抑郁与早期帕金森病患者执行功能损害的相关性分析.docVIP

抑郁与早期帕金森病患者执行功能损害的相关性分析 作者：郑鹏，王轶男，李继珍，樊红彬，徐凯，耿德勤 【摘要】 目的 评估早期非痴呆帕金森病(PD)患者全面认知功能和执行功能，探讨抑郁等相关因素对认知功能的影响。方法 41例早期PD患者进行PD统一评分量表(UPDRS)、Hoehn和Yahr分期、老年认知功能量表(SECF)、韦氏成人智力量表(WAIS-RC)操作智商(PIQ)、汉密尔顿抑郁量表(HAMD)评估。结果 较高 教育 水平、较年轻和发病年龄较早的患者SECF、WAIS-RC测验得分较高，疾病严重程度和认知功能相关。患者出现执行功能减退而并非全面认知功能减退，并与抑郁的严重程度相关。当把患者分为较低教育水平组(≤5年学校教育，n=21)和较高教育水平组(6年学校教育，n=20)，PIQ得分仅在较低教育水平组与抑郁存在负相关。结论非痴呆PD患者早期即可出现认知功能障碍。抑郁可能使执行功能减退程度恶化，特别是对于较低教育水平的患者。 【关键词】 帕金森病;认知;执行功能;教育;抑郁 　　Abstract: Objective To assess the overall cognitive performance and executive function in patients with early non-demented Parkinson′s disease (PD), and the effect of variables such as depression and education on cognitive function. Methods 41 patients underwent clinical assessment including the Unified Parkinson′s Disease Rating Scale, Hoehn-Yahr Scale, the scale of elderly cognitive function (SECF), performance intelligence quotient (PIQ) of Wechsler Adult Intelligence Scale-Revised for China (WAIS-RC) Test and Hamilton Rating Scale for Depression (HAMD). Results Patients with higher education background, younger age, and whose onset at a younger age performed better on SECF and WAIS-RC. Severity of disease was negatively correlated with cognitive performance. Performance on PIQ instead of SECF worsened with increased severity of depressive symptoms. When patients were divided into groups with lower (≤5 yrs of schooling, n=21) and higher (6 yrs schooling, n=20), the PIQ and HAMD were negatively correlated only in the group with lower educational level. Conclusion Patients with non-demented PD may exhibit cognitive impairment even at an early stage. Depression may exacerbate the executive dysfunction, especially in patients with lower educational level. 　　Key words: Parkinson′s disease; cognition; executive function; education; depression 　　帕金森病(PD)是一种好发于老年人的进展型中枢神经系统变性疾病，60岁以上老年人患病率约为1%[1]。过去一直认为该病的临床特征主要以运动障碍为主，然而，随着近20年来有关PD非运动功能症状的报道逐渐增多，越来越多的研究者认为PD的非运动功能障碍(例如认知功能障碍和精神障碍)亦非常普遍[2]。认知功能障碍和抑郁均是严重影响PD患者晚期生活质量的主要因素