抑郁对早期帕金森病患者认知功能的影响

Influence of depression on cognitive function in patients with early Parkinson's disease

目的探讨抑郁对早期帕金森病(PD)患者认知功能的影响。方法对60例早期PD患者,依据汉密尔顿抑郁量表(HAMD)分为抑郁组和非抑郁组。对两组进行临床评估和神经心理学测验,包括统一帕金森病评分量表第3部分(UPDRS-III)、H-Y分期、简易精神状态检查量表(MMSE)、韦氏成人智力量表数字广度测验(DST)、数字符号替换测验(DSST)、动物流畅性测验(AFT)、连线测验A(TMA)、画钟测验(CDT)和Stroop色词测验(CWT)。结果非抑郁组仅DST倒背、TMA、CWT-C、SIE耗时测验评分差于正常对照组(P<0.05),而抑郁组各项神经心理学测验评分均差于正常对照(P<0.05);与非抑郁组比,抑郁组HAMD评分高(P<0.05),抑郁组除MMSE、DST总分、顺背分、CWT-B测验外,余各项测验评分差(P<0.05)。轻中度抑郁组与非抑郁组间各项认知测验差异无统计学意义(P>0.05)。结论抑郁加重早期帕金森病患者多个认知功能领域损害。

Objective To assess the effect of depression on cognitive function in patients with early Parkinson ＆#39;s disease.Methods Hamilton depression rating scale （ HAMD） was used to divide the 60 patients with early Parkinson＆#39;s disease into two groups ,namely,depressed Parkinson＆#39;s disease （DPD） group and non depressed Parkinson＆#39;s disease （NPD） group.They were investigated by the clinical evaluation and a series of neuropsychological tests which included the Unified Parkinson Disease Rating Scale（UPDRS-III）,Revised Hoehn and Yahr Staging Scale（H-Y）,mini mental scale examination （MMSE）,Wechsler Adult Intelligence Scale Digit Span Test （DST）,Digit Symbol Substitution Test （ DSST） ,Animal Fluency Test （ AFT） ,Trail Making Test A （ TMA） ,Clock Drawing Test （ CDT） and Stroop Color Word Test （CWT）.Results Compared with healthy controls（HC）,NPD group achieved significantly lower scores only in DST backwards, TMA,CWT-C,SIE（P〈0.05）,while DPD group did in all neuropsychological tests（P〈0.05）.The score of HAMD was higher in DPD group than in NPD group（P〈0.05）.All neuropsychological tests except MMSE,DST total score,DST forward score and CWT-B in DPD group were significantly lower than those in NPD group （P〈0.05）.However,no results were significantly deferent between mild to moder-ate depression group and NPD group （ P〉0 .05 ） .Conclusion The depression in early Parkinson＇s disease might exacerbate cognitive function damage.