左旋多巴对老年帕金森病患者语言和视空间工作记忆的影响  

Effect of Levodopa on verbal and spatial working memory in elderly patients with Parkinson＇s disease

作　　者：马建军[1] 李学[1] 杨红旗[1] 祁亚伟[1] 冯艳[1] 袁丽品[1] 徐军[1] 

机构地区：[1]河南省人民医院神经内科,郑州450003

出　　处：《中华老年医学杂志》2014年第11期1183-1186,共4页Chinese Journal of Geriatrics

基　　金：河南省医学科技攻关项目（200803105、201203108）;河南省基础与前沿技术研究计划项目（122300410139）

摘　　要：目的 观察左旋多巴对老年帕金森病（PD）患者语言和视空间工作记忆的影响. 方法 采用修订的Smith工作记忆检查软件,对32例PD患者在未服药时和服用苄丝肼左旋多巴第8周时分别进行语言工作记忆和视空间工作记忆测试,并与32例年龄、性别和教育程度相匹配的健康对照组进行比较. 结果 PD组未服药时,语音性语言工作记忆成绩及视觉空间距离工作记忆成绩均低于对照组（P＜0.01）;而语义性语言工作记忆成绩及视觉空间位置工作记忆成绩与对照组比较差异均无统计学意义（P＞0.05）.服用苄丝肼左旋多巴后,PD患者语音性语言工作成绩（88.6±6.5）％和视觉空间距离工作记忆成绩（84.2±8.8）％明显提高,与未服药前[（82.1±6.6）％和（75.2±8.9）％]相比,差异均有统计学意义（P＜0.01）,而语义性语言工作记忆成绩和视觉空间位置工作记忆服药前后无明显变化（P＞0.05）.PD患者语义性、语音性语言工作记忆以及视觉空间距离、视觉空间位置工作记忆的正确率均与病程呈负相关,与年龄和受教育程度无关. 结论 左旋多巴可改善PD患者语音性语言工作记忆和视觉空间距离工作记忆,而对语义性语言工作记忆和视觉空间位置工作记忆无影响,推测多巴胺替代治疗对PD患者的工作记忆存在着双分离作用.Objective To observe the effects of levodopa on verbal and spatial working memory in elderly patients with Parkinson＇s disease （PD）.Methods The modified Smith working memory software were applied to study the verbal and spatial working memory in 32 PD patients before and 8 weeks after treatment with levodopa and benserazide hydrochloride tablets.The results of PD patients were compared with those in 32 normal controls matched for age,sex and education.Results The correct rates of phonological verbal and coordinate visuospatial working memory were significantly lower in the PD patients without treatment than in the normal controls （both P＜0.01）.The correct rates of semantic verbal and categorical visuospatial working memory had no significant differences between the PD patients without treatment and the normal controls （both P＞0.05）.The correct rates of phonological verbal working memory and coordinate visuospatial working memory were significantly higher in the PD patients after administration of levodopa and benserazide tablets than in PD patients without treatment [（88.6±6.5）％ vs.（82.1 ± 6.6）％,（84.2±8.8）％ vs.（75.2±8.9）％,respectively,both P＜0.01],but there were no significant differences in the correct rates of semantic verbal working memory and categorical visuospatial working memory between the above two groups （both P＞0.05）.The correct rates of phonological verbal,semantic verbal,coordinate visuospatial and categorical visuospatial working memory were negatively correlated with the course of disease,and had no correlations with age and the degree of education.Conclusions Levodopa can improve the functions of phonological verbal working memory and the coordinate visuospatial working memory,but has no effect on the semantic verbal working memory and the categorical visuospatial working memory.It is postulated that dopamine replacement therapy may have double dissociable effects on the different working memories.

关 键 词：帕金森病 记忆障碍 认知 左旋多巴 

分 类 号：R742.5[医药卫生—神经病学与精神病学]