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多巴胺能药物可改善帕金森病患者在低认知需求下的认知控制。

Dopaminergic medication improves cognitive control under low cognitive demand in Parkinson's disease.

机构信息

Cognitive Motor Neuroscience Group, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Queen Square Institute of Neurology.

出版信息

Neuropsychology. 2020 Jul;34(5):551-559. doi: 10.1037/neu0000629. Epub 2020 Mar 23.

Abstract

OBJECTIVE

Dopamine agonists are the main pharmacological intervention for the motor symptoms of Parkinson's disease (PD). However, dopaminergic medication has been associated with disinhibitory psychopathology in some patients. The aim of this study was to test the effect of dopaminergic medication on inhibitory control in patients with PD using the paced Random Number Generation task (RNG), which requires inhibition of prepotent counting in series to produce a random sequence of numbers.

METHOD

Twenty-three PD patients performed RNG on and off dopaminergic medication. Cognitive load was manipulated by performing RNG at faster (1Hz) and slower (0.5 Hz) rates. For RNG, two scores (CS1 and CS2) were derived, which are considered indices of more automatic and more controlled counting, respectively.

RESULTS

There were no main effects of medication on RNG performance. There was a significant main effect of cognitive load on CS1, with higher CS1 scores at the faster rate ( = <.01). A significant interaction effect between medication and rate (cognitive load; = .03) followed by post hoc testing, revealed that CS2 scores were higher, on medication, at the slower but not the faster rate.

CONCLUSIONS

Patients with PD displayed increased use of more controlled processing strategies on medication at the slowest rate of RNG. Therefore, while dopaminergic medication has been associated with disinhibitory psychopathology, our results suggest that dopamine therapy may enhance some forms of inhibitory cognitive control in PD, but only if there is sufficient time to engage controlled processing strategies. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

目的

多巴胺激动剂是治疗帕金森病(PD)运动症状的主要药物干预手段。然而,一些患者的多巴胺能药物治疗与去抑制性精神病理学有关。本研究旨在使用 paced Random Number Generation 任务(RNG)测试多巴胺能药物对 PD 患者抑制控制的影响,该任务需要抑制连续的优势计数以产生随机数字序列。

方法

23 名 PD 患者在服用和停用多巴胺能药物时进行 RNG。通过以更快(1Hz)和更慢(0.5 Hz)的速度进行 RNG 来操纵认知负荷。对于 RNG,得出两个分数(CS1 和 CS2),它们分别被认为是更自动和更受控计数的指标。

结果

药物对 RNG 表现没有主要影响。认知负荷对 CS1 有显著的主要影响,较快的速度( = <.01)产生较高的 CS1 分数。药物和速度(认知负荷)之间存在显著的交互作用效应( =.03),随后进行了事后检验,结果表明在较慢但不是更快的速度下,CS2 分数在药物治疗时更高。

结论

PD 患者在 RNG 最慢的速度下表现出更多受控处理策略的使用增加。因此,尽管多巴胺能药物与去抑制性精神病理学有关,但我们的结果表明,多巴胺治疗可能会增强 PD 中某些形式的抑制性认知控制,但前提是有足够的时间来运用受控处理策略。

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