帕金森病睡眠障碍与认知功能关系研究

Study on the relationship between sleep disorders and cognitive function in Parkinson's disease

目的探讨帕金森病患者睡眠障碍与认知功能的关系,并分析快速动眼睡眠期睡眠行为障碍(RBD)对帕金森病(PD)患者各认知域的影响。方法选取2019年3月至2023年1月在河北医科大学第一医院住院行夜间多导睡眠监测证实有睡眠障碍的帕金森病患者36例,所有患者均进行了神经精神状况检测。分析了所有患者的人口统计学资料,包括性别、年龄、受教育年限、体质指数(BMI)、颈围、腹围、发病年龄、病程。对所有研究对象进行帕金森病运动症状评估、认知功能评估及睡眠评估。结果PD患者执行功能减退与较高的RBD评分及帕金森病患者的周期性腿动指数(PLMI)相关。PD-RBD患者较PD-nRBD患者认知功能下降更明显,其中视空间和执行功能、抽象功能减退有显著性差异。REM睡眠行为异常筛查量表(RBDSQ)≥6的PD患者认知功能下降更明显,蒙特利尔认知评估量表(MoCA)总分及视空间和执行功能、抽象功能的下降较RBDSQ<6的PD患者有显著性差异。伴有RBD的PD患者认知功能减退更明显,RBDSQ≥6与夜间多导睡眠监测(PSG)证实的RBD患者认知域的损伤一致,提示RBDSQ可用于评估预测PD患者认知功能的损害。结论RBD可导致PD患者认知功能下降,视空间和执行功能及抽象功能减退明显,RBDSQ≥6分与PSG诊断RBD的PD患者认知域损害一致,提示RBDSQ可用于评估预测PD患者认知功能的损害。

Objectivee To explore the correlation between sleep disorders and cognitive function in Parkinson's disease,and to analyze the impact of RBD on various cognitive domains of Parkinson's disease patients.Methods A total of 36 patients with Parkinson's disease who were hospitalized in the First Hospital of Hebei Medical University from March 2019 to January 2023 were selected for nocturnal polysomnography confirmed to have sleep disorders,and all patients were tested for neuropsychiatric conditions.Demographic data of all patients,including sex,age,years of schooling,BMI,neck circumference,abdominal circumference,age of onset,and course of disease were analyzed.Parkinson's disease motor symptoms were assessed for all study participants,cognitive function assessment,sleep assessment.Results Decreased executive function in PD patients was associated with higher RBD score and PLMI index.The cognitive decline of PD-RBD patients was more obvious than that of PD-nRBD patients,and there were significant differences in visual space and executive function and abstract function decline.The decline of cognitive function was more obvious in PD patients with RBDSQ≥6,and the decline in total MoCA score,visual space and executive function and abstract function was significantly different than that in PD patients with RBDSQ<6.Cognitive decline in PD patients with RBD patients is more obvious,and RBDSQ≥6 is consistent with the damage to the cognitive domain of RBD patients confirmed by PSG,suggesting that RBDSQ can be used to evaluate and predict cognitive impairment in PD patients.Conclusion RBDSQ≥6 score was consistent with cognitive domain impairment in PD patients diagnosed with RBD,suggesting that RBDSQ can be used to evaluate and predict cognitive impairment in PD patients.