Clinical differences among mild cognitive impairment subtypes in Parkinson's disease.
Clinical differences among mild cognitive impairment subtypes in Parkinson's disease.
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DOI：
10.1002/mds.25062
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发表时间：
2012-08
期刊：
影响因子：
--
通讯作者：
Goetz CG
中科院分区：
文献类型：
--
作者：
Goldman JG;Weis H;Stebbins G;Bernard B;Goetz CG
轻度认知功能障碍越来越被认为是帕金森病（PD）的一种结构，约25%的非痴呆PD患者发生轻度认知功能障碍。尽管执行功能障碍是PD中最常见的认知缺陷类型，但PD轻度认知障碍（PD-MCI）的认知表型很广泛。PD-MCI亚型由遗忘和非遗忘域损害以及单域和多域损害代表。然而，目前尚不清楚不同PD-MCI亚型的患者除了认知特征外，其他临床特征是否也存在差异。我们在运动障碍中心研究了128名PD-MCI受试者，比较了PD-MCI亚型的临床、运动和行为特征。我们发现不同比例的损害亚型：非遗忘单域（47.7%），遗忘多域（24.2%），遗忘单域（18.8%），和非遗忘多域（9.5%）。注意/执行功能和视觉空间能力是最常见的受损领域。PD-MCI亚型的运动特征不同，非遗忘型多域PD-MCI受试者表现出特别明显的姿势不稳定和步态问题。PD-MCI亚型之间在年龄、PD持续时间、药物使用、情绪或行为障碍或血管疾病方面的差异不显著。除了不同的认知特征外，PD-MCI亚型在运动表型和严重程度上不同，但在情绪、行为或血管共病方面没有差异。在非遗忘多域亚型中更大的姿势不稳定和步态障碍强调PD中步态和认知的共同非多巴胺能神经基质。此外，认知功能障碍的负担增加，而不是认知缺陷的类型，可能与PD-MCI中更大的运动障碍有关。
Mild cognitive impairment is increasingly recognized as a construct in Parkinson’s disease (PD) and occurs in about 25% of non-demented PD patients. Although executive dysfunction is the most frequent type of cognitive deficit in PD, the cognitive phenotype of PD mild cognitive impairment (PD-MCI) is broad. PD-MCI subtypes are represented by amnestic and nonamnestic domain impairment as well as single- and multiple-domain impairment. However, it is unclear whether patients with different PD-MCI subtypes also differ in other clinical characteristics besides cognitive profile. We studied 128 PD-MCI subjects at our Movement Disorders center, comparing clinical, motor, and behavioral characteristics across the PD-MCI subtypes. We found varying proportions of impairment subtypes: nonamnestic single-domain (47.7%), amnestic multiple-domain (24.2%), amnestic single-domain (18.8%), and nonamnestic multiple-domain (9.5%). Attentional/executive functioning and visuospatial abilities were the most frequently impaired domains. PD-MCI subtypes differed in their motor features with nonamnestic multiple-domain PD-MCI subjects showing particularly pronounced problems with postural instability and gait. Differences among PD-MCI subtypes in age, PD duration, medication use, mood or behavioral disturbances, or vascular disease were not significant. In addition to differing cognitive profiles, PD-MCI subtypes differ in motor phenotype and severity but not in mood, behavioral, or vascular co-morbidities. Greater postural instability and gait disturbances in the nonamnestic multiple-domain subtype emphasize shared non-dopaminergic neural substrates of gait and cognition in PD. Furthermore, increased burden of cognitive dysfunction, rather than type of cognitive deficit, may be associated with greater motor impairment in PD-MCI.
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DOI：
10.1093/brain/awq079
发表时间：
2010-06
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Bohnen NI;Müller ML;Kotagal V;Koeppe RA;Kilbourn MA;Albin RL;Frey KA
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影响因子：
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DOI：
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发表时间：
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影响因子：
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