Department of Neurology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey.
Parkinsonism Relat Disord. 2009 Nov;15(9):688-91. doi: 10.1016/j.parkreldis.2009.04.008. Epub 2009 May 15.
Cognitive impairment either as dementia (PD-D) or mild cognitive impairment (PD-MCI) is common in Parkinson's disease (PD). The clinical features and cognitive profile differs from Alzheimer's disease (AD) or amnestic MCI (aMCI). In this study we aim to disclose the utility of pre-selected practical neuropsychological tests in differentiation of PD-D and AD, and also PD-MCI and aMCI. Consecutive cases with mild to moderate AD (n = 32) and PD-D (n = 26); aMCI (n = 34) and PD-MCI (n = 19) were evaluated. Although MMSE scores were similar in PD-D and AD or in PD-MCI and aMCI groups, memory impairment assessed by enhanced cued recall (ECR) was more apparent in AD than PD-D; and ECR scores tended to be worse in aMCI group than PD-MCI group. In contrast, clock drawing was more impaired in PD-D than AD. For differentiation of PD-D from AD, ECR, clock drawing and letter fluency were found to be valuable with moderately high sensitivity and specificities. In differentiation of aMCI and PD-MCI, ECR, clock drawing test and copying of intersecting pentagons were helpful. Stepwise linear discrimination function analysis disclosed that combination of ECR and clock drawing tests correctly classified 70.7% of the overall study population (71.4% of AD, 71.9% of aMCI, 69.6% of PD-D and 68.8% of PD-MCI). These findings suggest that ECR and clock drawing tests can be valuable as an additive to clinical diagnostic criteria in differentiation of PD-D and PD-MCI cases from AD and aMCI.
认知障碍，无论是痴呆症（PD-D）还是轻度认知障碍（PD-MCI），在帕金森病（PD）中都很常见。其临床特征和认知特征与阿尔茨海默病（AD）或遗忘型轻度认知障碍（aMCI）不同。在这项研究中，我们旨在揭示预先选择的实用神经心理学测试在区分 PD-D 和 AD 以及 PD-MCI 和 aMCI 中的作用。连续评估了轻度至中度 AD（n = 32）和 PD-D（n = 26）；aMCI（n = 34）和 PD-MCI（n = 19）病例。虽然 PD-D 和 AD 或 PD-MCI 和 aMCI 组的 MMSE 评分相似，但增强提示回忆（ECR）评估的记忆障碍在 AD 中更为明显，而在 aMCI 组中 ECR 评分往往更差。相比之下，在 PD-D 中时钟绘制受损更明显。对于 PD-D 与 AD 的区分，ECR、时钟绘制和字母流畅性被发现具有中等高的敏感性和特异性。对于 aMCI 和 PD-MCI 的区分，ECR、时钟绘制测试和交叉五边形的复制是有帮助的。逐步线性判别函数分析显示，ECR 和时钟绘制测试的组合正确分类了 70.7%的总体研究人群（AD 为 71.4%，aMCI 为 71.9%，PD-D 为 69.6%，PD-MCI 为 68.8%）。这些发现表明，ECR 和时钟绘制测试可以作为临床诊断标准的附加标准，有助于区分 PD-D 和 PD-MCI 病例与 AD 和 aMCI。
