首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 140 毫秒
1.
Glial cell line-derived neurotrophic factor(GDNF) plays an important role in the protection of dopaminergic neurons, but there are few reports of the relationship between GDNF and its precursors(α-pro-GDNF and β-pro-GDNF) and cognitive impairment in Parkinson's disease. This study aimed to investigate the relationship between the serum levels of GDNF and its precursors and cognitive impairment in Parkinson's disease, and to assess their potential as a diagnostic marker. Fifty-three primary outpatients and hospitalized patients with Parkinson's disease(23 men and 30 women) with an average age of 66.58 years were enrolled from the Affiliated Hospital of Xuzhou Medical University of China in this case-control study. The patients were divided into the Parkinson's disease with cognitive impairment group(n = 27) and the Parkinson's disease with normal cognitive function group(n = 26) based on their Mini-Mental State Examination, Montreal Cognitive Assessment, and Clinical Dementia Rating scores. In addition, 26 age-and sex-matched healthy subjects were included as the healthy control group. Results demonstrated that serum GDNF levels were significantly higher in the Parkinson's disease with normal cognitive function group than in the other two groups. There were no significant differences in GDNF precursor levels among the three groups. Correlation analysis revealed that serum GDNF levels, GDNF/α-pro-GDNF ratios, and GDNF/β-pro-GDNF ratios were moderately or highly correlated with the Mini-Mental State Examination, Montreal Cognitive Assessment, and Clinical Dementia Rating scores. To explore the risk factors for cognitive impairment in patients with Parkinson's disease, logistic regression analysis and stepwise linear regression analysis were performed. Both GDNF levels and Hoehn-Yahr stage were risk factors for cognitive impairment in Parkinson's disease, and were the common influencing factors for cognitive scale scores. Neither α-pro-GDNF nor β-pro-GDNF was risk factors for cognitive impairment in Parkinson's disease. A receiver operating characteristic curve of GDNF was generated to predict cognitive function in Parkinson's disease(area under the curve = 0.859). This result indicates that the possibility that serum GDNF can correctly distinguish whether patients with Parkinson's disease have cognitive impairment is 0.859. Together, these results suggest that serum GDNF may be an effective diagnostic marker for cognitive impairment in Parkinson's disease. However, α-pro-GDNF and β-pro-GDNF are not useful for predicting cognitive impairment in this disease. This study was approved by Ethics Committee of the Affiliated Hospital of Xuzhou Medical University, China(approval No. XYFY2017-KL047-01) on November 30, 2017.  相似文献   

2.
BACKGROUND:In previous studies, cognitive function in elderly type 2 diabetic patients was evaluated by psychometric tests. These studies have confirmed that P300 event-related potential is an objective way of assessing cognitive function. OBJECTIVE: To analyze the objectivity of P300 for assessment of cognitive function in elderly type 2 diabetic patients. DESIGN, TIME AND SETTING: This case-control experiment was performed at the Department of Endocrinology of the Fourth Affiliated Hospital, Guangxi Medical University from January 2004 to December 2006. PARTICIPANTS: Seventy-two patients (38 males and 34 females) with type 2 diabetes mellitus were enrolled in this study. The patients were divided according to those with diabetes alone (diabetes alone group) (n=38) and those with diabetes and cerebral ischemia (diabetes and cerebral ischemia group) (n=34). A further 31 healthy individuals (16 males and 15 females), who received health examinations over the same period, were included as normal controls (normal control group). METHODS: All subjects were assessed by Mini-Mental State Examination (MMSE). Abnormalities in cognitive functions were identified by analyzing the auditory P300 event-related potentials. MAIN OUTCOME MEASURES: Auditory event-related potentials and MMSE scores. Multiple linear regression analysis was conducted using the "enter method" with the 72 elderly patients with type 2 diabetes mellitus. P3 latency, P3 amplitude and N2 latency served as dependent variables. Age, sex, education, course of the disease, glycosylated hemoglobin, and ischemic brain damage were used as independent variables. RESULTS: No significant difference in scores of MMSE was detected between the diabetes alone and normal control groups (P 〉 0.05). MMSE score was significantly lower in the diabetes and cerebral ischemia group (P 〈 0.01) than in the normal control group. N2 and P3 latencies of auditory event-related potential were significantly longer, and P3 a  相似文献   

