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帕金森病的听觉系统受累:电生理和神经心理学相关性。

The auditory system involvement in Parkinson disease: electrophysiological and neuropsychological correlations.

机构信息

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

出版信息

J Clin Neurophysiol. 2009 Dec;26(6):430-7. doi: 10.1097/WNP.0b013e3181c2bcc8.

Abstract

In the course of Parkinson disease (PD), apart from motor symptoms, presence of mental disturbances such as dementia and depression is common. The aims of this study were to assess the auditory system involvement in patients with PD using electrophysiological and neuropsychological tests and to correlate the cognitive impairment and the auditory evoked potentials tests results. The auditory and cognitive functions were studied in 53 patients with idiopathic PD, mean age 65.8 +/- 9.1 years; mean disease duration 7.8 +/- 5.0 years; mean motor disability score 2.5 +/- 0.8 points in Hoehn-Yahr scale compared with a control group matched for age and sex. In patients and controls, cognitive functions were analyzed electrophysiologically using middle latency auditory evoked potentials (MLAEP) and long latency (event-related potentials, P300) auditory evoked potentials. Neuropsychological testing consisted of Wisconsin Card Sorting Test (WCST). According to WCST results, patients with PD were divided into 2 subgroups: patients with normal and abnormal WCST performance (WCST(-) and WCST(+) subgroups, respectively). Sixteen of 46 patients (34.8%) showed cognitive impairment when evaluated with WCST. Statistically significant differences in middle latency auditory evoked potentials and P300 results between WCST(-) and WCST(+) groups were found consisting of P300 abnormalities in 93.8% patients in WCST(+) and 57.7% in WCST(-) group. Middle latency auditory evoked potentials were abnormal in 71.4% and 63% patients in WCST(+) and WCST(-) group, respectively. P300 was absent significantly more often (P < 0.01) in the subgroup with cognitive impairment. The difference in middle latency auditory evoked potentials results between these subgroups was statistically insignificant. The auditory evoked potentials changes were more common among patients with abnormal WCST performance. According to our results, the auditory evoked potentials of different latencies are helpful in the assessment of cognitive changes accompanying PD.

摘要

在帕金森病(PD)的过程中,除了运动症状外,还经常出现痴呆和抑郁等精神障碍。本研究的目的是使用电生理和神经心理学测试评估 PD 患者的听觉系统受累情况,并将认知障碍与听觉诱发电位测试结果相关联。对 53 名特发性 PD 患者(平均年龄 65.8 ± 9.1 岁;平均病程 7.8 ± 5.0 年;Hoehn-Yahr 量表上的平均运动障碍评分 2.5 ± 0.8 分)和年龄、性别相匹配的对照组进行了听觉和认知功能研究。在患者和对照组中,使用中潜伏期听觉诱发电位(MLAEP)和长潜伏期(事件相关电位,P300)听觉诱发电位对认知功能进行了电生理分析。神经心理学测试包括威斯康星卡片分类测试(WCST)。根据 WCST 结果,将 PD 患者分为 2 个亚组:WCST 表现正常和异常(WCST(-)和 WCST(+)亚组)的患者。16/46 名患者(34.8%)在 WCST 评估时表现出认知障碍。在 WCST(-)和 WCST(+)组之间,发现中潜伏期听觉诱发电位和 P300 结果存在统计学显著差异,其中 93.8%的 WCST(+)患者和 57.7%的 WCST(-)患者存在 P300 异常。WCST(+)和 WCST(-)组的中潜伏期听觉诱发电位异常率分别为 71.4%和 63%。在有认知障碍的亚组中,P300 缺失明显更常见(P < 0.01)。这两个亚组之间中潜伏期听觉诱发电位结果的差异无统计学意义。在 WCST 表现异常的患者中,听觉诱发电位变化更为常见。根据我们的结果,不同潜伏期的听觉诱发电位有助于评估 PD 伴发的认知变化。

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