Jones Jacob D, Tanner Jared J, Okun Michael, Price Catherine C, Bowers Dawn
1Department of Clinical and Health Psychology,McKnight Brain Institute,University of Florida,Gainesville,Florida.
2Center for Movement Disorders and Neurorestoration,McKnight Brain Institute,University of Florida,Gainesville,Florida.
J Int Neuropsychol Soc. 2017 Apr;23(4):322-331. doi: 10.1017/S1355617717000017. Epub 2017 Feb 6.
This study examined whether individuals with Parkinson's disease (PD) are at increased vulnerability for vascular-related cognitive impairment relative to controls. The underlying assumption behind this hypothesis relates to brain reserve and that both PD and vascular risk factors impair similar fronto-executive cognitive systems.
The sample included 67 PD patients and 61 older controls (total N=128). Participants completed neuropsychological measures of executive functioning, processing speed, verbal delayed recall/memory, language, and auditory attention. Cardiovascular risk was assessed with the Framingham Cardiovascular Risk index. Participants underwent brain imaging (T1 and T2 FLAIR). Trained raters measured total and regional leukoaraiosis (periventricular, deep subcortical, and infracortical).
Hierarchical regressions revealed that more severe cardiovascular risk was related to worse executive functioning, processing speed, and delayed verbal recall in both Parkinson patients and controls. More severe cardiovascular risk was related to worse language functioning in the PD group, but not controls. In contrast, leukoaraiosis related to both cardiovascular risk and executive functioning for controls, but not the PD group.
Overall, results revealed that PD and cardiovascular risk factors are independent risk factors for cognitive impairment. Generally, the influence of cardiovascular risk factors on cognition is similar in PD patients and controls. (JINS, 2017, 23, 322-331).
本研究探讨帕金森病（PD）患者相对于对照组是否更容易出现血管相关的认知障碍。该假设背后的潜在假设与脑储备有关，且帕金森病和血管危险因素都会损害相似的额前叶执行认知系统。
样本包括67名帕金森病患者和61名老年对照组（共128人）。参与者完成了执行功能、处理速度、言语延迟回忆/记忆、语言和听觉注意力的神经心理学测量。采用弗雷明汉心血管风险指数评估心血管风险。参与者接受了脑部成像（T1和T2 FLAIR）。经过培训的评估者测量了总的和局部的白质疏松（脑室周围、皮质下深部和皮质下）。
分层回归显示，在帕金森病患者和对照组中，更严重的心血管风险与更差的执行功能、处理速度和言语延迟回忆有关。在帕金森病组中，更严重的心血管风险与更差的语言功能有关，但在对照组中并非如此。相比之下，白质疏松与对照组的心血管风险和执行功能都有关，但与帕金森病组无关。
总体而言，结果显示帕金森病和心血管危险因素是认知障碍的独立危险因素。一般来说，心血管危险因素对认知的影响在帕金森病患者和对照组中相似。（《神经心理学杂志》，2017年，第23卷，第322 - 331页）
