Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS), Italy.
Department of Anatomy, Histology, Forensic Medicine & Orthopedics, Sapienza University, Rome, Italy.
Mov Disord. 2020 Mar;35(3):409-418. doi: 10.1002/mds.27920. Epub 2019 Nov 21.
It is well known that a deficit in inhibitory control is a hallmark of Parkinson's disease (PD). However, inhibition is not a unitary construct, and it is unclear whether patients in the early stage of the disease (Hoehn and Yahr stage 1) exhibit a deficit in outright stopping (reactive inhibition), a deficit in the ability to shape their response strategies according to the context (proactive inhibition), or both.
We assessed whether PD patients at Hoehn and Yahr stage 1 show a global or selective impairment in inhibitory control. As it has been suggested that inhibition relies upon a right-lateralized pathway, we tested whether left-dominant PD patients suffered from a more severe deficit in this executive function than right-dominant PD patients.
Via a reaching stop-signal task, we assessed both proactive and reactive inhibition in 17 left-dominant PD and 17 right-dominant PD patients and in 24 age-matched participants.
We found that reactive inhibition was more impaired in PD patients than in healthy participants. However, proactive inhibition was not affected. Furthermore, we found no differences between left-dominant PD and right-dominant PD patients.
For the first time, we found evidence for a deficit of reactive inhibition in the early-stage PD patients in the absence of evidence for deficits in proactive inhibition. These findings have clinical relevance as they provide critical insights on the time course of the disease. In addition, we confirmed, on a population of PD patients at Hoehn and Yahr stage 1, previous results showing that the onset of the disease does not affect inhibition. © 2019 International Parkinson and Movement Disorder Society.
众所周知，抑制控制不足是帕金森病（PD）的一个标志。然而，抑制并不是一个单一的结构，目前尚不清楚疾病早期的患者（Hoehn 和 Yahr 1 期）是否存在完全停止（反应性抑制）的缺陷，是否存在根据上下文调整反应策略的能力（前瞻性抑制）的缺陷，或者两者都有。
我们评估 Hoehn 和 Yahr 1 期的 PD 患者是否存在抑制控制的整体或选择性损伤。由于抑制作用依赖于右侧偏侧化通路，我们测试了左侧优势 PD 患者在这种执行功能中是否比右侧优势 PD 患者遭受更严重的缺陷。
通过伸手停止信号任务，我们评估了 17 名左侧优势 PD 和 17 名右侧优势 PD 患者以及 24 名年龄匹配的参与者的前瞻性和反应性抑制。
我们发现，反应性抑制在 PD 患者中比在健康参与者中受损更严重。然而，前瞻性抑制不受影响。此外，我们没有发现左侧优势 PD 和右侧优势 PD 患者之间的差异。
我们首次发现早期 PD 患者存在反应性抑制缺陷的证据，而没有证据表明前瞻性抑制缺陷。这些发现具有临床意义，因为它们提供了对疾病发展时间过程的关键见解。此外，我们在 Hoehn 和 Yahr 1 期的 PD 患者人群中证实了先前的结果，即疾病的发作不会影响抑制。
