Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Neurology. 2012 Sep 25;79(13):1323-31. doi: 10.1212/WNL.0b013e31826c1acd. Epub 2012 Sep 12.
Cognitive impairment and neurocirculatory abnormalities such as orthostatic hypotension (OH), supine hypertension (SH), and failure to decrease blood pressure at night (nondipping) occur relatively commonly in Parkinson disease (PD); however, whether cognitive dysfunction in early PD is related to neurocirculatory abnormalities has not been established. Cognitive dysfunction in PD is associated with white matter hyperintensities on MRI. We report results of an analysis of neuropsychological and hemodynamic parameters in patients with early PD.
Among 87 patients, 25 had normal cognition, 48 had mild cognitive impairment, and 14 had dementia, based on comprehensive neuropsychological tests. Orthostatic vital signs and ambulatory 24-hour blood pressure monitoring were recorded, and brain magnetic resonance scans were obtained for all patients.
Cognitive impairment was associated with OH, SH, and white matter hyperintensities but not with nondipping. Dementia and white matter hyperintensities were common in SH. Of 13 patients with OH + SH, every one had mild cognitive impairment or dementia.
Cognitive dysfunction is related to neurocirculatory abnormalities, especially OH + SH, in early PD, raising the possibility that early detection and effective treatment of those abnormalities might slow the rate of cognitive decline.
认知障碍和神经循环异常，如直立性低血压（OH）、仰卧位高血压（SH）和夜间血压无法降低（非杓型），在帕金森病（PD）中较为常见；然而，早期 PD 中的认知功能障碍是否与神经循环异常有关尚未确定。PD 中的认知功能障碍与 MRI 上的白质高信号有关。我们报告了对早期 PD 患者神经心理学和血液动力学参数分析的结果。
在 87 名患者中，根据全面的神经心理学测试，25 名患者认知正常，48 名患者轻度认知障碍，14 名患者痴呆。记录直立生命体征和动态 24 小时血压监测，并对所有患者进行脑磁共振扫描。
认知障碍与 OH、SH 和白质高信号有关，但与非杓型无关。痴呆和白质高信号在 SH 中较为常见。在 13 名 OH + SH 患者中，每位患者均有轻度认知障碍或痴呆。
早期 PD 中的认知功能障碍与神经循环异常有关，尤其是 OH + SH，这提示早期发现和有效治疗这些异常可能会减缓认知下降的速度。
