Levin B E, Katzen H L
Department of Neurology, University of Miami School of Medicine, Florida 33136.
Adv Neurol. 1995;65:85-95.
Early cognitive changes in patients with PD are often subtle and influenced by factors that interact with the disease process, including age and age of disease onset, medication, and the specific constellation of motor symptoms. These factors notwithstanding, there is ample evidence that specific cognitive changes occur early in the course of PD. Whereas language processing deficits are infrequent, subtle changes in olfaction and contrast sensitivity have been repeatedly observed. Executive function deficits are often prominent and, as an integral part of many tasks, also influence performance on a wide range of cognitive measures. This is particularly true for memory and visuospatial dysfunction, two areas that rely heavily on executive demands. Finally, depressive symptoms are also frequent in the early stages of the disease. The significance of early behavioral changes and their prognostic implications are largely unknown and need to be assessed prospectively.
帕金森病患者早期的认知变化往往很细微，并受到与疾病进程相互作用的因素影响，这些因素包括年龄、发病年龄、药物治疗以及运动症状的具体组合。尽管存在这些因素，但有充分证据表明帕金森病病程早期会出现特定的认知变化。语言处理缺陷并不常见，但嗅觉和对比敏感度的细微变化已被反复观察到。执行功能缺陷往往很突出，并且作为许多任务的一个组成部分，也会影响广泛认知测量的表现。对于记忆和视觉空间功能障碍来说尤其如此，这两个领域在很大程度上依赖于执行要求。最后，抑郁症状在疾病早期也很常见。早期行为变化的意义及其预后影响在很大程度上尚不清楚，需要进行前瞻性评估。
