早期帕金森病伴发抑郁对认知功能的影响

Effect of depressive symptoms on cognitive function in patients with early Parkinson's disease

目的探讨抑郁症状对早期帕金森病(PD)病人认知功能的影响。方法选取22例合并抑郁症的早期PD病人及20例无抑郁症状的早期PD病人,分别作为抑郁组和非抑郁组。对2组进行汉密尔顿抑郁量表(HAMD)、统一帕金森病评分表第三部分(UPDRS-Ⅲ)、Hoehn-Yahr分期、简易智能检查量表(MMSE)、韦氏成人智力量表数字广度(DST)、数字符号替换测验(DSST)、动物流畅性测验(AFT)、连线测验(TMT)、画钟测验(CDT)和Stroop色词测验(CWT)测评并比较。结果抑郁组与非抑郁组间HAMD评分差异无统计学意义[(26.82±2.30)分比(28.00±1.59)分,P>0.05]。2组间MMSE评分差异无统计学意义[(26.82±2.30)分比(28.00±1.59)分,P>0.05],而DST倒背、DSST、CDT、Stroop干扰量(SIE)耗时差异有统计学意义[(3.45±0.74)分比(4.10±0.97)分;(17.64±7.92)分比(25.00±10.21)分;(3.23±0.69)分比(3.68±0.57)分;(52.33±27.43)分比(34.06±15.24)分,P<0.05],TMT、AFT、CWT-C耗时差异亦有统计学意义(P<0.01)。轻中度抑郁组与非抑郁组间各项认知测验结果差异无统计学意义(P>0.05)。结论重度抑郁加重早期PD病人的注意、工作记忆、视觉运动协调性、视空间、抑制控制等与执行功能有关的多个认知功能领域损害。

Objective To assess the effect of depressive symptoms on cognitive function in early Parkinson＇s disease（ PD） patients. Methods Twenty-two patients of early depressed Parkinson＇s disease（ d PD） and 20 patients of early non-depressed Parkinson＇s disease（ n PD） were collected and grouped as d PD group and n PD group. The two groups were investigated by the Unified parkinson disease rating scale（ UPDRS Ⅲ）, Revised Hoehn and Yahr staging scale, mini mental scale examination（ MMSE）,Wechsler adult intelligence scale digit span（ DST）,digital symbol substitution test（ DSST）,animal fluency test（ AFT）,trail making test（ TMT）,clock drawing test（ CDT） and Stroop color word test（ CWT）. Results Between the two groups,there was no significant difference in scores of MMSE [（ 26. 82 ± 2. 30） vs（ 28. 00 ± 1. 59）,P〉0. 05 ],while there were significant differences in scores of DST Daobei,DSST,CDT and stroop interference effects（ SIE）（ 3. 45 ± 0. 74 vs4. 10± 0. 97; 17. 64 ± 7. 92 vs 25. 00 ± 10. 21; 3. 23 ± 0. 69 vs 3. 68 ± 0. 57; 52. 33 ± 27. 43 vs 34. 06 ±15. 24,P〈0. 05）,and there were significant differences in TMT、AFT and CWT-C tests between the two groups. However,no significantly different was founded between mild to moderate depression group and the non-depressed group. Conclusions It suggests that sever depression in early PD might damage attention,working memory,visual motor coordination,visual spatial,and inhibitory control related to the field of executive functions.