计算机辅助交互式分类学习软件评估帕金森病患者学习与记忆的初步研究

Preliminary study on computer aided interactive classified software for evaluating learning and memory in patients with Parkinson's disease

目的:通过新型计算机辅助交互式分类学习软件对帕金森病(PD)患者学习与记忆功能进行评估,揭示其认知障碍的特点。方法:采用简易智能精神状态检查(MMSE)量表、蒙特利尔认知评估(MoCA)量表、汉密尔顿抑郁17(HAMD-17)量表及统一PD评分量表(UPDRS)分别对原发性PD患者[其中PD"on"组(n=15),PD"off"组(n=7)]及正常对照组(n=15)的认知、抑郁状态和运动功能进行评价;并对2组患者进行计算机辅助交互式分类学习任务检测。结果:①PD"on"及PD"off"组与正常对照组比,MMSE及MoCA均无显著差异(P>0.05)。②测试Ⅰ(基于反馈的分类任务)中PD"on"组与PD"off"组存在显著差异(P<0.05)。③测试Ⅱ(基于反馈的概率分类任务)在奖励任务中,PD"off"组与正常对照组比显著减退(P<0.05),而PD"on"组无显著差异,PD"on"及PD"off"组间存在显著差异(P<0.05);在惩罚任务中,与正常对照组比,PD"on"及PD"off"组均无显著差异(P>0.05)。结论:PD"on"患者存在基于反馈的分类任务的减退,而PD"off"患者存在基于奖励反馈的分类任务的减退,进一步支持PD患者背侧纹状体多巴胺缺乏较腹侧纹状体显著,药物的使用对基于反馈的学习具有一定的影响。

Objective To study the efficacy of compute-aided interactive classified software for evaluating learning and memory in patients of Parkinson＇s disease （PD）. Methods Fifteen normal controls and 22 PD patients divided into two groups based on medicine usage： PD（on）（n=lS） and PD（off）（n=7） were enrolled in this study. Each group was compared with others by the unified PD rating scale （UPDRS scores）, cognitive status （mini-mental state examination, MMSE and Montreal cognitive assessment, MoCA）, depression state, and the computer aided interactive classified learning task. Results ①Scores of MMSE and MoCA in PD（on） and PD（off） groups showed no significant difference with that of normal controls （P〉0.05）;②Task Ⅰ （feedback-based classified task）： PD（on） group showed significant difference when compared with PD （off） group （P〈0.05）; ③Task Ⅱ （feedback-based probabilistic classification）： in reward task, PD （off） showed significant reduction（P〈0.05） while PD（on） group did not; in the punish task, there were no significant differences between normal control and PD（on） and PD（off） group （P〉0.05）. Conclusions PD（on） group showed reduction in feedback-based classified task, while PD （off） group showed reduction in reward feedback task, which further indicated that in PD patients the shortage of dopamine in dorsal striatum was more prominent than that in ventral striatum, and the use of drugs might affect the results in feedback-based learning.