Clinical Analysis Of Parkinson’s Disease And Three Dimensions Of Personality

Objective: Based on the Cloninger’s theoretical model three dimensions of personality,in this research,we explored the relationship between three dimensions of personality and demographic as well as clinical characteristics of Parkinson’s disease(PD),in order to improve the understanding of clinical and scientific researchers on the changes of personality in PD;To explore the related factors that affect the quality of life in PD and ultimately establish a equation of linear regression;To determine optimal diagnostic thresholds of three dimensions of personality assisting the diagnosis of PD,which could lay a foundation for the diagnosis and differential diagnosis of PD.Methods: Selecting 33 patients who were diagnosed as PD from August to December 2020 in the specialized outpatient department of PD established in the First Hospital of Jilin University as PD group,meanwhile,recruiting 33 healthy volunteers as a control group.General data,including age,sex,education level and cognitive level,of both groups were collected.In addition,depression degree and three-dimension-personality including novelty seeking(NS),harm avoidance(HA)and reward dependence(RD)were evaluated.Clinical data were collected in the PD group,including the duration of disease,onset-sides,motor subtypes and severity,Hoehn & Yahr(H-Y)stage and assessment of quality of life.Comparing whether there were differences in NS,HA and RD in PD and health groups as well as in various subgroups of clinical features.Evaluating the correlation among quality of life in PD and all available data,then formulated an equation of linear regression.To assist the diagnosis of Parkinson’s disease,the ROC curve was used to evaluate the area under the curves of NS,HA,RD and ultimately calculated the optimal diagnostic thresholds.Results:(1)There were no significant differences in general data between PD group and healthy group,including age,sex,MMSE and education level(P >0.05),but significant differences present in depression degree and score of three dimensions of personality NS,HA and RD(P <0.05).(2)Compared to the healthy group,there were no significant differences in general data,including gender,age,MMSE and education level in the left-or right-onset of PD group(P >0.05),conversely,degree of depression,scores of NS,HA and RD presenting significant differences(P <0.05).No significant differences were discovered in the degree of depression,scores of NS,HA and RD between the left-or right-onset of PD groups(P >0.05).(3)Contrasting the left-and right-onset of PD groups,no statistical differences were found in the clinical data including quality of life,disease-duration,motor subtypes,medication,and H-Y stage(P >0.05),except score of UPDRS-III(P <0.05).(4)In PD,there were no statistical differences in the scores of NS,HA and RD among various motor subtypes,medical treatment and H-Y stage(P >0.05).Statistically significant differences were showed in the score of HA and RD(P <0.05),but not NS(P >0.05),among different degree of depression.(5)The score of quality of life was negatively correlated with scores of RD and MMSE,besides,positively correlated with duration of disease,H-Y stage,score of UPDRS-III,degree of depression and score of HA.Bringing these related factors into a equation of linear regression,that is,the score of quality of life = 15.514 + 0.407×the score of UPDRS-III + 0.546×degree of depression(6 points≤ score of UPDRS-III≤37 points,the degree of depression ranging from no depression to severe depression).(6)Logistic regression analysis between PD and healthy groups showed that moderate depression and score of HA were independent influencing factors for PD(P <0.05).The results showed that the risk of Parkinson’s disease was 1.219 times higher for each 1-point increase in the score of HA.People with moderate depression had a 9.982 times higher risk of developing Parkinson’s disease than those without depression.(7)The ROC curve showed that the score of HA had the highest diagnostic value among three dimensions of personality.The area under the ROC curve of HA was 0.833,and the corresponding optimal diagnostic thresholds was 13.5.Besides,95% confidence intervals was 0.738～0.928,with sensitivity of 87.9%,specificity of 63.6%,and Youden index of 0.515.Conclusion:(1)Compared to healthy people,three dimensions of personality of PD showed lower novelty seeking,higher harm avoidance and lower reward dependence.(2)The onset-side of motor symptoms in PD had no effect on the three dimensions of personality including novelty seeking,harm avoidance and reward dependence.(3)Motor subtypes,medication and H-Y stage of PD did not affect the three dimensions of personality.(4)Degree of depression had an effect on harm avoidance and reward dependence.Generally,the more severe the depression,the more prominent the harm avoidance and the weaker the reward dependence,while,the difference in novelty seeking is not obvious.(5)The more severe the motor symptoms of Parkinson’s disease were,the higher the degree of depression was,the worse the quality of life was.The equation of linear regression was that the score of quality of life = 15.514 + 0.407×the score of UPDRS-III + 0.546×degree of depression(6 points≤score of UPDRS-III≤37 points,the degree of depression ranging from no depression to severe depression).(6)Moderate depression and harm avoidance was independent influencing factors of PD.(7)Three dimensions of personality novelty seeking,harm avoidance and reward dependence can assist the diagnosis of Parkinson’s disease,among which harm avoidance personality was the most significant,with optimal diagnostic thresholds of 13.5.