Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Can J Neurol Sci. 2023 Jan;50(1):44-48. doi: 10.1017/cjn.2021.507. Epub 2021 Dec 13.
Psychosis is one of the incapacitating nonmotor symptoms of Parkinson's disease (PD). Although several risk factors that include older age, rapid eye movement sleep behavior disorder, depression, and cognitive dysfunction have been identified, the exact neural correlates remain elusive. As cognitive impairment has a close association with psychosis in PD, it is useful to know the spectrum of cognitive impairment in PD patients with psychosis (PD-P).
This cross-sectional study compared various cognitive parameters of PD-P (visual/minor hallucinations) and PD patients with no psychosis (PD-NP). A neuropsychological battery encapsulating several cognitive domains (executive, visuospatial, learning, and memory) was used for the cognitive assessment of 37 PD-P and 51 PD-NP patients who were matched for age, gender, education, and disease duration.
The two groups were comparable in terms of disease severity and stage. Although the groups had a comparable mean score on Montreal cognitive assessment, the PD-P group performed poorly in tests focused on executive function (color trail test, forward digit span), verbal learning and memory (Rey auditory and verbal learning test), and visuospatial functions (complex figure test, corsi block tapping test). Those with complex visual hallucinations performed poorly in the color trial test (part A) compared to those with minor hallucinations.
Psychosis is associated with a multidomain cognitive dysfunction in PD. All PD patients should undergo detailed cognitive assessment as cognitive dysfunction may be a marker of psychosis in the future. Additional longitudinal studies are warranted to obtain detailed insights into this issue.
精神病是帕金森病（PD）的一种使人丧失能力的非运动症状。尽管已经确定了几个风险因素，包括年龄较大、快速眼动睡眠行为障碍、抑郁和认知功能障碍，但确切的神经相关性仍难以捉摸。由于认知障碍与 PD 中的精神病密切相关，因此了解 PD 伴精神病（PD-P）患者的认知障碍谱很有用。
本横断面研究比较了 PD-P（视觉/轻度幻觉）和无精神病的 PD 患者（PD-NP）的各种认知参数。使用神经心理学测试包，包括几个认知领域（执行、视空间、学习和记忆），对 37 名 PD-P 和 51 名 PD-NP 患者进行认知评估，这些患者在年龄、性别、教育程度和疾病持续时间方面相匹配。
两组在疾病严重程度和阶段方面具有可比性。尽管两组在蒙特利尔认知评估中的平均得分相当，但 PD-P 组在执行功能（颜色追踪测试、前向数字跨度）、言语学习和记忆（ Rey 听觉和言语学习测试）以及视空间功能（复杂图形测试、科西方块测试）方面表现较差。那些有复杂视觉幻觉的人在颜色试验测试（A 部分）中的表现比那些有轻微幻觉的人差。
精神病与 PD 中的多领域认知功能障碍有关。所有 PD 患者都应进行详细的认知评估，因为认知功能障碍可能是未来精神病的一个标志物。需要进行额外的纵向研究，以更详细地了解这一问题。
