Das Dhiman, Biswas Atanu, Roy Arijit, Sauerbier Anna, Bhattacharyya Kalyan B
Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
Neurol India. 2016 May-Jun;64(3):419-27. doi: 10.4103/0028-3886.181533.
Cognitive symptoms are common in advanced Parkinson's disease (PD). However, assessment of cognitive impairment is difficult in PD because of accompanying motor symptoms and the coexistence of nonmotor symptoms. Specific subdomains affected in the disease are not reflected in the conventional scales used for assessing cognition.
This study was aimed at looking at the spectrum of cognitive impairment in the various phenotypes and stages of PD and the correlation of cognitive impairment with motor and nonmotor symptoms of PD.
Fifty PD patients fulfilling the UK PD Society Brain Bank's criteria were selected after obtaining explicit consent. Patients were assessed clinically and by using various scales like Scales for Outcomes in PD-Cognition (SCOPA-COG), mini-mental state examination, and Beck's Depression Inventory and Scoring.
The mean age was 58 years, 82% of the patients were male, and the mean modified Hoehn and Yahr staging was 2. The most commonly affected domains were memory and executive functioning. Cognitive impairment was more in those with late-onset disease, more advanced stage of disease, and in the postural instability and gait disorder (PIGD) subgroup. The cognitive function deteriorated with increasing age and duration of the illness. Significant correlation with cognitive impairment was obtained for the manifestations of increased motor disability, presence of coexistent psychotic symptoms and depression.
Cognitive impairment was common among PD patients, and it was more prevalent with increasing duration of the disease, in older patients, in late-onset disease, and in the PIGD subgroup. Increasing motor disability and associated psychotic symptoms as well as depression significantly increased the cognitive impairment.
认知症状在晚期帕金森病（PD）中很常见。然而，由于伴有运动症状以及非运动症状的共存，PD患者的认知障碍评估较为困难。该疾病中受影响的特定子领域未反映在用于评估认知的传统量表中。
本研究旨在观察PD不同表型和阶段的认知障碍范围，以及认知障碍与PD运动和非运动症状的相关性。
在获得明确同意后，选择了50例符合英国帕金森病协会脑库标准的PD患者。对患者进行临床评估，并使用帕金森病认知结局量表（SCOPA-COG）、简易精神状态检查表和贝克抑郁量表及评分等各种量表进行评估。
平均年龄为58岁，82%的患者为男性，平均改良Hoehn和Yahr分期为2期。最常受影响的领域是记忆和执行功能。晚发型疾病、疾病晚期以及姿势不稳和步态障碍（PIGD）亚组的患者认知障碍更严重。认知功能随着年龄增长和病程延长而恶化。运动残疾增加、存在共存的精神病性症状和抑郁的表现与认知障碍存在显著相关性。
认知障碍在PD患者中很常见，且在病程延长、老年患者、晚发型疾病以及PIGD亚组中更为普遍。运动残疾增加以及相关的精神病性症状和抑郁显著增加了认知障碍。
