Caviness John N, Driver-Dunckley Erika, Connor Donald J, Sabbagh Marwan N, Hentz Joseph G, Noble Brie, Evidente Virgilio Gerald H, Shill Holly A, Adler Charles H
Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA.
Mov Disord. 2007 Jul 15;22(9):1272-7. doi: 10.1002/mds.21453.
Our purpose was to characterize a state of mild cognitive impairment (MCI) in Parkinson's disease (PD) (PD-MCI) that would be analogous to the MCI that is posited as a precursor of Alzheimer's disease (AD). We categorized 86 PD subjects in a brain bank population as either cognitively normal (PD-CogNL), PD-MCI using criteria that included a 1.5 standard deviation or greater deficit upon neuropsychological testing consistently across at least one cognitive domain without dementia, and PD dementia (PD-D) using DSM-IV criteria. Twenty-one percent of our PD sample met criteria for PD-MCI, 62% were PD-CogNL, and 17% had PD-D. The mean duration of PD and MMSE scores of the PD-MCI group were intermediate and significantly different from both PD-CogNL and PD-D. The cognitive domain most frequently abnormal in PD-MCI was frontal/executive dysfunction followed by amnestic deficit. Single domain PD-MCI was more common than PD-MCI involving multiple domains. We conclude that a stage of clinical cognitive impairment in PD exists between PD-CogNL and PD-D, and it may be defined by applying criteria similar to the MCI that is posited as a precursor of AD. Defining PD-MCI offers an opportunity for further study of cognitive impairment in PD and targets for earlier therapeutic intervention.
我们的目的是描述帕金森病（PD）中的轻度认知障碍（MCI）状态（PD-MCI），这种状态类似于被认为是阿尔茨海默病（AD）前驱的MCI。我们将脑库中的86名PD受试者分类为认知正常（PD-CogNL）、使用包括在至少一个认知领域经神经心理学测试持续存在1.5个标准差或更大缺陷且无痴呆的标准的PD-MCI，以及使用《精神疾病诊断与统计手册》第四版（DSM-IV）标准的PD痴呆（PD-D）。我们的PD样本中有21%符合PD-MCI标准，62%为PD-CogNL，17%患有PD-D。PD-MCI组的PD病程和简易精神状态检查表（MMSE）评分处于中间水平，且与PD-CogNL和PD-D均有显著差异。PD-MCI中最常出现异常的认知领域是额叶/执行功能障碍，其次是遗忘缺陷。单领域PD-MCI比多领域PD-MCI更常见。我们得出结论，PD-CogNL和PD-D之间存在PD临床认知障碍阶段，它可能通过应用类似于被认为是AD前驱的MCI的标准来定义。定义PD-MCI为进一步研究PD中的认知障碍以及早期治疗干预目标提供了机会。
