早发性帕金森病的神经心理学测验与P300检测特点分析  

Neuropsychology test and P300 detection characteristics analysis in early-onset Parkinson＇s disease

作　　者：黄静[1] 张玉虎[1] 聂坤[1] 甘蓉[1] 王丽敏[1] 唐红梅[1] 赵洁皓[1] 黄智恒[1] 王丽娟[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)神经内科广东省神经科学研究所,广州510018

出　　处：《中华神经科杂志》2013年第12期820-823,共4页Chinese Journal of Neurology

基　　金：国家自然科学基金资助项目（30801219,30870863,81271560）;广东省科技计划项目（2011B080701087,2009B030801251）

摘　　要：目的 探讨早发性帕金森病的临床特征和认知功能特点.方法 以发病年龄为分界点将242例患者分为早发性帕金森病组（≤50岁,76例）和晚发性帕金森病组（＞ 50岁,166例）,对各组患者的年龄、病程、家族史等一般临床特征进行比较;分析两组患者的总体和各分项认知功能的差异,并对两组患者的P300进行分析比较.结果 早发性帕金森病组的阳性家族史比例显著高于晚发性帕金森病组[21.1％（16/76）与6.02％ （10/166）,x2=7.87,P=0.005].早发性帕金森病组蒙特利尔认知评估（MoCA）量表总分及各分项中视空间与执行功能、注意力、延迟回忆和定向的评分（分）均显著高于晚发性帕金森病组（23.89±3.31与22.17±4.66; 3.57±1.33与3.12±1.4; 38.00±0.98与4.93±1.21;2.46±1.49与1.73 ±1.57; 5.75±0.58与5.36±0.95,t=3.44、3.79、3.12、1.98、2.52,均P＜0.05）.韦氏智力及韦氏记忆力分量表测试结果发现,早发性帕金森病组的相似性、图形排列、积木测试和数字广度评分（分）高于晚发性帕金森病组（10.54±2.48与8.26±2.82;7.91±3.33与6.73±2.38; 8.74±3.10与7.52±2.67; 10.15±2.48与9.14 ±2.29,t =3.30、2.62、2.58、2.53,均P＜0.05）.晚发性帕金森病组P300的P3潜伏期和N2潜伏期较早发性帕金森病组明显延长,P3的波幅显著下降.结论 遗传因素在早发性帕金森病中可能起重要作用;早发性帕金森病的认知功能受损程度轻,执行功能、视空间及注意力在早发性帕金森病中保存相对完整.Objective To investigate the clinical and cognitive characteristics of early-onset Parkinson＇s disease（EOPD）. Methods Two hundred and forty-two Parkinson＇ s disease （PD） patients were divided into EOPD （ ~〈50 year-old,n = 76） and late-onset Parkinson＇ s disease（ LOPD; 〉 50 year-old, n = 166 ） according to their age. The age, disease duration, family history and other general clinical features were compared between EOPD and LOPD groups. Global and various aspects of cognitive dysfunction were analysed between the 2 groups. Additionally, P300 long latency auditory evoked potentials was employed to confirm the cognition function. Results EOPD patients had a positive family history, compared with LOPD group （21.1% （ 16/76 ） vs 6. 02% （ 10/166 ）, X2 = 7.87, P = 0. 005 ）. Montreal Cognitive Assessment （MoCA） Scale in space and executive functions, attention, delayed recall, orientation and total scores in EOPD group were significantly higher （23.89 -± 3.31 vs 22. 17 -± 4.66; 3.57 -± 1.33 vs 3.12 -± 1.4; 38.00±0.98vs4.93±1.21; 2.46 ±1.49 vs 1.73±1.57; 5.75 ±0.58 vs5.36±O. 95,t = 3. 44,3. 79, 3.12 ,l. 98,2. 52, all P 〈 0. 05 ）. Besides, LOPD patients displayed defective performance on similarity, graphic arrangement,block test and digital span （ 10. 54 ± 2. 48 vs 8.26 ± 2. 82; 7.91 ± 3.33 vs 6. 73 ± 2.38; 8.74±3.10 vs 7.52 ±2.67; 10.15 ±2.48 vs 9.14 ±2.29,t =3.30,2.62,2.58,2.53,all P〈 0. 05 ）. In addition, P300 latencies were markedly delayed and the P300 amplitudes were notably declined in LOPD group. Conclusions Positive family history may play an important role in the etiology of EOPD. The cognitive impairments in EOPD patients are milder than LOPD patients. Executive efficiency, space function and attention are well-preserved in EOPD.

关 键 词：帕金森病 认知 神经心理学测验 事件相关电位 P300 

分 类 号：R742.5[医药卫生—神经病学与精神病学]