抗胆碱能药物负担与非痴呆帕金森病的认知亚型。
Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson's Disease without Dementia.
机构信息
Department of Clinical and Health Psychology, University of Florida, PO Box 100165 Gainesville, FL 32610-0165.
Norman Fixel Institute for Neurological Diseases, University of Florida, 3009 SW Williston Road Gainesville, FL 32608.
出版信息
Arch Clin Neuropsychol. 2024 Nov 22;39(8):1443-1449. doi: 10.1093/arclin/acae041.
OBJECTIVE
Cognitive changes are heterogeneous in Parkinson's disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.
METHOD
A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants' medications were scored (0-3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS' relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.
RESULTS
Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.
CONCLUSIONS
Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.
目的
帕金森病（PD）患者的认知变化存在异质性。本研究比较了抗胆碱能负担是否会导致认知域表现的差异以及经验衍生的 PD-认知表型。
方法
回顾性图表审查包含了无痴呆的特发性 PD 参与者（n=493）。根据抗胆碱能认知负担量表（ACBS）对参与者的药物进行评分（0-3）并求和。我们检查了 ACBS 与五个认知域综合指标（规范 z 分数）和三个（基于 K-均值聚类的）认知表型之间的关系：认知完整、低执行功能（EF）和主要受损的 EF/记忆。分析包括 Spearman 相关分析、协方差分析和 Pearson 卡方检验。
结果
总体而言，表型在抗胆碱能负担方面没有差异，并且（经过假发现率校正后）没有认知域相关。当比较 ACBS 截断值（即得分≥3）以上和以下的患者时，未发现显著的表型或认知域差异。
结论
在无痴呆的特发性 PD 大型临床样本中，抗胆碱能药物使用并未导致认知表现的差异。
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