Department of Clinical Neuroscience and Preventive Medicine, Danube University, Krems, Austria.
J Neuropsychol. 2013 Sep;7(2):193-224. doi: 10.1111/jnp.12028.
Executive dysfunction can be present from the early stages of Parkinson's disease (PD). It is characterized by deficits in internal control of attention, set shifting, planning, inhibitory control, dual task performance, and on a range of decision-making and social cognition tasks. Treatment with dopaminergic medication has variable effects on executive deficits, improving some, leaving some unchanged, and worsening others. In this review, we start by defining the specific nature of executive dysfunction in PD and describe suitable neuropsychological tests. We then discuss how executive deficits relate to pathology in specific territories of the basal ganglia, consider the impact of dopaminergic treatment on executive function (EF) in this context, and review the changes in EFs with disease progression. In later sections, we summarize correlates of executive dysfunction in PD with motor performance (e.g., postural instability, freezing of gait) and a variety of psychiatric (e.g., depression, apathy) and other clinical symptoms, and finally discuss the implications of these for the patients' daily life.
执行功能障碍可在帕金森病（PD）的早期阶段出现。其特征是注意力的内部控制、定势转移、计划、抑制控制、双重任务表现以及一系列决策和社会认知任务方面存在缺陷。多巴胺能药物治疗对执行缺陷的影响各不相同，改善了一些，一些不变，还有一些则恶化了。在这篇综述中，我们首先定义 PD 中执行功能障碍的特定性质，并描述合适的神经心理学测试。然后我们讨论执行缺陷与基底神经节特定区域的病理学之间的关系，考虑在这种情况下多巴胺能治疗对执行功能（EF）的影响，并回顾随着疾病进展执行功能的变化。在后面的部分中，我们总结了 PD 中执行功能障碍与运动表现（例如，姿势不稳定、步态冻结）以及各种精神科（例如，抑郁、淡漠）和其他临床症状的相关性，最后讨论了这些对患者日常生活的影响。