3.
BACKGROUND: The results showed that mirror writing (MW) was correlated with the development of written language, so that MW examination may be one of methods to examine the intelligence of elderly people. OBJECTIVE: To study the MW in elderly patients with Alzheimer disease (AD) and vascular dementia (VaD) and take appropriate scale for their evaluation. DESIGN: Taking the written portion of the Chinese Aphasia Examination Scale (1994) for assessment. SETTING: Department of Neurology, Neuropsychological Laboratory, Beijing Hospital. PARTICIPANTS: From March 1998 to January 2001, 33 patients with AD, 30 patients with VaD admitted into Department of Neurology, Beijing Hospital was enrolled into study. Criteria according to the Diagnostic and Statistical Manual of Mental Disorder, 4th edition (DSM-IV), published by the American Psychiatric Association was used to diagnose AD, while criteria according to the National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l’ Enseignement en Neurosciences (NINDS-AIREN) and Alzheimer Disease Diagnostic and Treatment Center (ADDCT) were used for diagnosis of VaD. AD group contained 19 males and 14 females aged 60–83 years. Twenty-eight males and 2 females, aged 60–87 years made up the VaD group. The 63 healthy elderly subjects matched on age and education as controls were enrolled into study. The matched controls were categorized AD control (n =33) and VaD control (n =30). All patients and controls were understanding and agree with all items of assessment. METHODS: MW examination, Mini Mental State Examination (MMSE), Hachinski Ischemic Scale, the Global Deterioration Scale (GDS) were examined in all subjects. ① Use the written potion of the Chinese Aphasia examination Scale (1994), patient using MW for 91%–100% of dictation had complete MW, those using MW for 51%–90% of dictation had severe MW, those using MW for 11%–50% had moderate MW, those using MW for 1%–10% had mild MW. ② According to the MMSE, the patients were considered to have dementia if they were illiterate and had an MMSE score ≤ 17 score or educated time ≤ 6 years and MMSE ≤ 20 score or educated time > 6 years and MMSE ≤ 24 score. ③ Using the Hachinski Ischemic Scale to differentiate the AD and VaD, it included 6 items and total 9 scores. > 7 score was VaD, < 4 score was AD and 4–7 score was blended dementia. ④ Using the GDS to assess cognitive function: Standard criteria were divided in 7 degrees: 1 degree: no impairment of cognition and 7 degree: very severe impairment of cognition. MAIN OUTCOME MEASURES: The data of MW examination, evaluation of MMSE, Hachinski Ischemic Scale and the GDS of all assessed subjects. RESULTS: All 63 cases of AD and VaD and 63 healthy controls were entered for analysis. ①Results of MW examination: A total of 17 patients with AD were characterized as using MW, 3 with moderate MW and 14 patients with mild MW. In the corresponding control group, only 2 subjects were characterized as being mild MW. The VaD group has 23 patients with MW, 2 with moderate and 21 patients with mild MW. ② MMSE score: MMSE score of AD group was much lower than that of individuals in control group [(20.15±3.40), (29.73±0.40) score, P < 0.01], MMSE score of VaD group was much lower than that of individuals in control group [(19.33±2.75), (29.12±0.63) score, P < 0.01]. ③ Hachinski Ischemic Scale and GDS score: Rating according to the Hachinski Ischemic Scale was higher in VaD patients compared to AD patients [(9.61±1.69), (1.09±0.60) score, P < 0.01]. The GDS score did not significantly differ between the AD group and the VaD group. CONCLUSION: ① MW examination could be used as an indicator of intelligence in healthy elderly people and also could be used as one of methods to assess the intelligence in AD and VaD patients. ② Grade of severity of MW may indirectly reflect the degree of dementia.  相似文献   

