Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease.
Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease.
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DOI：
10.1016/j.parkreldis.2015.04.002
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发表时间：
2015-07
影响因子：
4.1
通讯作者：
Leverenz JB
中科院分区：
文献类型：
--
作者：
Kelly VE;Johnson CO;McGough EL;Shumway-Cook A;Horak FB;Chung KA;Espay AJ;Revilla FJ;Devoto J;Wood-Siverio C;Factor SA;Cholerton B;Edwards KL;Peterson AL;Quinn JF;Montine TJ;Zabetian CP;Leverenz JB
研究表明帕金森病（PD）的整体认知与姿势不稳定/步态障碍（PIGD）之间存在关联，但特定认知领域与PIGD症状之间的关系尚不清楚。本研究在一个大型的、特征良好的PD患者样本中研究了认知（全局和特定认知领域）与PIGD症状的相关性。通过详细的神经心理学评估测量认知功能，包括整体认知、执行功能、记忆、视觉空间功能和语言。PIGD症状使用运动障碍协会统一帕金森病评定量表（MDS-PIGRS）第三部分运动检查子量表进行测量。进行多元线性回归分析，以评估认知和PIGD症状之间的关系，模型调整了年龄，性别，教育，招募地点，疾病持续时间和运动症状严重程度。该分析包括783名参与者，平均（标准差）年龄为67.3（9.7）岁，中位数（四分位数间距）MDS-MRS运动子量表评分为26（17，35）。整体认知、执行功能、记忆和音素流畅性的缺陷与更严重的PIGD症状相关。执行功能缺陷与步态、冻结和姿势稳定性障碍相关，而视觉空间障碍仅与更严重的冻结相关，记忆功能较差仅与更大的姿势不稳定相关。虽然整体认知和执行功能方面的障碍与更严重的PIGD症状相关，但特定的认知领域与不同的PIGD成分差异相关，这表明存在多种神经通路，有助于PD患者认知和PIGD症状之间的关联。
Research suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson’s disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD. Cognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language. PIGD symptoms were measured using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III, Motor Examination subscale. Multiple linear regression analyses were performed to assess the relationship between cognition and PIGD symptoms with models adjusting for age, sex, education, enrollment site, disease duration, and motor symptom severity. The analysis included 783 participants, with mean (standard deviation) age of 67.3 (9.7) years and median (interquartile range) MDS-UPDRS Motor Subscale score of 26 (17, 35). Deficits in global cognition, executive function, memory, and phonemic fluency were associated with more severe PIGD symptoms. Deficits in executive function were associated with impairments in gait, freezing, and postural stability, while visuospatial impairments were associated only with more severe freezing, and poorer memory function was associated only with greater postural instability. While impairments in global cognition and aspects of executive functioning were associated with more severe PIGD symptoms, specific cognitive domains were differentially related to distinct PIGD components, suggesting the presence of multiple neural pathways contributing to associations between cognition and PIGD symptoms in persons with PD.