DIFFERENT EFFECTS OF DOPAMINERGIC AND ANTICHOLINERGIC THERAPIES ON COGNITIVE AND MOTOR FUNCTION IN PARKINSONS-DISEASE - A FOLLOW-UP-STUDY OF UNTREATED PATIENTS
DIFFERENT EFFECTS OF DOPAMINERGIC AND ANTICHOLINERGIC THERAPIES ON COGNITIVE AND MOTOR FUNCTION IN PARKINSONS-DISEASE - A FOLLOW-UP-STUDY OF UNTREATED PATIENTS
复制标题
DOI：
10.1093/brain/115.6.1701
复制
发表时间：
1992-12-01
期刊：
影响因子：
14.5
通讯作者：
SULLIVAN, EV
中科院分区：
文献类型：
--
作者：
COOPER, JA;SAGAR, HJ;SULLIVAN, EV
一组82例新诊断的帕金森病患者从未接受过治疗，在随机接受三种单药治疗（左旋多巴、溴隐亭或抗胆碱能药物）后约4个月，对他们的认知能力进行了重新评估。多巴胺能和抗胆碱能治疗都导致运动控制的改善，但其对认知能力的影响分离。抗胆碱能药物会损害信息立即登记的过程，而多巴胺能治疗会改善依赖于工作记忆和认知排序的任务。其他认知指标显示治疗后无变化。受胆碱能和多巴胺能调节影响的缺陷是那些在帕金森病的早期未治疗状态中受到最大损害的缺陷。数据支持的概念，认知障碍帕金森氏病是多因素的起源：短期记忆过程是由多巴胺能和胆碱能皮质下额叶系统，但帕金森氏病的认知障碍是独立的这种皮质下神经化学病理，可能是由于早期神经元功能障碍的大脑皮层。
The cognitive performance of a group of 82 newly diagnosed patients with Parkinson's disease who had never been treated was reassessed approximately 4 mths after randomization to one of three monotherapies (levodopa, bromocriptine or anticholinergic drugs). Dopaminergic and anticholinergic treatments both led to improvement in motor control but their effects upon cognitive performance dissociated. Anticholinergic drugs produced impairment in processes underlying the immediate registration of information whilst dopaminergic therapy produced improvement on a task dependent on working memory and cognitive sequencing. Other cognitive measures showed no change on treatment. The deficits that were affected by cholinergic and dopaminergic modulation are those that were most compromised in the early, untreated state in Parkinson's disease. The data support the notion that cognitive impairment in Parkinson's disease is multifactorial in origin: short-term memory processes are served by both dopaminergic and cholinergic subcortico-frontal systems but much of the cognitive impairment of Parkinson's disease is independent of this subcortical neurochemical pathology and may be due to early neuronal dysfunction within the cerebral cortex.