帕金森病患者程序性学习的初步研究

A pilot study of procedural learning in patients with non-demented Parkinson' s disease

目的研究三种学习记忆任务在非痴呆、并排除合并抑郁症的帕金森病(PD)病人中损害程度。方法采用程序性学习测试软件Nissen二版(SRTT)、外显记忆项目为韦氏记忆量表,内隐记忆项目则采用自由组词和残图命名对16例Hoehn-Yah分级Ⅰ-Ⅱ级的PD进行研究,其中程序性学习测试设置了正常对照组。结果在PD组未发现外显记忆和内隐记忆项目有统计意义的改变;统计学显示SRTT在正常组随着学习节数增加则明显缩短操作时问,错误也在减少,而PD组虽然错误显著减少,但操作时间改变无统计学意义。结论在PD早期患者中,程序性学习任务SRTT测试发现有选择性损害,而其他记忆项目如韦氏记忆量表、自由组词和残图命名评分则无异常,提示记忆的分离现象。

Objective To study memory changes in patients with non-demented Parkinson＇ s disease （PD） without depression. Methods The Nissen Version （serial reaction time task, SRTT） software, as a task of procedural learning, along with the WMS-CR and two tasks of implicit memory were used in 16 PD patients（ Hoehn-Yahr score Ⅰ - Ⅱ degrees） and normal controls enrolled. Results In the explicit WMS-CR and the implicit （word stem completion and degraded picture naming） tasks, the patients＇ scores fell within normal limits. In the SRTT, controls displayed significantly reduced response times and error rates across blocks of repeated sequence trials. By contrast, PD patients only showed a reduction in error rates but no change in response times. Conclusion Impairment of nigrostriatal pathway selectively affects performance in visuo-motor learning tasks such as the SRTT, but not in the explicit tasks of WMS-CR, and the implicit tasks such as word stem completion and degraded picture naming, supporting the multiple memory, theory.