Comparative cognitive and neuropsychiatric profiles between Parkinson's disease, multiple system atrophy and progressive supranuclear palsy
Comparative cognitive and neuropsychiatric profiles between Parkinson's disease, multiple system atrophy and progressive supranuclear palsy
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DOI：
10.1007/s00415-018-9038-x
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发表时间：
2018-11-01
影响因子：
6
通讯作者：
Picillo, Marina
中科院分区：
文献类型：
--
作者：
Santangelo, Gabriella;Cuoco, Sofia;Picillo, Marina
背景帕金森综合征的特点是广泛的非运动症状。一些研究探讨了与帕金森病（PD）相比，非典型帕金森综合征的认知缺陷和神经精神症状。方法对55例PD、44例MSA和42例PSP患者进行认知功能测试，评估其注意力、语言、记忆力、认知障碍、抑郁障碍、情感淡漠等方面的差异。视觉空间和执行功能以及评估抑郁和冷漠的量表。在这些患者中，选择了20名PD、20名MSA和20名PSP患者，以匹配年龄、教育和整体认知状态。在每个整体患者组，临床，行为和认知parameters.Results之间的相关性分析进行匹配的组之间的主要差异是在认知测试探索口头学习，执行和语言功能。在评估执行功能的认知测试中，PSP组比PD组和MSA组受损更严重。另一方面，MSA组获得了与PD组相似的认知表现。至于行为症状，在整个PSP和MSA组，冷漠和抑郁症更严重的PD组，而冷漠（而不是抑郁症）更严重的PSP组相比，MSA group.Conclusions本研究强调的普遍性认知缺陷，冷漠和抑郁症状的PSP，而很少的认知差异被发现PD和MSA之间。这些发现间接支持了前额叶皮层下回路功能障碍（即，背外侧前额叶和边缘回路）。MSA和PD之间的认知相似性加强了基底神经节改变和相应的额叶传入阻滞在认知缺陷发生中的关键作用。
Background Parkinsonian syndromes are characterized by a wide spectrum of non-motor symptoms. A few studies explored cognitive deficits and neuropsychiatric symptoms in atypical parkinsonism compared to Parkinson's disease (PD). The study was performed to identify cognitive and neuropsychiatric differences between PD, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) and to evaluate the influence of clinical features, depressive symptomatology and apathy on cognitive performances in the three groups.Methods Fifty-five PD, 44 MSA and 42 PSP patients underwent cognitive tests assessing attention, language, memory, visuospatial and executive functions as well as scales assessing depression and apathy. Out of these patients, 20 PD, 20 MSA and 20 PSP patients were selected to be matched for age, education and global cognitive status. Within each whole patients group, correlational analysis was performed between clinical, behavioural and cognitive parameters.Results The main difference among the groups matched was on cognitive tests exploring verbal learning, executive and linguistic functions. The PSP group was more impaired than the PD and MSA groups on cognitive tests assessing executive functions. On the other hand, MSA group obtained similar cognitive performance to the PD group. As to behavioural symptoms, in whole PSP and MSA groups, apathy and depression were more severe than in PD group, while apathy (but not depression) were more severe in the PSP group as compared to the MSA group.Conclusions The present study underlined the pervasiveness of cognitive deficits, apathy and depressive symptoms in PSP, whereas little cognitive differences were found between PD and MSA. The findings indirectly supported a dysfunction of prefronto-subcortical circuitries (i.e., dorsolateral prefrontal and limbic circuits) in PSP and PD. Cognitive similarities between MSA and PD reinforced the pivotal role of altered basal ganglia and corresponding frontal deafferentation in the occurrence of the cognitive deficits.