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中国帕金森病伴轻度认知障碍和痴呆的神经生理学特征

A neurophysiological profile in Parkinson's disease with mild cognitive impairment and dementia in China.

作者信息

Wang Ya-qin, Tang Bei-sha, Yan Xin-xiang, Chen Zhi-heng, Xu Qian, Liu Zhen-hua, Li Kai, Wang Kai, Guo Ji-feng

机构信息

Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, Hunan, People's Republic of China; Department of Healthy Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.

Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, Hunan, People's Republic of China; State Key Laboratory of Medical Genetics, Changsha, Hunan, People's Republic of China; Neurodegenerative Disorders Research Center, Central South University, Changsha, Hunan, People's Republic of China; Key Laboratory of Hunan Province in Neurodegenerative Disorders, Changsha, 410008 Hunan, People's Republic of China.

出版信息

J Clin Neurosci. 2015 Jun;22(6):981-5. doi: 10.1016/j.jocn.2014.11.030. Epub 2015 Apr 15.

Abstract

Mild cognitive impairment (MCI) and dementia (D) are frequent features of Parkinson's disease (PD) but widely disparate criteria have been used. Our understanding of the prevalence and cognitive profile of Chinese PD patients remains limited. In order to determine the frequency and pattern of cognitive dysfunction and identify risk factors for cognitive dysfunction in the Chinese Han PD population we performed a cross-sectional study in a cohort of 330 PD patients and 163 healthy controls. Five cognitive domains (executive function, attention, praxis and visuospatial function, memory, and language) and mood/behavior were evaluated. According to the Movement Disorder Society Task Force consensus criteria, up to 29.1% of PD patients were classified as PD-MCI and 32.1% as PD-D. Impairments occur in a range of cognitive domains with dysexecutive profile predominating. Healthy controls also outperformed cognitively preserved PD patients in tasks of executive function and attention. Logistic regression indicated that PD-MCI may be predicted by lower educational level and apathy. Additionally, later disease onset, longer disease duration, more severe motor symptoms and higher neuropsychiatric inventory score were associated with a faster transition from PD-MCI to PD-D. These findings suggest that all PD patients should undergo routine cognitive screening. For high-risk patients early recognition and therapeutic intervention is imperative.

摘要

轻度认知障碍(MCI)和痴呆(D)是帕金森病(PD)的常见特征,但所采用的标准却大相径庭。我们对中国PD患者的患病率和认知特征的了解仍然有限。为了确定中国汉族PD人群中认知功能障碍的频率和模式,并识别认知功能障碍的危险因素,我们对330例PD患者和163例健康对照进行了一项横断面研究。评估了五个认知领域(执行功能、注意力、实践和视觉空间功能、记忆和语言)以及情绪/行为。根据运动障碍协会特别工作组的共识标准,高达29.1%的PD患者被归类为PD-MCI,32.1%被归类为PD-D。认知障碍发生在一系列认知领域,以执行功能障碍为主。健康对照在执行功能和注意力任务中的表现也优于认知功能保留的PD患者。逻辑回归表明,较低的教育水平和冷漠可能预测PD-MCI。此外,疾病发病较晚、病程较长、运动症状较严重以及神经精神量表得分较高与从PD-MCI向PD-D的更快转变相关。这些发现表明,所有PD患者都应接受常规认知筛查。对于高危患者,早期识别和治疗干预势在必行。

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