4.
A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for cognitive disorder in depressed patients.  相似文献   

5.
BACKGROUND: Cognitive dysfunction occurs in elderly patients following general anesthesia, and this might be associated with genetics. Studies have shown that theε4 allele gene is closely associated with senile dementia.OBJECTIVE: To compare and analyze the correlations between cognitive dysfunction and single nucleotide polymorphism of apolipoprotein E (ApoE) following inhaJation or intravenous anesthesia.DESIGN, TIME AND SETTING: A randomized, controlled study was performed. The patients were recruited from the Department of Anesthesia, Second Affiliated Hospital, Medical College, Xi'an Jiaotong University, China between May 2005 and December 2008. Genetic analyses were conducted at the Departments of Neuroanatomy and Forensic Medicine, Medical College, Xi'an Jiaotong University, China.PARTICIPANTS: A total of 1 000 patients of ASA Ⅰ-Ⅱ grade, without genetic connection, were enrolled in this study, comprising 520 males and 480 females, aged (70.1±4.6) years and weighing (57.3±7.5) kg. No patients suffered from cognitive dysfunction.METHODS: The patients were equally and randomly divided into intravenous anesthesia and gas anesthesia groups. Total intravenous anesthesia and inhaled anesthesia were used. Genomic DNA from whole blood was extracted. The ApoE gene was amplified by PCR. Restriction fragment length polymorphism of ApoE gene was analyzed. Cognitive function was evaluated by Mini-Mental State Examination (MMSE). Patients scoring < 25 points were diagnosed with cognitive dysfunction.MAIN OUTCOME MEASURES: Correlation of ApoE gene frequency and ApoEε4 allele to MMSE scores was measured.RESULTS: MMSE scores in patients from the gas anesthesia group significantly decreased 3 days after surgery, compared with the intravenous anesthesia group. The proportion of patients that scored < 25 points was significantly greater in the gas anesthesia group compared with the intravenous anesthesia group 3 days after surgery. Reduced MMSE scores closely correlated with expression of the ApoEε4 allele in the gas anesthesia group (odds ratio=2.83; 95% confidence interval was 1.25-6.39, P<0.05). However, decreased MMSE scores did not closely correlated with expression of the ApoEε4 allele in the intravenous anesthesia group (odds ratio=0.96; 95% confidence interval was 0.37-2.39, P>0.05).CONCLUSION: Results demonstrated a correlation between cognitive dysfunction and ApoE single nucleotide polymorphism in elderly patients after gas anesthesia. However, no relationship between cognitive dysfunction and ApoE single nucleotide polymorphism was determined in elderly patients following intravenous anesthesia. Therefore, elderly patients, especially those expressing the ApoEε4 gene, should be cautiously exposed to gas anesthesia.  相似文献   

6.
Current evidence shows that apolipoprotein E(APOE), apolipoprotein CI(APOC1) and low density lipoprotein receptor-related protein(LRP) variations are related to late-onset Alzheimer's disease. However, it remains unclear if genetic polymorphisms in these genes are associated with cognitive decline in late-onset Alzheimer's disease patients. We performed a 30-month longitudinal cohort study to investigate the relationship between Alzheimer's disease and APOE, APOC1, and LRP. In this study, 78 Chinese Han patients with late-onset Alzheimer's disease were recruited form Guangxi Zhuang Autonomous Region in China. APOE, APOC1, and LRP genotyping was performed using polymerase chain reaction-restriction fragment length polymorphisms. The Mini-Mental State Examination and Clinical Dementia Rating Scale were used to assess patients' cognitive function. After a 30-month follow-up period, we found a significant reduction in Mini-Mental State Examination total score, a higher proportion of patients fulfilling cognitive impairment progression criteria, and a higher proportion of APOC1 H2 carriers in APOE ε4 carriers compared with non-carriers. In addition, the APOE ε4 allele frequency was significantly higher in the cognitive impairment progression group compared with the non-cognitive impairment progression group. In conclusion, APOE ε4 plays an important role in augmenting cognitive decline, and APOC1 H2 may act synergistically with APOE ε4 in increasing the risk of cognitive decline in Chinese patients with late-onset Alzheimer's disease.  相似文献   

