Oh Joo Young, Kim Ye-Sung, Choi Byung Hee, Sohn Eun Hee, Lee Ae Young
Department of Neurology, Chungnam National University Hospital, College of Medicine, 640 Daesadong, Junggu, Daejon 301-721, South Korea.
Arch Gerontol Geriatr. 2009 Nov-Dec;49(3):351-4. doi: 10.1016/j.archger.2008.11.013. Epub 2009 Jan 10.
Most patients with idiopathic PD (IPD) show variable degrees of cognitive decline. The purpose of this study was to evaluate the relationship between the predominant motor symptom at the time of disease onset and the level of cognitive function in patients with IPD. A total of 159 patients with IPD were enrolled in this study. The patients' initial motor symptoms were classified into three types: tremor-dominant (TD), bradykinesia and rigidity-dominant (BRD), gait and postural instability-dominant (GPD). Disease severity was rated according to the Hoehn-Yahr classification (H&Y stage). Overall cognitive status was evaluated using the Korean versions of the Mini-Mental State Examination (K-MMSE) and the Modified Mini-Mental State (3MS) tests. The GPD group showed the lowest scores of the K-MMSE/3MS, and the patients with TD showed the best performance in the cognitive analysis (p<0.05). The patients who were older at disease onset showed worse cognitive performance than those the patients who were younger at disease onset (p<0.05). There was no difference in cognitive status according to H&Y stages. The accurate classification of initial motor symptoms and the detailed history, including the exact onset age of IPD, may allow us to predict cognitive decline in IPD.
大多数特发性帕金森病（IPD）患者表现出不同程度的认知功能下降。本研究的目的是评估IPD患者疾病发作时的主要运动症状与认知功能水平之间的关系。本研究共纳入159例IPD患者。患者的初始运动症状分为三种类型：震颤为主型（TD）、运动迟缓及强直为主型（BRD）、步态及姿势不稳为主型（GPD）。根据Hoehn-Yahr分级（H&Y分期）对疾病严重程度进行评分。使用韩国版简易精神状态检查表（K-MMSE）和改良简易精神状态检查表（3MS）对整体认知状态进行评估。GPD组的K-MMSE/3MS得分最低，而TD患者在认知分析中表现最佳（p<0.05）。疾病发作时年龄较大的患者比疾病发作时年龄较小的患者认知表现更差（p<0.05）。根据H&Y分期，认知状态没有差异。准确分类初始运动症状以及详细病史，包括IPD的确切发病年龄，可能有助于我们预测IPD患者的认知功能下降。
