L-DOPA WITHDRAWAL IN PARKINSONS-DISEASE SELECTIVELY IMPAIRS COGNITIVE PERFORMANCE IN TESTS SENSITIVE TO FRONTAL-LOBE DYSFUNCTION
L-DOPA WITHDRAWAL IN PARKINSONS-DISEASE SELECTIVELY IMPAIRS COGNITIVE PERFORMANCE IN TESTS SENSITIVE TO FRONTAL-LOBE DYSFUNCTION
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DOI：
10.1007/bf02245167
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发表时间：
1992-06-01
影响因子：
3.4
通讯作者：
PAUL, GM
中科院分区：
文献类型：
--
作者：
LANGE, KW;ROBBINS, TW;PAUL, GM
对10名特发性帕金森病(PD)患者在服用或停用L-多巴药物的同时，进行了一系列关于学习、记忆、计划和注意力的自动化测试。受控撤除L-多巴影响了三项测试的表现，这三项测试以前被证明对额叶功能障碍敏感；一项是空间工作记忆任务，一项是伦敦塔计划测试，另一项是视觉辨别范式，其中还包括选择性注意的维度内和维度外转移测试。更具体地说，空间工作记忆测试中的错误增加了，思维的准确性和潜伏期都受到了损害。在L-多巴停药后，思考时间显著减慢，尽管可能对运动减速的污染影响完全由一种带轭的控制程序控制。十分之九的患者在服用而不是停用L-多巴药物时，达到了视觉辨别的进一步阶段，即定势转移范式。停药后空间广度也受到损害，但在图形和空间再认记忆、与样本或视觉空间条件联想学习的同步匹配和延迟匹配测试中，L-多巴停药对其无影响。与大量对照组的比较证实了之前的发现，即帕金森病与大多数这些测试中的缺陷有关。这些结果是从帕金森病患者中发现的一些认知缺陷的额纹状体多巴胺依赖的性质来讨论的，但在认知功能的其他方面的缺陷明显的多巴胺独立的性质，特别是在视觉识别记忆和联想学习的测试中。
A group of ten patients with idiopathic Parkinson's disease (PD) was tested on a series of automated tests of learning, memory, planning and attention whilst either on or Off L-dopa medication. Controlled withdrawal Of L-dopa interfered with aspects of performance on three of the tests that had previously been shown to be sensitive to frontal lobe dysfunction; a spatial working memory task, the Tower of London planning test, and a visual discrimination paradigm that also included intra- and extra-dimensional shift tests of selective attention. More specifically, errors were increased in the spatial working memory test, and both the accuracy and latency of thinking were impaired. Thinking time was significantly slowed following L-dopa withdrawal, even though the possible contaminating effects on motor slowing were fully controlled by a yoked control procedure. Nine out of ten patients reached a further stage of the visual discrimination, set-shifting paradigm when on, rather than Off, L-dopa medication. Spatial span was also impaired off medication, but there were no effects of L-dopa withdrawal on tests of pattern and spatial recognition memory, simultaneous and delayed matching to sample or visuospatial conditional associative learning. Comparisons with a large control group confirmed previous findings that PD is associated with deficits on the majority of these tests. The results are discussed in terms of the fronto-striatal, dopamine dependent nature of some of the cognitive deficits found in PD, but the apparent dopamine-independent nature of deficits in other aspects of cognitive functioning, notably in tests of visual recognition memory and associative learning.