7.
BACKGROUND: Encephalofluctuograph Technology (ET) is an advanced and non-traumatic analytical method of brain function. ET can acquire super-slow waves from electroencephalic signals. Studies have shown that these particular spectra can reflect neurochemical processes in the brain. OBJECTIVE: To verify neurotransmitter changes in the brains Parkinson’s disease (PD) patients through the use of ET. DESIGN, TIME AND SETTING: A non-randomized concurrent control experiment was performed at the Department of Neurology in Southern Building, General Hospital of Chinese PLA from August to December 2007. PARTICIPANTS: Sixty-one outpatients with PD were selected from the General Hospital of Chinese PLA from August 2007 to December 2007. In addition, 48 healthy subjects were selected as normal controls. METHODS: All patients underwent assessment of the sub scale Ⅱ, Ⅲ, and V of the Unified Parkinson’s Disease Rating Scale (UPDRS), in which part Ⅱ was used to inform activity of daily living, part Ⅲ reflected athletic ability, and part Ⅴ was the Hoehn & Yahr grade for symptoms evaluation. Correlation analysis was performed between dopamine levels and UPDRS assessment. Neurotransmitter changes were observed forty-eight prior to and 1.5 hours after medicating with Benserazide. The S1, S2, S4, S5, S7, and S11 spectras respectively reflect gamma-aminobutyric acid (GABA), glutamic acid (Glu), 5-hydroxytryptamine (5-HT), acetylcholine (ACh), norepinephrine, and dopamine. MAIN OUTCOME MEASURES: Neurotransmitter changes in the brains of all subjects, and correlations between dopamine concentrations and UPDRS assessment. Neurotransmitter changes in a subgroup of patients prior to and 1.5 hours after medicating with Benserazide. RESULTS: Concentrations of 5-HT, ACh, and norepinephrine were decreased in the PD group, and GABA was increased. However, there was no significant difference compared with the normal control group (P > 0.05). The level of dopamine in PD group was significantly lower than that in the control group (P < 0.01). Dopamine concentrations in PD patients negatively correlated with UPDRS scores and the Hoehn &Yahr grade range (r = –0.4601, –0.4301, P < 0.01). Dopamine levels increased significantly in PD patients 1.5 hours after medicating with Benserazide compared with before (P < 0.01). CONCLUSION: Detection by ET demonstrated that dopamine concentrations were significantly decreased in the brains of PD patients, as well as played a role in the course of pathogenesis and therapy. These results provided useful information for future non-traumatic of PD. Key Words: 5-hydroxytryptamine; dopamine; neurotransmitters; norepinephrine; Parkinson’s disease  相似文献   

8.
BACKGROUND: Encephalofluctuograph Technology (ET) is an advanced and non-traumatic analytical method of brain function. ET can acquire super-slow waves from electroencephalic signals. Studies have shown that these particular spectra can reflect neurochemical processes in the brain. OBJECTIVE: To verify neurotransmitter changes in the brains Parkinson’s disease (PD) patients through the use of ET. DESIGN, TIME AND SETTING: A non-randomized concurrent control experiment was performed at the Department of Neurology in Southern Building, General Hospital of Chinese PLA from August to December 2007. PARTICIPANTS: Sixty-one outpatients with PD were selected from the General Hospital of Chinese PLA from August 2007 to December 2007. In addition, 48 healthy subjects were selected as normal controls. METHODS: All patients underwent assessment of the sub scale Ⅱ, Ⅲ, and V of the Unified Parkinson’s Disease Rating Scale (UPDRS), in which part Ⅱ was used to inform activity of daily living, part Ⅲ reflected athletic ability, and part Ⅴ was the Hoehn & Yahr grade for symptoms evaluation. Correlation analysis was performed between dopamine levels and UPDRS assessment. Neurotransmitter changes were observed forty-eight prior to and 1.5 hours after medicating with Benserazide. The S1, S2, S4, S5, S7, and S11 spectras respectively reflect gamma-aminobutyric acid (GABA), glutamic acid (Glu), 5-hydroxytryptamine (5-HT), acetylcholine (ACh), norepinephrine, and dopamine. MAIN OUTCOME MEASURES: Neurotransmitter changes in the brains of all subjects, and correlations between dopamine concentrations and UPDRS assessment. Neurotransmitter changes in a subgroup of patients prior to and 1.5 hours after medicating with Benserazide. RESULTS: Concentrations of 5-HT, ACh, and norepinephrine were decreased in the PD group, and GABA was increased. However, there was no significant difference compared with the normal control group (P > 0.05). The level of dopamine in PD group was significantly lower than that in the control group (P < 0.01). Dopamine concentrations in PD patients negatively correlated with UPDRS scores and the Hoehn &Yahr grade range (r = –0.4601, –0.4301, P < 0.01). Dopamine levels increased significantly in PD patients 1.5 hours after medicating with Benserazide compared with before (P < 0.01). CONCLUSION: Detection by ET demonstrated that dopamine concentrations were significantly decreased in the brains of PD patients, as well as played a role in the course of pathogenesis and therapy. These results provided useful information for future non-traumatic of PD. Key Words: 5-hydroxytryptamine; dopamine; neurotransmitters; norepinephrine; Parkinson’s disease  相似文献   

