Rozzini Luca, Chilovi Barbara Vicini, Bertoletti Erik, Conti Marta, Delrio Ilenia, Trabucchi Marco, Padovani Alessandro
Department of Neurology, University of Brescia, Italy.
Int Psychogeriatr. 2008 Feb;20(1):86-95. doi: 10.1017/S1041610207006163. Epub 2007 Sep 17.
Mild cognitive impairment (MCI) may be accompanied by extra pyramidal signs (EPS), which are related to the severity and type of cognitive impairment. We aimed to elucidate further the relationship between MCI and EPS, analyzing the correlation between the severity of EPS and cognitive functions, and the presence of EPS and neuro-psychiatric features.
Data were obtained from a longitudinal study of 150 MCI outpatients. Participants underwent a clinical assessment including the Unified Parkinson Disease Rating Scale, the Neuropsychiatric Inventory, the Tinetti Scale, and a standardized neuropsychological battery. Mild EPS could be defined as being present (MCI with mild EPS) using a subscale of UPDRS, based on three specific symptoms: bradykinesia, rigidity and tremor.
The two groups, one with mild EPS (24%) and one without EPS (76%), differed in gait abnormalities and presence of extrapyramidal symptoms. Groups did not differ in terms of general cognitive functions evaluated using the Mini-mental State Examination, while subjects with MCI with mild EPS performed significantly worse than those with MCI without EPS in total global score and in non-memory items of the Alzheimer's Disease Assessment Scale. Moreover, severity of EPS was significantly correlated with low performance on executive functions and with high performance on episodic memory. The group with MCI with mild EPS were observed to have a greater prevalence of patients with anxiety, depression, apathy and sleep disturbances than in MCI without EPS.
MCI may be associated with mild parkinsonian signs, the severity of which are related to the severity of cognitive impairment, in particular of non-memory functions, and to a differential pattern of psycho-behavioral symptoms.
轻度认知障碍（MCI）可能伴有锥体外系症状（EPS），这与认知障碍的严重程度和类型有关。我们旨在进一步阐明MCI与EPS之间的关系，分析EPS严重程度与认知功能之间的相关性，以及EPS的存在与神经精神特征之间的关系。
数据来自对150名MCI门诊患者的纵向研究。参与者接受了包括统一帕金森病评定量表、神经精神科问卷、Tinetti量表和标准化神经心理测试组在内的临床评估。基于运动迟缓、僵硬和震颤这三种特定症状，使用统一帕金森病评定量表的一个子量表可将轻度EPS定义为存在（伴有轻度EPS的MCI）。
两组，一组有轻度EPS（24%），另一组无EPS（76%），在步态异常和锥体外系症状的存在方面存在差异。使用简易精神状态检查表评估的一般认知功能方面，两组没有差异，而伴有轻度EPS的MCI患者在阿尔茨海默病评定量表的总综合评分和非记忆项目上的表现明显比不伴有EPS的MCI患者差。此外，EPS的严重程度与执行功能的低表现以及情景记忆的高表现显著相关。观察到伴有轻度EPS的MCI组中焦虑、抑郁、淡漠和睡眠障碍患者的患病率高于不伴有EPS的MCI组。
MCI可能与轻度帕金森氏体征有关，其严重程度与认知障碍的严重程度有关，尤其是与非记忆功能的严重程度有关，并且与心理行为症状的不同模式有关。
