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Author Notes:

Dr. Sheng-Han Kuo, 710 West 168th Street, room 305, New York, NY 10032, USA, Tel: (212)305-5558, Fax: (212)305-1304, Email: sk3295@columbia.edu

Dr. Lo: study concept and design, analysis and interpretation, critical revision of the manuscript for important intellectual content Ms. Figueroa: study concept and design, acquisition of data Dr. Pulst: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, study supervision Dr. Perlman: acquisition of data Dr. Wilmot: acquisition of data Dr. Gomez: acquisition of data Dr. Schmahmann: acquisition of data Dr. Paulson: acquisition of data Dr. Shakkottai: acquisition of data Dr. Ying: acquisition of data Dr. Zesiewicz: acquisition of data Dr. Bushara: acquisition of data Dr. Geschwind: acquisition of data Dr. Xia: acquisition of data Mr. Yu: analysis and interpretation Ms. Lee: analysis and interpretation Dr. Subramony: study concept and design, acquisition of data, study supervision Dr. Ashizawa: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, study supervision Dr. Kuo: study concept and design, acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content

Disclosure: The authors report no conflicts of interest.

Subject:

Research Funding:

NINDS K08 NS083738, Louis V. Gerstner Jr. Scholarship, American Brain Research Training Fellowship, Parkinson Disease Foundation, American Parkinson’s Disease Association, Rare Disease Clinical Research Network (RDCRN) (RC1NS068897), International Essential Tremor Foundation, and NIEHS pilot grant ES009089, and the Smart Foundation.

Keywords:

  • depression
  • cerebellum
  • spinocerebellar ataxias
  • suicide
  • neurodegeneration

Depression and clinical progression in spinocerebellar ataxias

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Journal Title:

Parkinsonism and Related Disorders

Volume:

Volume 22

Publisher:

, Pages 87-92

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background—Depression is a common comorbidity in spinocerebellar ataxias (SCAs) but its association with ataxia progression is not well understood. Objectives—To study the prevalence and influence of depressive symptoms in SCAs. Methods—We studied 300 participants with SCA 1, 2, 3 and 6 from the Clinical Research Consortium for Spinocerebellar Ataxias (CRC-SCA) and repeatedly measured depressive symptoms by the 9-item Patient Health Questionnaire (PHQ-9) along with other clinical features including ataxia, functional status, and quality of life every 6 months for 2 years. We employed regression models to study the effects of depressive symptoms on clinical progression indexed by Scale for Assessment and Rating of Ataxia (SARA), Unified Huntington’s Disease Rating Scale Part IV (UHDRS-IV) and EQ5D after adjusting for age, sex and pathological CAG repeats. Results—Comorbid depression is common in SCAs (26%). Although the baseline prevalence of depression was similar among different SCA types, suicidal ideation was more frequently reported in SCA3 (65%). Depressive symptoms were associated with SARA scores but did not significantly progress over time within 2 years or deteriorate by increased numbers of pathological CAG repeats. The effects of depression on ataxia progression varied across different SCA types. Nevertheless, depression had consistently negative and significant impact on functional status and quality of life in all SCAs, even after accounting for ataxia progression. Conclusions—Depressive symptoms are not simply the consequence of motor disability in SCAs. Comorbid depression per se contributes to different health outcomes and deserves more attention when caring patients with SCAs
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