Aarsland D, Brønnick K, Larsen J P, Tysnes O B, Alves G
The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO 8100, N-4068 Stavanger, Norway.
Neurology. 2009 Mar 31;72(13):1121-6. doi: 10.1212/01.wnl.0000338632.00552.cb. Epub 2008 Nov 19.
Little is known regarding the cognitive impairment in subjects with early, drug-naïve Parkinson disease (PD). The aim of this study was to explore the proportion with mild cognitive impairment (MCI) and subtypes in an incidence cohort of untreated PD in Southern and Western Norway.
A total of 196 non-demented, drug-naive patients who were recruited after an extensive search of all new cases of PD in the area and 201 healthy control subjects completed a battery of neuropsychological tests of verbal memory, visuospatial, and attentional-executive functioning. Subjects were classified as MCI if the age- and education-corrected z-score was falling 1.5 standard deviations below the mean for at least one of the cognitive domains.
The PD group was more impaired on all neuropsychological tests than controls, but the effect sizes were small. The largest effect size was found for verbal memory. A total of 18.9% of the patients with PD were classified as MCI, with a relative risk of 2.1 (1.2-3.6) in PD compared to the control group. Patients with PD with and without MCI did not differ significantly regarding demographic and motor features. Among PD-MCI patients, nearly two-thirds had a non-amnestic MCI subtype, and one third had an amnestic MCI subtype.
The findings demonstrate a twofold increase in the proportion with cognitive impairment in subjects with early, untreated Parkinson disease (PD) compared to controls. This has implications for diagnosis and management of PD. AD = Alzheimer disease; aMCI-MD = amnestic multiple-domain MCI; aMCI-SD = amnestic single-domain MCI; CVLT-2 = California Verbal Learning Test II; IQCode = Informant Questionnaire on Cognitive decline in the elderly; MADRS = Montgomery and Aasberg Depression Rating Scale; MCI = mild cognitive impairment; MMSE = Mini-Mental State Examination; naMCI-MD = non-amnestic multiple-domain MCI; naMCI-SD = non-amnestic single-domain MCI; PD = Parkinson disease; RR = relative risks; UPDRS = Unified Parkinson's Disease Rating Scale; VOSP = Visual Object and Space Perception Battery.
关于早期未用药的帕金森病（PD）患者的认知障碍情况，人们了解甚少。本研究旨在探究挪威南部和西部未经治疗的PD发病队列中轻度认知障碍（MCI）的比例及其亚型。
通过广泛搜索该地区所有新的PD病例，共招募了196名未患痴呆症、未用药的患者以及201名健康对照者，他们完成了一系列关于言语记忆、视觉空间和注意力执行功能的神经心理学测试。如果年龄和教育程度校正后的z分数在至少一个认知领域低于平均值1.5个标准差，则将受试者分类为MCI。
PD组在所有神经心理学测试中的表现均比对照组差，但效应量较小。言语记忆方面的效应量最大。共有18.9%的PD患者被分类为MCI，与对照组相比，PD患者的相对风险为2.1（1.2 - 3.6）。有和没有MCI的PD患者在人口统计学和运动特征方面无显著差异。在PD - MCI患者中，近三分之二为非遗忘型MCI亚型，三分之一为遗忘型MCI亚型。
研究结果表明，与对照组相比，早期未经治疗的帕金森病（PD）患者认知障碍的比例增加了两倍。这对PD的诊断和管理具有重要意义。AD = 阿尔茨海默病；aMCI - MD = 遗忘型多领域MCI；aMCI - SD = 遗忘型单领域MCI；CVLT - 2 = 加利福尼亚言语学习测试第二版；IQCode = 老年人认知衰退知情者问卷；MADRS = 蒙哥马利和阿斯伯格抑郁评定量表；MCI = 轻度认知障碍；MMSE = 简易精神状态检查表；naMCI - MD = 非遗忘型多领域MCI；naMCI - SD = 非遗忘型单领域MCI；PD = 帕金森病；RR = 相对风险；UPDRS = 统一帕金森病评定量表；VOSP = 视觉物体与空间感知测试
