中国现代神经疾病杂志 ›› 2016, Vol. 16 ›› Issue (5): 275-279. doi: 10.3969/j.issn.1672-6731.2016.05.006

• 神经心理学研究 • 上一篇    下一篇

2 多系统萎缩和帕金森病患者执行功能障碍研究

张旭, 孔晓叶, 王湘庆, 郎森阳   

  1. 100853 北京,解放军总医院神经内科
  • 出版日期:2016-05-25 发布日期:2016-05-24
  • 通讯作者: 郎森阳(Email:langsy@263.net)

Analysis on executive dysfunction of patients with multiple system atrophy and Parkinson's disease

ZHANG Xu, KONG Xiao-ye, WANG Xiang-qing, LANG Sen-yang   

  1. Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
  • Online:2016-05-25 Published:2016-05-24
  • Contact: LANG Sen-yang (Email: langsy@263.net)

摘要:

目的 探讨多系统萎缩和帕金森病患者执行功能障碍特点。方法 采用简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表(MoCA),以及Stroop 色词测验(SCWT)、数字符号转换测验(DSST)/图形符号转换测验(GSST)、画钟测验(CDT)和连线测验(TMT)评价34 例多系统萎缩患者[以小脑共济失调为主要表现型(MSA-C 型)21 例、以帕金森病综合征为主要表现型(MSA-P 型)13 例]和18 例原发性帕金森病患者的整体认知功能和执行功能。结果 各组受试者MoCA 评分差异有统计学意义(P = 0.019),其中PD 组和MSA-C 型组患者评分低于对照组(P = 0.015,0.002)。各组受试者SCWT 测验各部分评分(P = 0.035,0.013,0.012,0.037)、DSST 评分(P = 0.000)、GSST 评分(P = 0.000)、TMT 评分(P = 0.035)差异均有统计学意义,其中,MSA-C 型组和MSA-P 型组患者SCWT-A(P = 0.004,0.045)、SCWT-B(P = 0.001,0.036)和SCWT-D(P = 0.023,0.010)评分均高于对照组,PD 组、MSA-C 型组和MSA-P 型组患者SCWT-C 评分(P = 0.005,0.014,0.003)、DSST 评分(P = 0.003,0.000,0.000)和GSST 评分(P = 0.001,0.000,0.000)均高于对照组,仅MSA-P 型组患者TMT 评分高于对照组(P = 0.006)。结论 多系统萎缩和帕金森病患者均存在不同程度的执行功能障碍,SCWT 和DSST/GSST 测验有助于评价此类患者的执行功能障碍。

关键词: 多系统萎缩, 帕金森病, 认知障碍, 神经心理学测验

Abstract:

Objective  To explore the characteristics of executive dysfunction of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) by neuropsychological tests.  Methods  Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Stroop Color-Word Test (SCWT), Digital Symbol Substitution Test (DSST)/Graphic Symbol Substitution Test (GSST), Clock Drawing Test (CDT) and Trail Making Test (TMT) were used to assess the overall cognitive and executive function of 34 patients with MSA [21 with cerebellar-predominant (MSA-C) and 13 with parkinsonism-predominant (MSA-P)], 18 patients with primary PD and 14 normal controls.  Results  There was significant difference in MoCA score among different groups (P = 0.019). PD and MSA-C groups had lower MoCA score than that in normal control group (P = 0.015, 0.002). There were significant differences in each SCWT score (P = 0.035, 0.013, 0.012, 0.037), DSST (P = 0.000), GSST (P = 0.000) and TMT (P = 0.035) among different groups. Among them, MSA-C and MSA-P groups had significantly higher SCWT-A (P = 0.004, 0.045), SCWT-B (P = 0.001, 0.036) and SCWT-D scores (P = 0.023, 0.010) than those in normal control group. PD, MSA-C and MSA-P groups had significantly higher SCWT-C (P = 0.005, 0.014, 0.003), DSST (P = 0.003, 0.000, 0.000) and GSST scores (P = 0.001, 0.000, 0.000) than those in normal control group. MSA-P group had significantly higher TMT score than that in normal control group (P = 0.006).  Conclusions  Patients with MSA and PD may present executive dysfunction to different degrees. SCWT and DSST/GSST tests are useful in assessing executive dysfunction in those patients.

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