帕金森病患者认知功能障碍早期诊断的探讨

Early Diagnosis of Cognitive Impairment in Parkinson's Disease

目的分析帕金森病(PD)患者认知功能障碍的临床特点,探讨其发生机制,为帕金森病认知障碍早期诊断和干预提供策略。方法比较分析北京世纪坛医院收治的50例帕金森病患者与50例非帕金森病患者的临床资料,包括脑部CT和MRI扫描数据、MSSE评分、UPDRS评分及韦氏成人智力量表测验结果,筛查早期诊断帕金森病认知功能障碍的主要识别参数,如影像学参数和认知功能评分。结果帕金森病组MSSE评分、各分测量表评分、言语智商(VIQ)、操作智商(PIQ)、记忆商(MQ)、UPDRS评分均明显低于正常对照组,差异具有显著性(P<0.01);两组头颅CT或MRI的额叶脑沟宽度、顶叶脑沟宽度、侧脑室体部宽度指数等参数,差异具有统计学意义(P<0.01)。结论部分帕金森病患者存在认知功能障碍。帕金森病症状越重者,认知功能障碍也更明显,且记忆损害比智力受损严重。PD认知障碍的主要病理形态学改变可能为额叶脑沟宽度、顶叶脑沟宽度、侧脑室体部宽度指数的改变。

Objective To analyze the clinical features of cognitive impairment in patients with Parkinson＇ s disease （PD）, and explore its mechanism for early diagnosis of Parkinson＇ s cognitive impairment. Methods The clinical data of 50 patients with PD and 50 non-PD patients were compared, which included data of brain CT and MRI scan results, MSSE score, UPDRS score, and the Wechsler Adult Intelligence Scale subtests results, main identification parameters screening for early diagnosis of cognitive dysfunction in PD, such as imaging parameters and cognitive function scores. Results The scores of MSSE, VIQ, PIQ, MQ and UPDRS of PD group were significantly lower than those in the control group （P〈0.01）. The mean widths of the cerebral sulci of the frontal lobe, parietal lobe, and lateral body measured by head CT or MRI were lower in PD group than in the non-PD group （P〈0.01）. Conclusion PD patients have some cognitive impairment, the more severe the symptoms of Parkinson＇ s disease, the more obvious the cognitive dysfunction; and the intellectual impairment is severe than memory impairment is. The major pathological changes of PD cognitive impairment may be appeared as the width changes of cerebral sulci of the frontal lobe, parietal lobe and lateral body.