Motor symptoms at onset of Parkinson disease and risk for cognitive impairment and depression.
Motor symptoms at onset of Parkinson disease and risk for cognitive impairment and depression.
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DOI：
10.1097/wnn.0b013e31826dfd62
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Husain MM
中科院分区：
文献类型：
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作者：
Dewey RB Jr;Taneja A;McClintock SM;Cullum CM;Dewey RB 3rd;Bernstein I;Husain MM
为了确定帕金森病患者最初的运动症状是否预示着以后发展为认知障碍或抑郁症状的风险。我们招募了124名患有帕金森病的非痴呆症患者参加了一项关于认知功能和抑郁症状的队列研究，研究使用了经过验证的神经心理测试和抑郁症状清单。我们首先回顾患者的首发运动症状和发病侧，然后将患者分为4组：右侧发作性震颤、右侧发作性运动迟缓/强直、左侧发作性震颤、左侧发作性运动迟缓/强直。我们排除了出现双侧症状的患者。我们使用神经心理测试成绩和抑郁症状的方差分析来确定分组是否影响认知障碍或抑郁症状的风险。我们控制了我们对病程和运动严重程度的分析，根据统一的帕金森病评定量表第三部分运动评分来衡量。根据初始运动症状的类型和侧翼进行的任何认知测量都没有差异。右侧震颤组的抑郁症状评分最低，任何一组患者都没有报告严重的抑郁症状。我们的发现表明，与帕金森病的初始侧和运动症状类型相关的黑质细胞丢失模式与以后认知障碍的风险无关。相比之下，右侧震颤的患者出现抑郁症状的风险似乎比其他症状的患者要低。
To determine if side and type of initial motor symptoms in Parkinson disease predict risk for later development of cognitive impairment or depressive symptoms. We recruited 124 nondemented patients with Parkinson disease to participate in a cohort study of cognitive function and depressive symptoms that used validated neuropsychological tests and a depressive symptom inventory. We first reviewed the patients’ charts to determine their initial motor symptom and side of onset, and then classified the patients into 4 groups: right-side onset tremor, right-side onset bradykinesia/rigidity, left-side onset tremor, and left-side onset bradykinesia/rigidity. We excluded patients with bilateral symptom onset. We used analysis of variance on neuropsychological test performance and depressive symptoms to determine if group classification affected risk of cognitive impairment or depressive symptoms. We controlled our analyses for disease duration and motor severity as measured by the Unified Parkinson Disease Rating Scale Part III motor score. There were no differences in any cognitive measure by side and type of initial motor symptoms. The right-side onset tremor group had the lowest depressive symptom scores, and no patient in any group reported severe depressive symptoms. Our findings suggest that patterns of nigral cell loss correlating to the initial side and type of motor symptoms in Parkinson disease are not related to the risk of later cognitive impairment. By contrast, patients with right-side onset of tremor appear to have a lower risk of depressive symptoms than patients with other presentations.