Patrick Karlee, Cousins Elizabeth, Spitznagel Mary Beth
Kent State University, College of Arts and Sciences, Department of Psychological Sciences, Kent, Ohio, USA.
Dement Neuropsychol. 2024 Sep 2;18:e20230102. doi: 10.1590/1980-5764-DN-2023-0102. eCollection 2024.
Although the most prominent symptoms of Parkinson's disease (PD) are those impacting movement, cognitive dysfunction is prevalent and often presents early in the disease process. Individuals with cognitive symptoms of PD often complete cognitive screening, making it important to identify factors associated with cognitive screening performance to ensure prompt and accurate detection of cognitive impairments.
Despite a body of research examining relationships between motor symptoms and cognitive dysfunction in PD, no prior study has undertaken a systematic review of the magnitude of the relationship between motor symptoms and cognitive screening performance in PD.
This study was a systematic review and meta-analysis of the relationship between cognitive screening performance, as assessed by the Montreal Cognitive Assessment (MoCA), and motor symptoms of PD. After the systematic screening, 20 studies were included, and meta-regressions using mixed-effects models were conducted.
Motor symptoms across included studies were relatively mild, but average MoCA scores were at the established cutoff for risk of dementia in PD. The average disease duration was 5 years. Consistent with hypotheses, more severe motor symptoms were associated with lower MoCA scores (-0.22 (95%CI -0.29 to -0.16), p<0.001), indicating worse cognitive functioning.
The results indicate a significant negative correlation between MoCA performance and motor symptoms of PD. Average MoCA scores captured early disease-stage cognitive impairment when motor symptoms remained relatively mild. Serial screening for cognitive impairment beginning early in the disease course may be of benefit to ensure that cognitive dysfunction is detected as it arises.
尽管帕金森病（PD）最突出的症状是影响运动的症状，但认知功能障碍很普遍，且常在疾病过程早期出现。有PD认知症状的个体常进行认知筛查，因此识别与认知筛查表现相关的因素对于确保及时准确地检测认知障碍很重要。
尽管有大量研究探讨了PD运动症状与认知功能障碍之间的关系，但此前尚无研究对PD运动症状与认知筛查表现之间关系的程度进行系统综述。
本研究是对通过蒙特利尔认知评估（MoCA）评估的认知筛查表现与PD运动症状之间关系的系统综述和荟萃分析。经过系统筛选，纳入了20项研究，并使用混合效应模型进行了荟萃回归分析。
纳入研究中的运动症状相对较轻，但MoCA平均得分处于PD痴呆风险的既定临界值。平均病程为5年。与假设一致，更严重的运动症状与更低的MoCA得分相关（-0.22（95%CI -0.29至-0.16），p<0.001），表明认知功能更差。
结果表明MoCA表现与PD运动症状之间存在显著负相关。当运动症状仍相对较轻时，MoCA平均得分反映了疾病早期阶段的认知障碍。在疾病进程早期开始对认知障碍进行系列筛查可能有助于确保在认知功能障碍出现时就被检测到。