9.
BACKGROUND: Mild cognitive impairment (MCI) represents early status of Alzheimer’s disease. Magnetic resonance spectroscopy (MRS) has been used in early diagnosis and identification as well as monitoring of Alzheimer’s disease. However, little data is available concerning relationship between cognitive impairment and changes of biochemical metabolites. OBJECTIVE: To investigate the relationship between cognitive impairment and changes of biochemical metabolites as well as volumes of hippocampal formation (HPF) in MCI patients, accordingly to evaluate the roles of MRS in the diagnosis and the state monitoring of MCI. DESIGN, TIME AND SETTING: Case-contrast observation. The study was performed at the Outpatient Department and ward of Department of Neurology, Lianyungang Hospital of Xuzhou Medical College between September 2006 and December 2008. PARTICIPANTS: A total of 20 MCI patients were selected and 20 elderly with normal cognition, matched in gender, age and education, were selected. METHODS: Before volumes of the left HPF were measured by MRS, mini-mentalstate examination (MMSE), the Montreal Cognitive Assessment (MoCA), activities of daily living (ADL), clinical dementia rating (CDR) and Wechsler memory scale (WMS) were used to examine each participant. In addition, the N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (mI)/Cr of HPF were obtained. Moreover, the correlations between the NAA/Cr, Cho/Cr, mI/Cr and the volume of HPF in MCI group were analyzed. MAIN OUTCOME MEASURES: Volume of HPF, NAA/Cr, Cho/Cr, and mI/Cr. RESULTS: Compared with control group, reduced NAA/Cr (P < 0.01), increased mI/Cr (P < 0.01) and reduced volume of HPF (P < 0.05) were found in the MCI subjects. No significant difference was observed in the Cho/Cr between two groups (P > 0.05). In the MCI group, the NAA/Cr remarkably correlated with MoCA, memory quotient, and volumes of left HPF (P < 0.01); Cho/Cr significantly correlated with memory quotient (P < 0.05); mI/Cr has remarkably negative correlation with MoCA and volumes of left HPF (P < 0.01), but positive correlation with memory quotient (P < 0.01). The volumes of left HPF also remarkably correlated with MoCA and memory quotient (P < 0.01). CONCLUSION: An increased mI/Cr ratio, a decreased left HPF volumes and NAA/Cr ratio were observed in the MCI patients. Significant correlations between biochemical metabolites of HPF, HPF volumes and MoCA as well as memory quotient were observed. MRS plays an important role in the diagnosis and state monitoring of MCI.  相似文献   

