晚期帕金森病认知障碍的预测因素。
Predictors of cognitive impairment in advanced Parkinson's disease.
作者信息
Vingerhoets G, Verleden S, Santens P, Miatton M, De Reuck J
机构信息
Laboratory for Neuropsychology, Ghent University, Ghent, Belgium.
出版信息
J Neurol Neurosurg Psychiatry. 2003 Jun;74(6):793-6. doi: 10.1136/jnnp.74.6.793.
OBJECTIVE
To investigate the cognitive profile of patients with idiopathic Parkinson's disease and to determine the demographic and medical variables that contribute to the cognitive outcome.
DESIGN
Retrospective cohort analysis.
METHODS
100 patients with idiopathic Parkinson's disease were given a neuropsychological test battery investigating attention, memory, and visuospatial and executive functions. Test performance was compared against normative data, and linear regression determined significant predictors of cognitive impairment from a set of demographic and disease course variables.
RESULTS
Frontal-type cognitive dysfunction was widespread in patients with advanced Parkinson's disease. Attention and memory were mildly to moderately impaired, whereas visuospatial function showed only subtle impairment. Older age and tremor at onset were significant predictors of poor cognitive performance.
CONCLUSIONS
The observed cognitive impairment in patients with advanced Parkinson's disease is more than expected for normal aging. Although in apparent contrast with most previous research, reporting a greater risk of cognitive dysfunction in Parkinson's disease patients with predominant akinesia/rigidity, tremor at onset may be a marker for more widespread brain pathology that contributes to an increased risk of cognitive impairment.
目的
研究特发性帕金森病患者的认知特征，并确定影响认知结果的人口统计学和医学变量。
设计
回顾性队列分析。
方法
对100例特发性帕金森病患者进行了一组神经心理学测试，以评估注意力、记忆力、视觉空间和执行功能。将测试结果与标准数据进行比较，并通过线性回归从一组人口统计学和疾病病程变量中确定认知障碍的显著预测因素。
结果
额叶型认知功能障碍在晚期帕金森病患者中普遍存在。注意力和记忆力有轻度至中度受损，而视觉空间功能仅表现出轻微受损。年龄较大和发病时出现震颤是认知功能较差的显著预测因素。
结论
晚期帕金森病患者中观察到的认知障碍超过了正常衰老的预期。尽管与大多数先前的研究明显不同，先前研究表明运动不能/强直为主的帕金森病患者发生认知功能障碍的风险更高，但发病时出现震颤可能是更广泛脑病理改变的一个标志，这导致认知障碍风险增加。
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