Background: During early stages, patients with neurodegenerative diseases (NDG) often present with depressive symptoms. However, because depression is a heterogeneous disorder, more precise delineation of the specific depressive symptom profiles that arise early in distinct NDG syndromes is necessary to enhance patient diagnosis and care. Methods and Findings: Five-hundred and sixty four participants self-reported their depressive symptoms using the Geriatric Depression Scale (GDS), including 111 healthy older control subjects (NC) and 453 patients diagnosed with one of six NDGs who were at the mild stage of disease (CDR® Dementia Staging Instrument ≤ 1) [186 Alzheimer's disease (AD), 76 behavioral variant frontotemporal dementia (bvFTD), 52 semantic variant primary progressive aphasia (svPPA), 46 non-fluent variant PPA (nfvPPA), 49 progressive supranuclear palsy syndrome (PSPS), 44 corticobasal syndrome (CBS)]. The GDS was divided into subscales based on a previously published factor analysis, representing five symptoms (dysphoria, hopelessness, withdrawal, worry, and cognitive concerns). Mixed models were created to examine differences in depression subscale by group, and logistic regression analyses were performed to determine if patterns of depressive symptoms could predict a patient's NDG syndrome. PSPS patients presented with a hopeless, dysphoric, and withdrawn pattern, while patients with CBS presented with a similar but less severe pattern. Worry was a key symptom in the profile of patients with svPPA, while ADs only had abnormally elevated cognitive concerns. Depressive profile accurately predicted NDG diagnosis at a rate of between 70 and 84% accuracy. Conclusions: These results suggest that attention to specific depressive symptom profile can improve diagnostic sensitivity and can be used to provide more individualized patient care.

中文翻译：

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抑郁症状特征可预测早期特定的神经退行性疾病综合征。


背景：在早期阶段，神经退行性疾病（NDG）患者经常出现抑郁症状。然而，由于抑郁症是一种异质性疾病，因此有必要更精确地描述不同 NDG 综合征早期出现的特定抑郁症状特征，以加强患者的诊断和护理。方法和结果：564 名参与者使用老年抑郁量表 (GDS) 自我报告了他们的抑郁症状，其中包括 111 名健康老年对照受试者 (NC) 和 453 名被诊断患有 6 种 NDG 之一的轻度阶段患者疾病（CDR® 痴呆分期仪器 ≤ 1）[186 阿尔茨海默病 (AD)、76 行为变异型额颞叶痴呆 (bvFTD)、52 语义变异型原发性进行性失语 (svPPA)、46 不流利变异型 PPA (nfvPPA)、49 进行性核上性麻痹综合征（PSPS），44 皮质基底节综合征（CBS）]。 GDS 根据之前发表的因子分析分为多个子量表，代表五种症状（烦躁、绝望、退缩、担忧和认知问题）。创建混合模型来检查各组抑郁分量表的差异，并进行逻辑回归分析以确定抑郁症状模式是否可以预测患者的 NDG 综合征。 PSPS 患者表现出绝望、烦躁和孤僻的模式，而 CBS 患者则表现出类似但不那么严重的模式。担忧是 svPPA 患者的一个关键症状，而 AD 患者仅存在异常升高的认知问题。抑郁概况可以准确预测 NDG 诊断，准确率在 70% 到 84% 之间。 结论：这些结果表明，关注特定的抑郁症状特征可以提高诊断敏感性，并可用于提供更加个性化的患者护理。