Cognitive impairments in advanced PD without dementia
Cognitive impairments in advanced PD without dementia
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DOI：
10.1212/01.wnl.0000031426.21683.e2
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发表时间：
2002-11-12
期刊：
影响因子：
9.9
通讯作者：
DeLong, MR
中科院分区：
文献类型：
--
作者：
Green, J;McDonald, WM;DeLong, MR
目的：确定晚期PD非痴呆患者认知障碍的性质和频率及其与其他可能预测神经心理学表现的变量的关系。研究方法：非痴呆、非抑郁的特发性PD患者（n = 61）的神经心理学表现与临床可用的标准数据进行了量化。评估神经心理学指标与运动症状、年龄、受教育年限、病程、发病年龄、疾病恶化率和多巴胺能治疗的关系。结果如下：受损最常见的是对额叶功能敏感的指标（威斯康星州卡片分类测试类别数为67%，字母流畅性为30%，语言学习为30%）。多项神经心理学指标的表现与更大的整体运动异常（统一帕金森病评定量表总评分）、药物治疗时运动迟缓增加、年龄较大、病程较长和受教育程度降低相关。结论：即使在没有痴呆或抑郁症的情况下，晚期PD患者也可能表现出对参与认知基底节-丘脑皮质回路的背外侧前额叶区变化敏感的神经心理学指标的临床显著损害。
Objective: To determine the nature and frequency of cognitive impairments in nondemented patients with advanced PD and their relationship to other variables potentially predictive of neuropsychological performance. Methods: The neuropsychological performance of nondemented, nondepressed patients with idiopathic PD (n = 61) was quantified with respect to clinically available normative data. The relationship of neuropsychological measures to motor symptoms, age, years of education, disease duration, age at disease onset, disease deterioration rate, and dopaminergic therapy was assessed. Results: Impairment was most frequent on measures sensitive to frontal lobe function (67% on Wisconsin Card Sorting Test number of categories, 30% on letter fluency, 30% on verbal learning). Poorer performance on multiple neuropsychological measures was related to greater overall motor abnormality (total Unified Parkinson's Disease Rating Scale score), increased bradykinesia on medication, older age, longer disease duration, and reduced education. Conclusions: Even in the absence of dementia or depression, patients with advanced PD are likely to show clinically significant impairments on neuropsychological measures sensitive to changes in dorsolateral prefrontal regions participating in cognitive basal ganglia-thalamocortical circuits.