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帕金森病的视觉处理能力与认知衰退

Visual processing capacity and cognitive decline in Parkinson's disease.

作者信息

Gerner Katharina, Bublak Peter, Finke Kathrin, Schrenk Simon, Ruiz-Rizzo Adriana L, Wagner Franziska, Klingner Carsten, Brodoehl Stefan

机构信息

Friedrich Schiller University Jena, Jena, Thüringen, Germany.

Biomagnetic Center, Jena University Hospital, Jena, Thüringen, Germany.

出版信息

BMJ Neurol Open. 2025 Mar 21;7(1):e000953. doi: 10.1136/bmjno-2024-000953. eCollection 2025.

Abstract

BACKGROUND

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterised by motor symptoms. However, approximately half of patients with PD exhibit signs of dementia within a decade of diagnosis. While deficits in working memory and visuospatial abilities are recognised as hallmarks of cognitive decline in PD, these populations are rarely studied using detailed cognitive tools that link cognitive impairments to formal theoretical models, such as the theory of visual attention (TVA).

METHODS

This cross-sectional study addresses this gap by employing the TVA whole report paradigm to assess visual processing in a cohort of patients with PD, both with and without cognitive impairment. Participants were divided based on their Montreal Cognitive Assessment (MoCA) scores into two PD groups (n=25 each) and a healthy control group (n=25).

RESULTS

Our principal finding is that the visual processing speed (C) and visual short-term memory capacity (K) are significantly diminished in patients with PD with MoCA scores below 26 (Analysis of variance, p=0.016 for C and p<0.001 for K), while no notable differences were observed between controls and patients with PD with MoCA scores of 26 or above. Using a generalised linear model to assess the impact of factors such as age, gender and disease duration, we discovered that the C-parameter was significantly influenced by age, while the Kparameter was notably affected by gender.

CONCLUSION

TVA parameters demonstrate their suitability for detecting cognitive deficits in PD. Given their independence from motor and non-motor symptoms, TVA parameters may prove to be valuable tools for early diagnosis and longitudinal monitoring of cognitive deficits in individual patients with PD.

摘要

背景

帕金森病(PD)是一种以运动症状为特征的进行性神经退行性疾病。然而,约一半的帕金森病患者在确诊后十年内会出现痴呆症状。虽然工作记忆和视觉空间能力的缺陷被认为是帕金森病认知衰退的标志,但这些人群很少使用将认知障碍与正式理论模型(如视觉注意理论(TVA))联系起来的详细认知工具进行研究。

方法

这项横断面研究通过采用TVA全报告范式来评估一组帕金森病患者(包括有认知障碍和无认知障碍的患者)的视觉处理能力,以填补这一空白。参与者根据蒙特利尔认知评估(MoCA)得分分为两个帕金森病组(每组n = 25)和一个健康对照组(n = 25)。

结果

我们的主要发现是,MoCA得分低于26的帕金森病患者的视觉处理速度(C)和视觉短期记忆容量(K)显著降低(方差分析,C为p = 0.016,K为p < 0.001),而MoCA得分在26及以上的帕金森病患者与对照组之间未观察到显著差异。使用广义线性模型评估年龄、性别和病程等因素的影响,我们发现C参数受年龄显著影响,而K参数受性别显著影响。

结论

TVA参数证明了其适用于检测帕金森病中的认知缺陷。鉴于它们与运动和非运动症状无关,TVA参数可能被证明是早期诊断和纵向监测个体帕金森病患者认知缺陷的有价值工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e839/11931947/b36e77018788/bmjno-7-1-g001.jpg

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