10.
Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.  相似文献   

11.
目的比较简易精神状态量表(Mini-Mental State Examination,MMSE)和蒙特利尔认知评测量表(Montreal Cognitive Assessment,MoCA)对急性期缺血性脑血管病患者认知功能障碍的筛查能力。方法对筛选的107例发病7 d内的短暂性脑缺血发作(transient ischemic attack,TIA)或脑梗死患者应用MMSE及MoCA量表进行认知功能障碍的评测,比较经两量表评测筛查出认知障碍患者的比例。根据患者教育程度对应的MMSEI临界值筛选出MMSE评分在正常范围的患者,以MoCA量表评分26分为临界值将受试者分为MoCA评测正常组与异常组,比较两组在各个认知领域的得分。结果 107例患者MMSE平均分25.89±3.65分,MoCA平均分20.67±4.56分。MMSE评测异常者8例(7.5%),正常者99例(92.5%)。MoCA评测异常者98例(91.6%),正常者9例(8.4%)。MoCA评测正常者MMSE评测均正常。MMSE评测正常的99例患者中,MoCA评测正常者9例(9.1%,9/99),评测异常者(26分)90例(90.9%,90/99)。MoCA评测异常组在视空间与执行能力、命名、延迟记忆等认知领域得分低于MoCA评测正常组(P0.05)。结论 MoCA量表在筛查急性缺血性脑血管病患者认知障碍方面可能比MMSE量表更敏感,MMSE正常MoCA评测异常的患者认知损害主要表现在视空间执行功能、命名、延迟记忆等方面。  相似文献   

12.
The comparative ability of the Montreal Cognitive Assessment (MoCA) and MMSE to detect mild cognitive difficulties was investigated in 107 older adults. The sensitivity of the MoCA to detect cognitive impairment with a cutoff score of <26 was investigated, as compared to the MMSE across all scores, and at a cutoff of ≥27. Performance on MoCA subtests was compared at these MMSE cutoffs to determine profiles of early cognitive difficulties. The MoCA detected cognitive impairment not detected by the MMSE in a high proportion of participants, and this impairment was evident across various subtests. The MoCA appears to be a sensitive screening test for detection of early cognitive impairment.  相似文献   

13.
Background: The Montreal Cognitive Assessment (MoCA) appears more sensitive to mild cognitive impairment (MCI) than the Mini-Mental State Examination (MMSE): over 50% of TIA and stroke patients with an MMSE score of ≥27 ('normal' cognitive function) at ≥6 months after index event, score <26 on the MoCA, a cutoff which has good sensitivity and specificity for MCI in this population. We hypothesized that sensitivity of the MoCA to MCI might in part be due to detection of different patterns of cognitive domain impairment. We therefore compared performance on the MMSE and MoCA in subjects without major cognitive impairment (MMSE score of ≥24) with differing clinical characteristics: a TIA and stroke cohort in which frontal/executive deficits were expected to be prevalent and a memory research cohort. Methods: The MMSE and MoCA were done on consecutive patients with TIA or stroke in a population-based study (Oxford Vascular Study) 6 months or more after the index event and on consecutive subjects enrolled in a memory research cohort (the Oxford Project to Investigate Memory and Ageing). Patients with moderate-to-severe cognitive impairment (MMSE score of <24), dysphasia or inability to use the dominant arm were excluded. Results: Of 207 stroke patients (mean age ± SD: 72 ± 11.5 years, 54% male), 156 TIA patients (mean age 71 ± 12.1 years, 53% male) and 107 memory research subjects (mean age 76 ± 6.6 years, 46% male), stroke patients had the lowest mean ± SD cognitive scores (MMSE score of 27.7 ± 1.84 and MoCA score of 22.9 ± 3.6), whereas TIA (MMSE score of 28.4 ± 1.7 and MoCA score of 24.9 ± 3.3) and memory subject scores (MMSE score of 28.5 ± 1.7 and MoCA score of 25.5 ± 3.0) were more similar. Rates of MoCA score of <26 in subjects with normal MMSE ( ≥27) were lowest in memory subjects, intermediate in TIA and highest after stroke (34 vs. 48 vs. 67%, p < 0.001). The cerebrovascular patients scored lower than the memory subjects on all MoCA frontal/executive subtests with differences being most marked in visuoexecutive function, verbal fluency and sustained attention (all p < 0.0001) and in stroke versus TIA (after adjustment for age and education). Stroke patients performed worse than TIA patients only on MMSE orientation in contrast to 6/10 subtests of the MoCA. Results were similar after restricting analyses to those with an MMSE score of ≥27. Conclusions: The MoCA demonstrated more differences in cognitive profile between TIA, stroke and memory research subjects without major cognitive impairment than the MMSE. The MoCA showed between-group differences even in those with normal MMSE and would thus appear to be a useful brief tool to assess cognition in those with MCI, particularly where the ceiling effect of the MMSE is problematic.  相似文献   

14.

