帕金森病患者工作记忆障碍研究

Working memory in patients with Parkinson disease

目的 探讨帕金森病 (PD)患者工作记忆状况。方法 仿制并修订了Smith工作记忆检查软件 ,对 6 6例PD患者及 6 0名对照者进行工作记忆检查。结果 早期PD患者视觉空间工作记忆正确率较对照组低 (分别为 82 8%± 12 1%,90 9%± 6 7%) ,差异有显著意义 (t=3 0 76 ,P <0 0 1) ,视觉物体形状工作记忆正确率与对照组相近 (6 9 2 %± 10 9%,72 7%± 8 1%) ,差异无显著意义 (t=1 389,P >0 0 5 ) ;中期PD患者视觉空间与物体形状工作记忆正确率 (分别为 6 9 6 %± 15 6 %,6 3 11%±5 4 %) ,均较对照组低 ,差异有极显著意义 (t=6 399、t=3 377,P <0 0 0 0 1、P <0 0 1) ;中期PD患者视觉空间与物体形状工作记忆正确率均较早期PD患者低 ,差异有显著意义 (t=2 6 14、t =2 140 ,P <0 0 5 ) ;早期PD患者视觉颜色工作记忆正确率与对照组相近 (6 5 1%± 11 4 %,6 9 9%± 10 1%) ,差异无显著意义 (t=1 6 81,P >0 0 5 )。相关性分析发现 ,Hoehn Yahr分级与工作记忆正确率呈负相关。 结论PD患者早期即有视觉空间工作记忆损伤 ,而视觉物体形状工作记忆及颜色工作记忆正常 ,随着疾病进展至中期 ,PD患者视觉空间与物体形状工作记忆均受损伤 ,且程度较早期加重。

Objective To study the working memory changes in patients with Parkinson disease(PD).Methods The Smith working memory software was used and 66 cases of PD patients and 60 normal controls were enrolled.Results The results showed that the correct rate of visuo-spatial working memory was significantly decreased (P<0.01), and no visuo-object working memory impairment was found in the early stage (Hoehn-Yahr stage Ⅰ-Ⅱ) of PD. There were both spatial (P<0.0001) and object shape (P<0.01) working memory impairment found in the middle stage (Hoehn-Yahr stage Ⅲ) of PD and no visuo-object color (P>0.05) working memory impairment found in PD patients. The correct rate of visuo-spatial and visuo-object working memory in the middle stage of PD was significantly decreased than that in the early stage. The relative analysis showed that the Hoehn-Yahr stage, a negative relationship to the correct rate of visuo-spatial and visuo-object working memory.Conclusion Spatial working memory impairment without object shape and the color working memory impairment were found in the early stage of PD. As disease advanced both the visuo-spatial and object shape working memory deficits were found exacerbated.