Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Asian J Psychiatr. 2017 Dec;30:192-195. doi: 10.1016/j.ajp.2017.10.013. Epub 2017 Oct 28.
Patients with Parkinson's disease (PD) may develop several non-motor symptoms (NMS). Psychosis is one of the debilitating NMS of PD. The neurobiology of psychosis is not fully understood. This study aims to compare the frontal lobe functions of PD patients with and without psychosis using the Frontal Assessment Battery (FAB).
This study included 69 patients with PD; 34 with psychosis (PD-P) and 35 without psychosis (PD-NP). Mini Mental Status Examination (MMSE) was used to screen for cognitive impairment. Unified Parkinson's disease Rating scale part-III (UPDRS-III) was used to measure the severity and Hoehn and Yahr score (H&Y) was used to measure the stage of PD. Frontal lobe functions were assessed by FAB.
The PD-P and PD-NP groups were comparable for age (58.7±8.4 vs 55.7±8.2, p=0.14), age at onset of symptoms (51.4±8.1 vs 50.0±8.8, p=0.48), gender distribution (men: 88%vs 80%, p=0.51), MMSE (28.2±1.9 vs 28.7±1.2 p=0.12), levodopa equivalent dose/day (736.0±376.3 vs 625.2±332.2, p=0.19), UPDRS-III OFF-score (36.7±8.8 vs 35.4±13.2, p=0.64), UPDRS-III ON-score (13.2±5.4 vs 12.4±6.6, p=0.44) and H&Y stage (2.3±0.3 vs 2.3±0.3, p=0.07). PD-P group had lower total FAB score compared to PD-NP group (13.9±2.2 vs 16.5±1.8, p<0.01). On the FAB, PD-P group had lower scores compared to PD-NP in lexical fluency (FAB-2), programming (FAB-3), sensitivity to interference (FAB-4) and inhibitory control (FAB-5).
Patients with PD-P had significant frontal lobe dysfunction compared to PD-NP. FAB may be a simple and useful bedside tool to assess frontal dysfunction in patients with PD in a busy neurological set up.
帕金森病（PD）患者可能会出现多种非运动症状（NMS）。精神病是 PD 的一种使人虚弱的 NMS。精神病的神经生物学尚未完全清楚。本研究旨在使用额叶评估量表（FAB）比较有和没有精神病的 PD 患者的额叶功能。
本研究纳入了 69 例 PD 患者；34 例有精神病（PD-P），35 例无精神病（PD-NP）。使用简易精神状态检查（MMSE）筛查认知障碍。使用帕金森病统一评定量表第三部分（UPDRS-III）评估严重程度，使用 Hoehn 和 Yahr 评分（H&Y）评估 PD 分期。使用 FAB 评估额叶功能。
PD-P 组和 PD-NP 组在年龄（58.7±8.4 岁 vs 55.7±8.2 岁，p=0.14）、症状起始年龄（51.4±8.1 岁 vs 50.0±8.8 岁，p=0.48）、性别分布（男性：88%vs 80%，p=0.51）、MMSE（28.2±1.9 分 vs 28.7±1.2 分，p=0.12）、左旋多巴等效剂量/天（736.0±376.3 分 vs 625.2±332.2 分，p=0.19）、UPDRS-III 关期评分（36.7±8.8 分 vs 35.4±13.2 分，p=0.64）、UPDRS-III 开期评分（13.2±5.4 分 vs 12.4±6.6 分，p=0.44）和 H&Y 分期（2.3±0.3 分 vs 2.3±0.3 分，p=0.07）方面无差异。PD-P 组的总 FAB 评分明显低于 PD-NP 组（13.9±2.2 分 vs 16.5±1.8 分，p<0.01）。在 FAB 上，PD-P 组在词汇流畅性（FAB-2）、计划性（FAB-3）、对干扰的敏感性（FAB-4）和抑制控制（FAB-5）方面的得分均低于 PD-NP 组。
与 PD-NP 相比，PD-P 患者的额叶功能明显受损。FAB 可能是一种在繁忙的神经科环境中评估 PD 患者额叶功能的简单而有用的床边工具。
