Ismailova S B, Prokopenko S V, Pokhabov D V, Mosaleva E I, Alekseenko P V, Zhumzhanov I M
Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Federal Siberian Research Clinical Center under the Federal Medical and Biological Agency, Krasnoyarsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(7):36-41. doi: 10.17116/jnevro202112107136.
To assess the dynamics of cognitive impairments (CI) in patients with Parkinson's disease (PD) during L-dopa therapy.
The randomized clinical study included 41 patients with a refined diagnosis of PD 2.5-3.5 stages by Hoehn-Yahr scale, mainly with akinetic-rigid and mixed forms, and with CI associated with PD. All patients were on levodopa therapy. The average duration of the disease was 5 years. The study participants were randomized into two groups according to the design. To assess the dynamics of CI, a neuropsychological study was carried out twice with an interval of 6 months: in group I - at the «peak and outcome» of L-DOPA therapy, and in group II - at the «outcome and peak» of levodopa therapy, respectively. Assessment of cognitive functions (CF) was carried out using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), Geriatric Depression Scale (GDS).
The statistically significant improvement of CF at the «peak» of levodopa drugs and the deterioration at the «outcome» of L-DOPA therapy in the form of an increase in CI (<0.05) was revealed.
CI in PD, in a certain extent, may be dependent on L-DOPA therapy as well as motor manifestations. The most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.
评估帕金森病（PD）患者在左旋多巴治疗期间认知障碍（CI）的动态变化。
这项随机临床研究纳入了41例经Hoehn-Yahr量表精确诊断为2.5 - 3.5期的PD患者，主要为运动不能-强直型和混合型，且伴有与PD相关的CI。所有患者均接受左旋多巴治疗。疾病平均病程为5年。根据研究设计，将研究参与者随机分为两组。为评估CI的动态变化，间隔6个月进行两次神经心理学研究：第一组在左旋多巴治疗的“峰值和末期”进行，第二组分别在左旋多巴治疗的“末期和峰值"进行。使用简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、额叶评估量表（FAB）、帕金森病认知功能评定量表（SCOPA-Cog）、老年抑郁量表（GDS）对认知功能（CF）进行评估。
结果显示，左旋多巴药物治疗“峰值”时CF有统计学意义的改善，而在左旋多巴治疗“末期”时以CI增加的形式出现恶化（<0.05）。
PD中的CI在一定程度上可能依赖于左旋多巴治疗以及运动表现。最依赖左旋多巴治疗的CF是注意力、言语、执行和视觉空间功能。
