计算机辅助认知训练对帕金森病患者认知功能的影响  

Effect of computer-assisted cognitive training on cognitive function in Parkinson’s disease

作　　者：韩小改[1] 李学 李林忆 单泓[1] 别立莉[1] 马建军 HAN Xiaogai;LI Xue;LI Linyi;SHAN Hong;BIE Lili;Ma Jianjun(Henan Red Cross Blood Center,Zhengzhou 450012,China;Department of Neurology,Henan Provincial People's Hospital/People's Hospital of Zhengzhou University/People's Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省红十字血液中心,河南郑州450012 [2]河南省人民医院神经内科郑州大学人民医院河南大学人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2019年第16期1826-1832,共7页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技发展计划(编号:192102310085);河南省医学科技攻关计划(编号:201701018)

摘　　要：目的观察计算机辅助认知训练对伴轻度认知功能障碍的帕金森病(Parkinson's disease with mild cognitive impairment,PD-MCI)患者认知功能的影响。方法选取PD-MCI患者111例,采用随机数字表法将其分为观察组(56例)及对照组(55例)。2组患者均给予常规抗PD药物治疗,同时对照组接受一般认知训练,观察组接受计算机辅助认知训练。于训练前、治疗6周后对2组蒙特利尔认知评测量表(MoCA)、统一PD评价量表(UPDRS)、汉密尔顿抑郁量表(HMDS)、PD生活质量量表-39(PDQ-39)等评分及P300进行评估。结果治疗前,2组MoCA总分、UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ、HMDS和PDQ-39等评分组间差异均无统计学意义(P>0.05)。治疗后,2组MoCA总分、UPDRS-Ⅰ、UPDRS-Ⅱ、HMDS和PDQ-39等评分均较治疗前显著改善(P<0.05),观察组MoCA总分、UPDRS-Ⅰ、UPDRS-Ⅱ、HMDS和PDQ-39评分显著优于对照组(P<0.05)。对MoCA评分进步一分析,治疗后2组视空间与执行功能、延迟记忆、注意力、抽象、语言、定向力等得分较治疗前显著提高(P<0.05),且观察组视空间与执行功能、注意力、抽象、定向力等评分亦显著优于对照组(P<0.05)。治疗前,2组P300潜伏期、波幅比较差异无统计学意义(P>0.05);治疗后2组P300潜伏期显著缩短(P<0.05),P300波幅明显增加(P<0.05),且观察组P300潜伏期、波幅与对照组比较差异均有统计学意义(P<0.05)。结论计算机辅助认知训练可显著改善PD患者的认知功能和抑郁症状,提高生活质量。To explore the effect of computer-aided cognitive training on cognitive function in Parkinson’s disease with mild cognitive impairment(PD-MCI).Methods One hundred and eleven PD-MCI patients,in accordance with the random number table,were divided into two groups namely a observing group(56 cases) and a control group(55 cases).Both groups were given routine antiparkinsonism drug treatment.The control group was given common cognitive training.At the same time,the observing group was additionally given computer-aided cognitive training.Before and after six weeks of treatment,the Montreal cognitive assessment(MoCA),unified pakinson’s disease rating scale(UPDRS),hamilton depression scale(HMDS),the 39-item Parkinson’s disease questionnaire(PDQ-39) and P300 of the two groups were assessed to make a comparison.Results Before treatment,no significant difference was found in the average MoCA,UPDRS-Ⅰ,UPDRS-Ⅱ,UPDRS-Ⅲ,HMDS and PDQ-39 scores of the two groups(P>0.05).After treatment,improvement was observed in the total MoCA scores,UPDRS-Ⅰ,UPDRS-Ⅱ,HMDS and PDQ-39 scores in the two groups respectively(P<0.05),and significant differences was observed in the observing group compared with the control group(P<0.05).Improvement was observed in the visual space and executive function,delayed memory,attention,abstraction,language and disoreinatation in the two groups respectively(P<0.05),and the scores of visual space and executive function,attention,abstraction and disoreinatation in observing group were significantly better than control group(P<0.05).Before treatment,there was no significant difference in the P300 latency and amplitude between the two groups.After treatment,however,the P300 latency of the observing group decreased significantly lower than the control group and that before treatment.Meanwhile,the amplitude rose significantly higher than the control group and that before treatment.Conclusion Computer-aided cognitive training can effectively improve the cognitive function,the symptoms of depression of pa

关 键 词：帕金森病 计算机辅助认知训练 认知功能 抑郁 P300 

分 类 号：R742.5[医药卫生—神经病学与精神病学]