Yao Zhiwen, Shao Yuan, Han Xiang
Department of Neurology, YangPu Hospital, Tongji University School of Medicine, Shanghai 200092, China.
Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu210008, China.
Neurosci Lett. 2017 Aug 24;656:126-130. doi: 10.1016/j.neulet.2017.07.004. Epub 2017 Jul 8.
To explore whether the cognitive impairment is correlated with freezing of gait (FOG) in patients with Parkinson disease (PD).
A total of 186 patients with Parkinson disease (104 patients with FOG and 82 patients with no clinical history of freezing behavior) and 125 healthy individuals were selected for this study. Neuropsychological assessments, including the scales for outcomes in Parkinson disease cognition, unified Parkinson's disease rating scale, and Hamilton depression/anxiety rating scale etc., were applied to evaluate the patients'cognitive functioning.
We found that the scores of Unified Parkinson's Disease Rating Scale (UPDRS) were significantly higher among PD patients with FOG, compared with non-FOG group. We also showed that Mini-Mental State Examination score (MMSE) was lower among subjects with FOG than in patients without FOG. Patients with FOG displayed lower Scales for OUTCOMES: in Parkinson's Disease Cognition (SCOPA-COG) score than non-FOG patients. In addition, significant higher Hamilton Anxiety Rating Scale (HAMD) scores were found in patients with FOG than patients without FOG. Moreover, disease duration, stage of the disease, the severity of motor symptom, increased depressive and anxiety complaints measured by FOG questionnaire were significantly associated with severity of FOG. Meanwhile, we also found that the score of Freezing of Gait Questionnaire (FOGQ) score was negatively correlated with MMSE.
Our results demonstrated that FOG is related to impaired cognitive functions in PD patients with FOG. The understanding of impaired cognitive functions in PD patients with FOG can provide evidences for possible therapeutic interventions.
探讨帕金森病(PD)患者的认知障碍是否与冻结步态(FOG)相关。
本研究共纳入186例帕金森病患者(104例有冻结步态患者和82例无冻结行为临床病史患者)以及125名健康个体。应用神经心理学评估,包括帕金森病认知结局量表、统一帕金森病评定量表、汉密尔顿抑郁/焦虑评定量表等,来评估患者的认知功能。
我们发现,与无冻结步态组相比,有冻结步态的帕金森病患者统一帕金森病评定量表(UPDRS)得分显著更高。我们还表明,有冻结步态的受试者简易精神状态检查表(MMSE)得分低于无冻结步态的患者。有冻结步态的患者帕金森病认知结局量表(SCOPA-COG)得分低于无冻结步态的患者。此外,有冻结步态的患者汉密尔顿焦虑评定量表(HAMD)得分显著高于无冻结步态的患者。而且,病程、疾病分期、运动症状严重程度、冻结步态问卷测量的抑郁和焦虑主诉增加与冻结步态严重程度显著相关。同时,我们还发现冻结步态问卷(FOGQ)得分与MMSE呈负相关。
我们的结果表明,冻结步态与有冻结步态的帕金森病患者认知功能受损有关。对有冻结步态的帕金森病患者认知功能受损的理解可为可能的治疗干预提供依据。