Background

Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD), that can improve patients' motor and non-motor symptoms. However, there are differences in the improvement of patients' emotional symptoms and cognitive function.

Objective

To investigate the impact of active contact location and the volume of tissue activated (VTA) on patients' emotional symptoms and cognitive function in STN-DBS in PD.

Methods

A total of 185 PD patients were included in this study. We evaluated them using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE) scales at the preoperative, 1- and 12-month postoperative time points. Leads were positioned in standard space using the Lead-DBS toolbox, and VTA was calculated for analysis.

Results

When the lead active contact was closer to the ventral side of the STN, the patients' HAM-A improvement rate was higher, and when the active contact was closer to the anterior and dorsal sides of the STN, the patients' MoCA improvement rate was higher. Stimulation of the sensorimotor zone was more favorable to the improvement of HAM-A and HAM-D in patients. And, the stimulation of the associative zone was more favorable to the improvement of MoCA in patients.

Conclusion

Our results provide evidence that the 12-month outcomes of cognitive function and emotional symptoms in PD patients with STN-DBS were closely related to the specific location of the active contacts in the STN and influenced by the VTA.  相似文献   

15.
目的 初步研究帕金森病(PD)患者伴慢性疼痛的发生与分布情况、与疾病发展的关系以及对生活质量的影响.方法 对113例原发性PD患者进行视觉模拟评分法(VAS)、简易疼痛量表(BPI)、统一PD评分量表(UPDRS)、Hoehn-Yahr(H-Y)分期、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HRSD)、匹兹堡睡眠质量指数(PSQI)等评估.将患者分为无疼痛组、PD相关慢性疼痛组及非PD相关慢性疼痛组,其中PD相关慢性疼痛组再分为直接相关组和间接相关组.对各组进行分析比较.结果 PD相关慢性疼痛的发生率为42.5%(48/113).与无疼痛组相比,PD相关慢性疼痛组患者的起病早、病程长,且UPDRS Ⅲ评分、H-Y分期、HRSD、HAMA分值以及左旋多巴剂量均高于无疼痛组,差异均具有统计学意义;PD相关慢性疼痛组患者与非PD相关慢性疼痛组相比,其起病年龄(57.4±9.6与65.9±8.7,t=-2.596,P=0.012)、HRSD(12.9±7.9与8.7±3.7,t=2.605,P=0.014)以及疼痛强度VAS(61.6±25.9与38.0±30.1,U=-2.290,P=0.022)差异具有统计学意义.对PD直接疼痛及间接疼痛相关组的BPI 7项指标进行比较,除行走与交流能力外,其余5项指标的分值在直接相关组更高,两者差异具有统计学意义.结论 疼痛在PD患者中很普遍,其中绝大多数为PD相关慢性疼痛,患者起病早且生活质量较差.  相似文献   

16.
Cognitive impairment is one of the earliest, most common, and most disabling non‐motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale‐2 (DRS‐2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS‐2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS‐2 using equipercentile equating and log‐linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. © 2014 International Parkinson and Movement Disorder Society  相似文献   

17.
目的探讨初诊帕金森病(PD)患者非运动症状(NMS)的特点及其性别差异。方法选取首次就诊的PD患者203例(男性102例,女性101例)及正常对照者255例(男性110例,女性145例),收集入组对象的临床资料并采用简易智能评估量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、帕金森病睡眠量表(PDSS)、统一PD评分量表(UPDRS)第Ⅲ部分及Hoehn-Yahr(H-Y)分期对PD患者进行评估。应用NMS问卷筛查量表(NMSQ)评定其非运动症状,比较不同性别的NMS的特点。采用多因素线性回归分析PD患者NMDQ总分的影响因素。结果98.5%的PD患者均存在至少一项NMS,其中以记忆力下降(67.5%)、情绪低落(49.8%)最为常见。PD组NMS的总分及9个分域得分均显著高于对照组(均P<0.05)。PD组女性兴趣减退、情绪低落、焦虑及出汗增多的比率显著高于同组男性,而吞咽困难的比率显著降低(均P<0.05)。正常对照组(HC组)女性出汗增多的比率显著高于同组男性,记忆力下降的比率显著降低(均P<0.05)。PD男性及女性患者的NMS总分均受HAMD和PDSS影响(均P<0.05),而男性更易受病程影响(β=0.181,P=0.032)。结论PD初诊患者的非运动症状发生率明显高于正常人且具有性别差异。  相似文献   

