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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(11): 1126-1133
DOI: 10.1055/s-0042-1758444
Original Article

Depressive symptoms and axial motor disorders in individuals with Parkinson's disease: a cross-sectional study

Sintomas depressivos e distúrbios motores axiais em indivíduos com doença de Parkinson: um estudo transversal
Nathalie Ribeiro Artigas 
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brazil.
,
Ana Carolina Leonardi Dutra 
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brazil.
,
Nayron Medeiros Soares 
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brazil.
,
Gabriela Magalhães Pereira 
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brazil.
,
Vanessa Bielefeldt Leotti 
2   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Epidemiologia, Departamento de Estatística, Porto Alegre RS, Brazil.
,
Julia Schneider Krimberg 
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brazil.
3   Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Vida e da Saúde, Porto Alegre RS, Brazil.
,
Aline de Souza Pagnussat 
4   Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil.
,
Carlos Roberto de Mello Rieder 
4   Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil.
5   Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Clínica Médica, Divisão de Neurologia, Porto Alegre RS, Brazil.
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Abstract

Background Depression is an important nonmotor symptom of Parkinson's disease (PD) and has been associated with the motor symptoms in these individuals.

Objectives To determine whether there are relationships between depressive symptoms and abnormalities in axial postural alignment and axial motor deficits, especially postural instability, and trunk rigidity in PD.

Methods In this cross-sectional study, 65 individuals were evaluated using the Beck Depression Inventory-II (BDI-II) for the analysis of depressive symptoms and underwent a postural assessment of head, trunk, and hip sagittal alignment through computerized photogrammetry. The MDS-UPDRS was used to assess clinical aspects of PD, the Trunk Mobility Scale was used to assess axial rigidity, and the MiniBESTest to assess balance. To determine the relationship between depressive symptoms and postural alignment, multiple linear regression analysis was performed.

Results The participants with depressive symptoms had more severe motor deficits as well as greater trunk rigidity and worse postural instability (p < 0.05). When the postural angles were compared between men and women using Student's t-test, it was found that men had greater flexion angles of the head (p = 0.003) and trunk (p = 0.017). Using multiple linear regression analysis corrected for the age and sex of the participants, we verified that the anterior trunk inclination was significantly larger in the PD population with depressive symptoms (R2 = 0.453, β = 0.116, and p = 0.045).

Conclusion PD individuals with depressive symptoms have more severe flexed trunk posture, mainly in older men. Additionally, more severe depressive symptoms are associated with worsening postural instability, trunk rigidity and motor deficits in this population.

Resumo

Antecedentes A depressão é um sintoma não motor importante da doença de Parkinson (DP) e tem sido associada aos sintomas motores nesses indivíduos.

Objetivos Determinar se existem relações entre sintomas depressivos e anormalidades no alinhamento postural axial e déficits motores axiais, especialmente instabilidade postural e rigidez de tronco na DP.

Métodos Neste estudo transversal, 65 indivíduos foram avaliados pelo BDI-II para análise de sintomas depressivos e submetidos à avaliação postural do alinhamento sagital de cabeça, tronco e quadril por meio de fotogrametria computadorizada. A MDS-UPDRS avaliou os aspectos clínicos, TMS avaliou rigidez axial e o MiniBESTest equilíbrio. Para determinar a relação entre sintomas depressivos e alinhamento postural, realizou-se uma análise de regressão linear múltipla.

Resultados Os participantes com sintomas depressivos apresentaram déficits motores mais graves, bem como maior rigidez de tronco e pior instabilidade postural (p < 0,05). Quando comparados os ângulos posturais entre homens e mulheres pelo teste t de Student, verificou-se que os homens apresentaram maiores graus de flexão da cabeça (p = 0,003) e do tronco (p = 0,017). Por meio da análise de regressão linear múltipla corrigida para a idade e sexo dos participantes, verificamos que a inclinação anterior do tronco foi significativamente maior nos indivíduos com DP com sintomas depressivos do que sem sintomas depressivos (R2 = 0,453, β = 0,116 e p = 0,045)

Conclusão Indivíduos com DP com sintomas depressivos apresentam postura de tronco flexionado mais severa, principalmente em homens mais idosos. Além disso, os sintomas depressivos mais graves pioram significativamente a instabilidade postural, a rigidez do tronco e os déficits motores nessa população.

Keywords

Depression - Posture - Postural Balance - Photogrammetry - Muscle Rigidity

Palavras-chave

Depressão - Postura - Equilíbrio Postural - Fotogrametria - Rigidez Muscular

Authors' Contributions

All authors have made substantial contributions to all of the following: (1) the conception and design of the study, acquisition of the data, or analysis and interpretation of the data, (2) the drafting of the article or revising it critically for important intellectual content, and (3) the final approval of the version to be submitted.




Publication History

Received: 03 September 2021

Accepted: 22 December 2021

Article published online:
28 December 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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