Department of Neurology, University of Washington, Seattle, WA, USA.
Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA.
Clin Neuropsychol. 2023 Oct;37(7):1479-1497. doi: 10.1080/13854046.2022.2157885. Epub 2022 Dec 22.
Parkinson's disease (PD) and essential tremor (ET) involve neuroanatomical circuitry that impact frontal lobe functioning, via the striatum and cerebellum, respectively. The aim of this exploratory study was to investigate quantitative and qualitative performance between and within these groups on measures of verbal fluency. Sixty-three PD and 53 ET patients completed neuropsychological testing. Linear regression models with robust variance estimation compared verbal fluency performance between groups related to correct responses and errors. Paired -tests investigated within group error rates. PD patients gave more correct responses for phonological (=5.3, =.01) and category fluency (=4.1, =.01) than ET patients; however, when processing speed was added as a covariate, this attenuated performance on both measures and only phonological fluency remained significant (=4.0, =.04). There were no statistical differences in error scores between groups. Error rates within groups suggested that PD patients had higher error rates in total errors and perseveration errors on phonological fluency ( = 2.6, =.00; = 1.6, =.00) and higher total errors and set-loss error rates on category switching ( = 5.1, <.001; = 4.1, <.001). ET patients had higher error rate with relation to total errors and set-loss errors on phonological fluency ( = 2.5, =.00; = 1.5, =.02) and category switching ( = 3.9, =,00; = 3.9, <.001). PD patients performed better than ET patients on phonological fluency. PD patients appear to make more perseveration errors on phonological fluency, while ET patients made more set-loss errors. Implications for frontal lobe dysfunction and clinical impact are discussed.
帕金森病(PD)和特发性震颤(ET)涉及影响额叶功能的神经解剖回路,分别通过纹状体和小脑。本探索性研究的目的是研究这些组之间和内部在言语流畅性测量方面的定量和定性表现。63 名 PD 和 53 名 ET 患者完成了神经心理学测试。使用稳健方差估计的线性回归模型比较了与正确反应和错误相关的组间言语流畅性表现。配对检验研究了组内错误率。PD 患者在语音流畅性(=5.3,p=.01)和类别流畅性(=4.1,p=.01)方面的正确反应多于 ET 患者;然而,当将处理速度作为协变量添加时,这会减弱这两种措施的表现,只有语音流畅性仍然具有统计学意义(=4.0,p=.04)。组间无统计学差异。组内错误率表明,PD 患者在语音流畅性的总错误和持续错误(=2.6,p=.00;=1.6,p=.00)以及类别转换的总错误和设定损失错误率(=5.1,p<.001;=4.1,p<.001)较高。ET 患者在语音流畅性的总错误和设定损失错误(=2.5,p=.00;=1.5,p=.02)以及类别转换的总错误和设定损失错误(=3.9,p<.001;=3.9,p<.001)方面的错误率较高。PD 患者在语音流畅性方面的表现优于 ET 患者。PD 患者在语音流畅性方面似乎会犯更多的持续错误,而 ET 患者在类别转换方面会犯更多的设定损失错误。讨论了额叶功能障碍和临床影响的意义。