Malapani C, Pillon B, Dubois B, Agid Y
INSERM U 289, Hôpital de la Salpêtrière, Paris, France.
Neurology. 1994 Feb;44(2):319-26. doi: 10.1212/wnl.44.2.319.
Patients with Parkinson's disease (PD) have trouble programming two separate motor acts concurrently. We tested the hypotheses that (1) PD patients may also have difficulty processing two cognitive tasks simultaneously, and (2) the expected deficit may be related to the striatal dopaminergic depletion. We used auditory and visual choice reaction time (CRT) tasks, presented either separately or concurrently, and compared the performance of three groups of PD patients: a group of patients under their usual dose of levodopa ("standard"); a group assessed both at the time of maximal clinical benefit ("on" state) and at the time of minimal clinical benefit (treatment withdrawn for about 18 hours; "off" state); and a group of recently diagnosed untreated patients ("de novo"). Compared with controls, standard and "on" state patients had a normal performance for both separate and concurrent CRT tasks. In contrast, "off" state and de novo patients had a normal performance in the separate CRT tasks but significant deficits in the concurrent CRT tasks. These results suggest that adequate dopaminergic transmission is necessary for concurrent processing of cognitive information and that the striatum integrates the sensorimotor information required to program cognitive acts.
帕金森病（PD）患者在同时规划两种不同的运动行为时存在困难。我们检验了以下假设：（1）PD患者在同时处理两项认知任务时可能也存在困难；（2）预期的缺陷可能与纹状体多巴胺能耗竭有关。我们使用了听觉和视觉选择反应时（CRT）任务，这些任务分别或同时呈现，并比较了三组PD患者的表现：一组患者服用其常用剂量的左旋多巴（“标准组”）；一组在临床获益最大时（“开”状态）和临床获益最小时（停药约18小时；“关”状态）进行评估；还有一组是新诊断的未治疗患者（“初发”）。与对照组相比，标准组和“开”状态组患者在单独和同时进行的CRT任务中表现正常。相比之下，“关”状态组和初发组患者在单独的CRT任务中表现正常，但在同时进行的CRT任务中存在显著缺陷。这些结果表明，充足的多巴胺能传递对于认知信息的同时处理是必要的，并且纹状体整合了规划认知行为所需的感觉运动信息。
