Predictors of mild cognitive impairment in early-stage Parkinson's disease.
Predictors of mild cognitive impairment in early-stage Parkinson's disease.
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DOI：
10.1159/000351421
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发表时间：
2013-01
影响因子：
2.3
通讯作者：
Lyons KE
中科院分区：
文献类型：
--
作者：
Hanna-Pladdy B;Jones K;Cabanban R;Pahwa R;Lyons KE
本研究的目的是在广泛的神经变性之前识别帕金森病 (PD) 的轻度认知缺陷，并评估多巴胺耗竭和其他疾病相关预测因子可以在多大程度上解释认知特征。对 40 名非痴呆早期 PD 患者和 42 名健康对照者在使用或不使用多巴胺能药物期间的神经心理学表现进行了比较。逐步回归评估了早期帕金森病的认知预测因子和帕金森病认知的疾病相关预测因子（左旋多巴剂量、疾病持续时间、统一帕金森病评定量表评分、睡眠、生活质量和情绪）。 PD患者的神经心理学表现较低，在记忆、命名、视觉运动和复杂的注意力/执行缺陷等认知领域表现较差，但视觉空间、简单注意力和音位流畅功能完整。然而，除了简单的注意之外，没有药物作用。回归分析显示，年龄、工作记忆和记忆回忆是帕金森病的最佳认知预测因素，而年龄、生活质量、疾病持续时间和焦虑则预测帕金森病在关闭状态下的认知能力。非痴呆早期帕金森病患者表现出广泛的轻度认知缺陷，包括明显的记忆障碍。该特征与先前归因于多巴胺耗竭的预期孤立的额纹状体功能障碍不一致，这突出表明需要进一步表征帕金森病轻度认知障碍的黑质外来源。
The aim of this study was to identify mild cognitive deficits in Parkinson's disease (PD) prior to extensive neurodegeneration and to evaluate the extent to which dopamine depletion and other disease-related predictors can explain cognitive profiles. Neuropsychological performances of 40 nondemented early-stage PD patients and 42 healthy controls were compared across on or off dopaminergic medications. Stepwise regression evaluated cognitive predictors of early-stage PD and disease-related predictors of PD cognition (levodopa dose, disease duration, Unified Parkinson's Disease Rating Scale score, sleep, quality of life, and mood) across on and off states. Neuropsychological performance was lower in PD patients across cognitive domains with significant memory, naming, visuomotor, and complex attention/executive deficits, but with intact visuospatial, simple attention, and phonemic fluency functions. However, medication effects were absent except for simple attention. Regression analyses revealed age, working memory, and memory recall to be the best cognitive predictors of PD, while age, quality of life, disease duration, and anxiety predicted PD cognition in the off state. Nondemented early-stage PD patients presented with extensive mild cognitive deficits including prominent memory impairment. The profile was inconsistent with expected isolated frontostriatal dysfunction previously attributed to dopamine depletion and this highlights the need to further characterize extranigral sources of mild cognitive impairment in PD.