Lange K W, Tucha O, Alders G L, Preier M, Csoti I, Merz B, Mark G, Herting B, Fornadi F, Reichmann H, Vieregge P, Reiners K, Becker G, Naumann M
Institute of Experimental Psychology, University of Regensburg, Regensburg, Germany.
J Neural Transm (Vienna). 2003 Sep;110(9):983-95. doi: 10.1007/s00702-003-0011-0.
Groups of patients with Parkinson's disease (PD), striatonigral degeneration-type multiple system atrophy (MSA) or progressive supranuclear palsy (PSP) with motor disability stages II and III according to Hoehn and Yahr, and a healthy control group were compared using neuropsychological tests of executive functions. The results indicate that all three patient groups were impaired in the tests of executive functions. In comparison with healthy subjects, the three patient groups showed impaired performance regarding verbal fluency, problem solving and verbal and figural working memory. Patients with PD differed significantly from healthy subjects in a test of verbal recency, while patients with MSA or PSP were unimpaired. The comparison of patient groups revealed no differences between PD and MSA patients. However, patients with PSP showed greater impairment in both phonemic and semantic fluency than patients with PD or MSA. Using discriminant function analysis, it was found that variables derived from four verbal fluency tasks (simple and alternate semantic and phonemic fluency) discriminated among the three patient groups at a level significantly exceeding chance. Over 90% of patients with PSP were correctly classified. Patients with PD and MSA were correctly classified in over 70% of cases. These results suggest that verbal fluency tasks may be sensitive measures in the differential diagnosis of PD, MSA and PSP.
根据Hoehn和Yahr分级处于运动功能障碍II期和III期的帕金森病(PD)患者组、纹状体黑质变性型多系统萎缩(MSA)患者组或进行性核上性麻痹(PSP)患者组,与一个健康对照组,通过执行功能的神经心理学测试进行了比较。结果表明,所有三个患者组在执行功能测试中均受损。与健康受试者相比,这三个患者组在言语流畅性、问题解决以及言语和图形工作记忆方面表现受损。PD患者在言语近期记忆测试中与健康受试者有显著差异,而MSA或PSP患者未受损。患者组之间的比较显示,PD患者和MSA患者之间没有差异。然而,PSP患者在音素流畅性和语义流畅性方面比PD或MSA患者受损更严重。使用判别函数分析发现,来自四项言语流畅性任务(简单和交替语义及音素流畅性)的变量在区分这三个患者组时,其水平显著超过随机概率。超过90%的PSP患者被正确分类。PD和MSA患者在超过70%的病例中被正确分类。这些结果表明,言语流畅性任务可能是PD、MSA和PSP鉴别诊断中的敏感指标。