不同年龄和疾病阶段非痴呆帕金森病患者认知功能和听沉P300改变

目的探讨不同年龄和疾病阶段非痴呆帕金森病患者的P300改变.方法将120例帕金森病(PD)患者按病程分为早期PD组(60例)和晚期PD组(60例);其中早期PD组又按年龄分为年轻早期PD组(33例)和老年早期PD组(27例),晚期PD组又按年龄分为年轻晚期PD组(32例)和老年晚期PD组(28例).将60例正常人按年龄分为年轻对照组(34例)和老年对照组(26例).分别采用简明精神量表(MMSE)、Fuld物体记忆测验(FOM)、语言流畅性测验(RVR)、积木测验(BD)和数字广度测验(DS)评定认知功能,记录分析听觉诱发事件相关电位P300PL.结果年轻晚期PD组5项评分均低于年轻对照组,且P300PL延长(P＜0.01);老年早期PD组5项评分均低于老年对照组,且P300PL延长(P＜0.01);老年晚期PD组5项评分均低于老年对照组,且P300PL延长(P＜0.01);晚期PD组5项评分均低于对照组,且P300PL延长,差异有统计学意义(P＜0.01);而年轻早期PD组较年轻对照组5项评分及P300PL差异无统计学意义(P＞0.01);早期PD组较对照组5项评分及P300PL差异无统计学意义(P＞0.01).各组MMSE、FOM、RVR、BD、DS评分和P300峰潜伏时的延长呈负相关.结论非痴呆PD患者存在认知功能的下降,其认知功能的下降与发病年龄及疾病阶段有关.

Auditory P300 and cognitive function alterations in non-demented Parkinson's disease patients with different age and illness stage

Aim: To study the alterations of P300 in non-demented Parkinson's disease (PD) patients with different age and different stage of illness. Methods: The cognitive functions were assessed by MMSE,FOM,RVR,BD,DS and the event-related potential P300 evoked by auditory stimulation were recorded and analysed in 120 PD patients(33 cases of young early PD patients,27 cases of old early PD patients,32 cases of young advanced PD patients,and 28 cases of old advanced PD patients) and 60 normal subjects(34 cases of young controls and 26 cases of old controls). Results: Significantly lower scores of MMSE,FOM,RVR,BD,DS and increase of P300 peak latency (PL) were recorded in the young advanced PD patients compared with young controls(P<0.01). Significantly lower scores of MMSE,FOM,RVR,BD,DS and increase of P300PL were recorded in the old early PD patients compared with old controls(P<0.01).Significantly lower scores of MMSE,FOM,RVR,BD,DS and increase of P300PL were recorded in the old advanced PD patients compared with old controls(P<0.01).Significantly lower scores of MMSE,FOM,RVR,BD,DS and increase of P300PL were recorded in the advanced PD patients compared with controls(P<0.01).However, no significant difference of scores of MMSE,FOM,RVR,BD,DS and P300PL were recorded in the young early PD patients compared with young controls(P>0.01).No significant difference scores of MMSE,FOM,RVR,BD,DS and P300PL were recorded in the early PD patients compared with controls(P>0.01). P300PL was negatively correlated with the scores of MMSE,FOM,RVR,BD,DS among the groups. Conclusion:Cognitive decline exists in non-demented PD patients. The cognitive decline of PD patients is related to age and the disease stage.