左旋多巴对老年帕金森病患者前瞻性记忆和情绪记忆的影响

Effect of levodopa on prospective and emotional memory in elderly Parkinsons disease patients

目的观察左旋多巴对老年帕金森病(PD)患者前瞻性记忆和情绪记忆的影响。方法选择PD患者32例(PD组),在未服药时和服用苄丝肼左旋多巴第8周时,分别进行基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆(TBPM)测试,利用标准的情绪图片(包括正性、负性和中性效价)进行情绪记忆测试,并与年龄、性别和受教育年限相匹配的健康体检者32例(对照组)进行比较。结果与对照组比较,PD组服药前EBPM、TBPM、负性情绪图片再认成绩明显降低[(3.6±1.3)分vs(6.4±2.1)分,(3.7±1.3)分vs(5.3±1.5)分,(8.4±1.2)分vs(14.1±1.9)分,P<0.01]。PD组服药后TBPM较服药前明显升高[(5.2±1.4)分vs(3.7±1.3)分,P<0.01]。结论早期未治疗PD患者存在EBPM、TBPM和负性效价情绪记忆损害;左旋多巴可改善PD患者的TBPM,而对EBPM和情绪记忆无影响,推测多巴胺耗竭在TBPM中可能起重要作用。

Objective To study the effect of levodopa on prospective and emotional memory in Parkinson＇s disease （PD） patients. Methods Thirty-two PD patients served as a PD group and 32 healthy subjects undergoing physical examination served as a control group in this study. Event- based prospective memory （EBPM）, time-based prospective memory （TBPM） and emotional memory in PD group were tested using standard emotional valence pictures （including positive, neutral and negative valence） before and 8 weeks after taking levodopa and benserazide hydrochlo- ride,and compared with those in age-, sex- and education-matched control group. Results The EBPM,TBPM and negative valence picture memory scores were significantly lower in PD group before taking levodopa and benserazide hydrochloride than in control group （3.6 ±1.3 vs 6.4± 2.1,3.7±1.3 vs 5.3±1.5,8.4±1.2 vs 14.1±1.9,P〈0.01）. The TBPM score was significantly higher in PD group after taking levodopa and benserazide hydrochloride than before taking levo- dopa and benserazide hydrochloride （5.2± 1.4 vs 3.7 ± 1.3, P〈0.01）. Conclusion The EBPM, TBPM and negative valence picture memory are impaired in untreated early PD patients. Levodopa can improve the TBPM but not the EBPM and emotional memory in PD patients, and dopamine depletion may play an important role in TBPM.