Owen A M, James M, Leigh P N, Summers B A, Marsden C D, Quinn N P, Lange K W, Robbins T W
Department of Experimental Psychology, University of Cambridge, UK.
Brain. 1992 Dec;115 ( Pt 6):1727-51. doi: 10.1093/brain/115.6.1727.
Groups of patients with idiopathic Parkinson's disease, either medicated or unmedicated, were compared with matched groups of normal controls on a computerized battery previously shown to be sensitive to frontal lobe dysfunction, including tests of planning, spatial working memory and attentional set-shifting. In a series of problems based on the 'Tower of London' test, medicated patients with Parkinson's disease were shown to be impaired in the amount of time spent thinking about (planning) the solution to each problem. Additionally, an impairment in terms of the accuracy of the solution produced on this test was only evident in those patients with more severe clinical symptoms and was accompanied by deficits in an associated test of spatial short-term memory. Medicated patients with both mild and severe clinical symptoms were also impaired on a related test of spatial working memory. In contrast, a group of patients who were unmedicated and 'early in the course' of the disease were unimpaired in all three of these tests. However, all three Parkinson's disease groups were impaired in the test of attentional set-shifting ability, although unimpaired in a test of pattern recognition which is insensitive to frontal lobe damage. These data are compared with those previously published from a group of young neurosurgical patients with localized excisions of the frontal lobes and are discussed in terms of the specific nature of the cognitive deficit at different stages of Parkinson's disease.
将患有特发性帕金森病的患者组（无论是否接受药物治疗）与相匹配的正常对照组，在一组先前已证明对额叶功能障碍敏感的计算机化测试组合上进行比较，这些测试包括计划、空间工作记忆和注意力转换测试。在一系列基于“伦敦塔”测试的问题中，接受药物治疗的帕金森病患者在思考（计划）每个问题解决方案上所花费的时间存在受损情况。此外，在该测试中产生的解决方案准确性方面的损害，仅在那些临床症状更严重的患者中明显，并且在相关的空间短期记忆测试中也存在缺陷。患有轻度和重度临床症状的接受药物治疗的患者，在相关的空间工作记忆测试中也受到损害。相比之下，一组未接受药物治疗且处于疾病“早期”的患者在这三项测试中均未受损。然而，所有三个帕金森病患者组在注意力转换能力测试中均受损，尽管在对额叶损伤不敏感的模式识别测试中未受损。这些数据与先前一组患有额叶局部切除术的年轻神经外科患者所发表的数据进行比较，并就帕金森病不同阶段认知缺陷的具体性质进行了讨论。
