Taximaimaiti Reyisha, Wang Xiao-Ping
Department of Neurology, Shanghai TongRen Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurosci. 2021 Apr 27;15:660340. doi: 10.3389/fnins.2021.660340. eCollection 2021.
Freezing of gait (FOG) is one of the most common walking problems in Parkinson's disease (PD). Impaired cognitive function is believed to play an important role in developing and aggravating FOG in PD. But some evidence suggests that motor function discrepancy may affect testing results. Therefore, we think it is necessary for PD-FOG(+) and PD-FOG(-) patients to complete neuropsychological tests under similar motor conditions.
This study recruited 44 idiopathic PD patients [PD-FOG(+) = 22, PD-FOG(-) = 22] and 20 age-matched healthy controls (HC). PD-FOG(+) and PD-FOG(-) patients were matched for age, year of education, and Hoehn and Yahr score (H&Y). All participants underwent a comprehensive battery of neuropsychological assessment, and demographical and clinical information was also collected.
PD patients showed poorer cognitive function, higher risks of depression and anxiety, and more neuropsychiatric symptoms compared with HC. When controlling for age, years of education, and H&Y, there were no statistical differences in cognitive function between PD-FOG(+) and PD-FOG(-) patients. But PD-FOG(+) patients had worse motor and non-motor symptoms than PD-FOG(-) patients. PD patients whose motor symptoms initiated with rigidity and initiated unilaterally were more likely to experience FOG.
Traditional neuropsychological testing may not be sensitive enough to detect cognitive impairment in PD. Motor symptoms initiated with rigidity and initiated unilaterally might be an important predictor of FOG.
冻结步态(FOG)是帕金森病(PD)最常见的行走问题之一。认知功能受损被认为在PD患者FOG的发生和加重中起重要作用。但一些证据表明运动功能差异可能影响测试结果。因此,我们认为PD-FOG(+)和PD-FOG(-)患者有必要在相似的运动条件下完成神经心理学测试。
本研究招募了44例特发性PD患者[PD-FOG(+)=22例,PD-FOG(-)=22例]和20例年龄匹配的健康对照者(HC)。PD-FOG(+)和PD-FOG(-)患者在年龄、受教育年限、Hoehn和Yahr评分(H&Y)方面进行了匹配。所有参与者均接受了全面的神经心理学评估,并收集了人口统计学和临床信息。
与HC相比,PD患者表现出较差的认知功能、更高的抑郁和焦虑风险以及更多的神经精神症状。在控制年龄、受教育年限和H&Y后,PD-FOG(+)和PD-FOG(-)患者在认知功能上无统计学差异。但PD-FOG(+)患者比PD-FOG(-)患者有更严重的运动和非运动症状。以僵硬起病且为单侧起病的PD患者更易出现FOG。
传统的神经心理学测试可能对检测PD患者的认知障碍不够敏感。以僵硬起病且为单侧起病的运动症状可能是FOG的重要预测指标。