Sahin Hüseyin A, Terzi Murat, Uçak Sibel, Yapici Oktay, Basoglu Tarik, Onar Musa
Ondokuz Mayis University, Medical School, Department of Neurology, 55139 Kurupelit, Samsun, Turkey.
J Neuropsychiatry Clin Neurosci. 2006 Winter;18(1):64-72. doi: 10.1176/jnp.18.1.64.
Essential tremor (ET) is classified as a pure motor system disease. It has been previously reported that impairments in cognitive functions can be associated with ET. The authors assessed cognitive functions in a relatively young patient group with ET and comparison subjects. Correlations between tremor severity and regional cerebral blood flow (rCBF) and neuropsychological test performances of ET patients and comparison subjects were investigated. Sixteen patients with ET and 16 comparison subjects were assessed by a comprehensive neuropsychological test battery designed to assess global attention, language, memory, visuospatial functions, and executive functions. In 11 of 16 patients and in nine of 16 comparison subjects, rCBF was measured by technetium-99m-hexamethyl propylene amine oxime single photon emission computed tomography (technetium-99m-HMPAO SPECT). The tremor severity was quantified using the Clinical Rating Scale for Tremor (CRST). Findings revealed that ET patients differed significantly from comparison subjects on tests assessing visuospatial functions and verbal memory, whereas differences in other tests did not reach statistical significance. There was no significant difference between the rCBF of ET patients and comparison subjects. There were statistically significant inverse correlations between tremor severity and executive functions. Tremor severity was inversely correlated with bilateral frontal blood flow by technetium-99m-HMPAO SPECT. Conclusions suggest that the subclinical cognitive deficits characterized by visuospatial and verbal memory impairments and executive dysfunction may be a clinical feature of ET, and the cerebello-thalamo-frontal network may play a role in the pathophysiology of this disorder.
特发性震颤（ET）被归类为一种单纯的运动系统疾病。此前已有报道称，认知功能障碍可能与ET有关。作者评估了一组相对年轻的ET患者和对照受试者的认知功能。研究了ET患者和对照受试者的震颤严重程度与局部脑血流量（rCBF）以及神经心理测试表现之间的相关性。通过一套旨在评估整体注意力、语言、记忆、视觉空间功能和执行功能的综合神经心理测试电池，对16例ET患者和16例对照受试者进行了评估。在16例患者中的11例以及16例对照受试者中的9例中，通过锝-99m-六甲基丙烯胺肟单光子发射计算机断层扫描（锝-99m-HMPAO SPECT）测量了rCBF。使用震颤临床评分量表（CRST）对震颤严重程度进行量化。结果显示，在评估视觉空间功能和言语记忆的测试中，ET患者与对照受试者有显著差异，而在其他测试中的差异未达到统计学意义。ET患者和对照受试者的rCBF之间没有显著差异。震颤严重程度与执行功能之间存在统计学上的显著负相关。通过锝-99m-HMPAO SPECT，震颤严重程度与双侧额叶血流量呈负相关。结论表明，以视觉空间和言语记忆障碍以及执行功能障碍为特征的亚临床认知缺陷可能是ET的临床特征，并且小脑-丘脑-额叶网络可能在这种疾病的病理生理学中起作用。
