左旋多巴对早中期特发型帕金森病患者抑制性控制能力的影响  

Effects of levodopa on inhibitory control in patients with early-to-mid stage idiopathic Parkinson disease

作　　者：杨旭[1] 杨培红[2] 李晓红[1] Yang Xu;Yang Peihong;Li Xiaohong(Department of Neurology,Dalian Friendship Hospital,Dalian 116001,China;Department of Medical Imagery,Dalian Friendship Hospital,Dalian 116001,China)

机构地区：[1]大连市友谊医院神经内科,大连116001 [2]大连市友谊医院影像科,大连116001

出　　处：《中华行为医学与脑科学杂志》2024年第9期801-806,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：大连市友谊医院孵化项目(YYYYFH-202207ZD);大连市科技局生命健康领域指导计划项目(2023 JJ13SNYY3)。

摘　　要：目的通过随机数生成(random number generation,RNG)任务评估左旋多巴对帕金森病患者抑制性控制能力的影响。方法纳入2020年3月至2022年6月大连市友谊医院神经内科运动障碍门诊临床确诊的帕金森病患者47例,本院体检中心招募的年龄、性别及受教育程度相匹配且认知正常的健康志愿者45例。所有被试均执行2次不同速率RNG任务,将结果转换为连续数字序列量度值和随机数字序列量度值。使用SPSS 22.0软件进行统计学分析,采用混合设计方差分析对2组被试在用药/停药时不同速率RNG任务中的表现进行比较;计算最小临床重要性差值(the minimum clinical importance difference,MCID)评估存在统计学意义的药物效应是否具有临床意义。结果(1)药物和认知负荷对随机数字序列量度值的交互作用显著(F=15.15,P=0.03),表现为用药时且仅在慢速率时随机数字序列量度值更高[停药:(44.79±16.33)分,用药:(51.95±21.82)分;t=4.25,P=0.02];并且慢速率时用药与停药时随机数字序列量度值的差值(7.16)>MCID值(3.29)。(2)认知负荷对连续数字序列量度值的主效应显著(F=65.97,P<0.001),表现为快速率时连续数字序列量度值更高[快:(71.45±37.98)分,慢:(36.33±16.17)分]。结论左旋多巴在低认知负荷时可以改善帕金森病患者的抑制性控制能力。Objective To explore the effect of levodopa on inhibitory control in Parkinson disease patients using the paced random number generation task(RNG).Methods The study included 47 patients diagnosed with Parkinson disease in the Movement Disorder Clinic of the Department of Neurology at Dalian Friendship Hospital between March 2020 and June 2022,and 45 healthy volunteers with normal cognitive function were recruited from the Physical Examination Center of the same hospital and matched in terms of age,gender and education.All subjects performed the paced RNG task twice within two days,converting the results into continuous number sequences measure values and random number sequences measure values.SPSS 22.0 software was used for statistical analysis,and mixed-design ANOVA was used to compare the performance of the two groups of subjects in the paced RNG task during medication/withdrawal.The minimum clinical importance difference(MCID)was calculated to evaluate whether statistically significant medication effects have clinical significance.Results(1)Medication and cognitive load had an interaction effect on the random number sequences measure values(F=15.15,P=0.03),which showed that the random number sequences measure values increased under on-medication status and slow rate(off-medication:(44.79±16.33),on-medication:(51.95±21.82);t=4.25,P=0.02),and the difference in the combined standard deviation of random digits seriation measurements between on-medication and off-medication at a slow rate(7.16)was greater than that of MCID(3.29).(2)The main effect of cognitive load on the continuous number sequences measure values was statistically significant(F=65.97,P<0.001),and scores for rapid rate were higher(rapid:(71.45±37.98);slow:(36.33±16.17)).Conclusion Levodopa can improve inhibitory cognitive control in patients with Parkinson disease under low cognitive load.

关 键 词：帕金森病 执行功能 抑制性控制 多巴胺能 随机数生成任务 

分 类 号：R742.5[医药卫生—神经病学与精神病学]