la escala de personalidad sí se observa que los sujetos con temblor esencial muestra más ansiedad y depresión que los sujetos control, mientras que solo se diferencian en la subescala de trastorno límite con los enfermos de Parkinson. Con estos resultados concluimos que existen diferencias entre los sujetos con temblor esencial y los sujetos sanos en el rendimiento cognitivo, por tanto, la enfermedad sí está influyendo en el rendimiento cognitivo de los pacientes con esta entidad. Pero no observamos diferencias cognitivas con los participantes con enfermedad de Parkinson por lo que ambas enfermedades tienen puntos en común, ya sea a nivel estructural cerebral o como otros autores defienden, sean entidades de un mismo continuo.
Essential tremor is the second most common neurological disease, and is one of the most disabling in elderly population. Currently, the debate on non-motor problems associated with essential tremor has grown, and several studies have found a low cognitive performance in patients with essential tremor compared with normative data and controls groups. But these studies had small sample size or used short cognitive protocols. In this paper, we used a larger sample of subjects with essential tremor, comparing their cognitive performance, personality profile and depression score with a group of healthy subjects and with a group of patients with Parkinson disease, this entity has common features with essential tremor. The aims of this study are to describe the cognitive profile of patients with essential tremor, studying personality variables and depressive symptoms compared all to the control group and patients with Parkinson. We selected 96 subjects which 32 suffer from essential tremor, 32 Parkinson disease and 32 healthy subjects, homogeneous in age, sex and educational level. We collected data from different medical variables. We apply a comprehensive neuropsychological battery evaluating attentional, visuospatial and executive functions, verbal and visual memory and language, in addition to passing an evaluation test of emotional disturbances and personality. For statistical analysis, we used analysis of variance to compare between groups for quantitative variables and the chi-square test for qualitative variables. Correlations applied to study the relationship of the severity and progression of the disease with different test. And we made a regression model with the test as the dependent variable and sociodemographic variables as independent. The result of the study shows that there are cognitive differences between essential tremor and control groups in different cognitive domains: attention, executive functions, verbal memory and language. However, no differences were seen in cognitive performance when compared to subjects with Parkinson. The punctuations in depression test did not show differences among the studied groups. In the personality scale some differences were seen, as subjects with essential tremor shown more anxiety and depression than control subjects, while there were only differences in the borderline features subscale with Parkinson disease subjects. With these results, we conclude that there are differences between subjects with essential tremor and healthy subjects in cognitive performance, thus the disease is influencing cognitive performance in patients with this condition. However, we do not observe cognitive differences with participants with Parkinson's disease so that both diseases have some points in common, either cerebral structural or as other authors defend, both diseases are entities of the same continuum.
Essential tremor is the second most common neurological disease, and is one of the most disabling in elderly population. Currently, the debate on non-motor problems associated with essential tremor has grown, and several studies have found a low cognitive performance in patients with essential tremor compared with normative data and controls groups. But these studies had small sample size or used short cognitive protocols. In this paper, we used a larger sample of subjects with essential tremor, comparing their cognitive performance, personality profile and depression score with a group of healthy subjects and with a group of patients with Parkinson disease, this entity has common features with essential tremor. The aims of this study are to describe the cognitive profile of patients with essential tremor, studying personality variables and depressive symptoms compared all to the control group and patients with Parkinson. We selected 96 subjects which 32 suffer from essential tremor, 32 Parkinson disease and 32 healthy subjects, homogeneous in age, sex and educational level. We collected data from different medical variables. We apply a comprehensive neuropsychological battery evaluating attentional, visuospatial and executive functions, verbal and visual memory and language, in addition to passing an evaluation test of emotional disturbances and personality. For statistical analysis, we used analysis of variance to compare between groups for quantitative variables and the chi-square test for qualitative variables. Correlations applied to study the relationship of the severity and progression of the disease with different test. And we made a regression model with the test as the dependent variable and sociodemographic variables as independent. The result of the study shows that there are cognitive differences between essential tremor and control groups in different cognitive domains: attention, executive functions, verbal memory and language. However, no differences were seen in cognitive performance when compared to subjects with Parkinson. The punctuations in depression test did not show differences among the studied groups. In the personality scale some differences were seen, as subjects with essential tremor shown more anxiety and depression than control subjects, while there were only differences in the borderline features subscale with Parkinson disease subjects. With these results, we conclude that there are differences between subjects with essential tremor and healthy subjects in cognitive performance, thus the disease is influencing cognitive performance in patients with this condition. However, we do not observe cognitive differences with participants with Parkinson's disease so that both diseases have some points in common, either cerebral structural or as other authors defend, both diseases are entities of the same continuum.
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Psicología, Departamento de Psicología Básica II (Procesos Cognitivos), leída el 16-11-2015