18.
目的 临床回顾分析帕金森病(PD)患者快速眼球运动(REM)睡眠行为障碍(RBD)的发生率及其危险因素,前瞻性研究RBD对PD进展的影响.方法 根据国际睡眠障碍分型修订版(ICSD-R)关于RBD的最低诊断标准,对符合临床疑似RBD(cpRBD)的患者进行统一PD评估量表(UPDRS)、MMSE、蒙特利尔认知功能评估量表(MoCA)等测定与随访观察,随访时间为2.5年.结果 基线时cpRBD的发生率为35.6%(47/132),随访末的发生率为41.7%(55/132),脱落率为11.4%(15/132).RBD的独立危险因素为MoCA分值低(OR=0.817,P=0.004),而震颤型起病形式为RBD的保护因素(OR=0.247,P=0.020).cpRBD患者病情进展较非cpRBD患者快[UPDRSⅢ终点与基线差值:(9.86±4.96)分与(6.76±4.26)分,t=2.909,P=0.005;H-Y分期终点与基线差值:(0.77±0.54)期与(0.33±0.49)期,t=3.664,P=0.000].结论 RBD的发生可能预测PD病情的快速进展、认知功能损害、精神症状的出现.  相似文献   

19.
目的探讨蒙特利尔认知评估量表(MOCA)和简易精神状态量表(MMSE)在帕金森病轻度认知功能障碍(PDMCI)筛查中的应用。方法采用随机抽样方法,应用MOCA和MMSE对75例诊断为PDMCI患者、帕金森病认知功能正常(PDN)患者180例和健康患者145例进行评估,比较二者筛查PDMCI的敏感性和特异性。结果在文盲组MMSE的敏感性为93.10%,特异性为100%,而MOCA的敏感性仅为0%,特异性为92.72%;在小学组MMSE的敏感性为87.50%,特异性为100%,而MOCA的敏感性为41.67%,特异性为79.17%;在初中及以上学历组MMSE的敏感性为27.27%,特异性为100%,MOCA的敏感性为90.91%,特异性为85.71%。结论 MOCA适合初中及以上学历的PDMCI筛查工具,MMSE适合初中以下学历PDMCI筛查工具。  相似文献   

20.
目的 研究帕金森病(Parkinson's disease,PD)伴有轻度认知功能缺损(mild cognitiveimpairment,MCI,即PD-MCI)患者患病率及其神经心理学特征.方法 设立PD患者组(n=103)及健康对照组(n=32)进行比较.心理学测验工具由MMSE、痴呆评定量表及其他神经心理学测试组成,汉密尔顿抑郁量表用以评定患者的抑郁程度.结果 (1)21例(20.4%)PD患者被诊断为痴呆,37例(35.9%)患者认知功能完整,45例(43.7%)患者有MCI;(2)与认知正常的PD患者相比,PD-MCI患者年龄更大,PD起病更晚,且运动损害更为严重;(3)PD-MCI的患病率和神经心理学特征与PD症状主要累及何侧及分型有一定关系:左侧组比右侧组患者出现MCI的概率要高(74.2%和42.2%,χ2=7.589,P<0.05);震颤为主型患者与混合型患者相比,Stroop测词试验(SWT)的耗时(s)显著减少(80.8±39.9和94.4±30.0,t=3.332,P<0.01).结论在PD患者中,筛查出PD-MCI患者有着重要的临床意义,有助于临床医生针对性地处理不同PD患者,并易化对其预后的判断.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号