Alonso-Prieto E, Michel-Esteban E, Trujillo-Matienzo C, Palmero-Soler E
Departamento de Neuropsicología, Instituto de Neurología y Neurocirugía Vedado, Ciudad Habana, Cuba.
Neurologia. 2004 Dec;19(10):710-8.
Idiopathic Parkinson's disease induces alterations both motor and cognitive. Levodopa, the treatment of choice, offers initial improvement, but causes long term important complications. It is ignored if it provokes or not a similar situation in cognitive function.
Two groups of idiopathic parkinsonian patients were studied. One of them was using levodopa as a regular treatment, the other had de novo patients. A group of healthy controls was also studied. The levodopa group was evaluated when levodopa plasma concentration was maximum and when it was minimum. A cognitive battery was used in order to assess the cognitive status of all subjects.
Significant differences between the two groups of patients and the healthy controls were found when the treated group had a maximum plasmatic concentration of levodopa. There were also significant differences when they had a minimum concentration in comparison with the healthy controls. The performances of the patients taking levodopa varied between both conditions.
Parkinson's disease provokes a wide variety of cognitive alterations, therefore basal ganglia can be related to a more general function as learning and storing cognitive and motor programs. Levodopa influences in a different way different cognitive functions differently and its influence varies between highest and lowest plasmatic concentrations periods. These results allow us to draw important conclusions about the cognitive alterations caused by the natural course of Parkinson's disease, the introduction of treatment with levodopa and the relationship between basal ganglia and human cognition.
特发性帕金森病会引发运动和认知方面的改变。左旋多巴作为首选治疗药物，能带来初期改善，但会引发长期的重要并发症。目前尚不清楚它是否会在认知功能方面引发类似情况。
对两组特发性帕金森病患者进行了研究。其中一组长期使用左旋多巴进行治疗，另一组为初发患者。同时还研究了一组健康对照者。对左旋多巴组在血浆左旋多巴浓度最高时和最低时进行了评估。使用一套认知测试组合来评估所有受试者的认知状态。
当治疗组血浆左旋多巴浓度最高时，两组患者与健康对照者之间存在显著差异。与健康对照者相比，当他们血浆浓度最低时也存在显著差异。服用左旋多巴的患者在两种情况下的表现有所不同。
帕金森病会引发多种认知改变，因此基底神经节可能与学习和存储认知及运动程序等更一般的功能相关。左旋多巴对不同认知功能的影响方式不同，且其影响在血浆浓度最高和最低时期有所变化。这些结果使我们能够就帕金森病自然病程所导致的认知改变、左旋多巴治疗的引入以及基底神经节与人类认知之间的关系得出重要结论。
