School of Psychology, Bangor University, Bangor, United Kingdom.
Mov Disord. 2011 Nov;26(13):2305-15. doi: 10.1002/mds.23868. Epub 2011 Oct 3.
Impairment of executive function (EF) is commonly reported as a feature of PD. However, the exact pattern of executive impairment remains unclear. Also, there is an ongoing discussion surrounding the definition and conceptualization of EF, which might affect the clarity of research evidence on cognition in PD. The aim of this systematic review was to describe the pattern of executive impairment in early-stage PD emerging from the research literature and to identify critical issues for improving consistency in this field. The PsychInfo, MEDLINE, Science Direct, CINAHL, and Cochrane Library databases were searched using the term "Parkinson's disease" combined with each of 14 cognitive abilities defined as representing aspects of EF. The review was limited to studies that investigated EF as the central variable in early-stage, nondemented PD patients. The review identified 33 studies of EF that were operationalized in terms of 30 abilities tested by 60 measures and variously interpreted. Many measures were used only once, so only a small part of the available research evidence could be synthesized in the meta-analysis. The meta-analysis was undertaken using data from five commonly used tests of EF drawn from 18 studies. This revealed consistent evidence for cognitive difficulties across all five EF tests. Research on EF in PD is characterized by a considerable lack of clarity with regard to measure selection and interpretation. The findings support the view that EF impairments are evident in PD. However, the clinical significance of the cognitive abnormalities reported has yet to be clarified.
执行功能 (EF) 损伤是 PD 的常见特征。然而，确切的执行损伤模式仍不清楚。此外，关于 EF 的定义和概念化还存在持续的讨论，这可能会影响 PD 认知研究证据的清晰度。本系统评价的目的是描述早期 PD 患者的执行损伤模式，并确定改善该领域一致性的关键问题。使用术语“帕金森病”结合 EF 定义的 14 种认知能力中的每一种，在 PsychInfo、MEDLINE、Science Direct、CINAHL 和 Cochrane Library 数据库中进行了搜索。该综述仅限于研究早期非痴呆 PD 患者的 EF 作为主要变量的研究。该综述确定了 33 项 EF 研究，这些研究是根据 60 项测试中的 30 项能力进行操作的，并且有不同的解释。许多措施仅使用一次，因此只能对可用研究证据的一小部分进行综合分析。元分析使用来自 18 项研究的五项常用 EF 测试中的数据进行。这表明所有五项 EF 测试均存在认知困难的一致证据。PD 中的 EF 研究的特点是在测量选择和解释方面存在很大的不明确性。研究结果支持 PD 中存在 EF 损伤的观点。然而，报告的认知异常的临床意义尚未阐明。
