中重度晚发抑郁症患者的神经认知功能损害分析

目的探讨中重度晚发抑郁症患者神经认知功能损害的特征。方法选取2017年2月至2019年2月我院收治的中重度晚发抑郁症患者50例作为观察组,采用重复性成套神经心理状态测验(RBANS)、词语流畅性测验(VFT)、威斯康星卡片分类测验(WCST)对神经认知功能损害情况予以评定,与同期收治的对照组50名健康体检者进行比较。采用汉密顿抑郁量表(HAMD-17)评估观察组抑郁严重程度,并分析它与认知损害的关系。结果在RBANS测验中,观察组晚期抑郁症患者即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度评分均低于对照组,差异具有统计学意义(P0.05);观察组VFT测验评分经评定低于对照组(P0.05);在WCST测验中,两组完成分类数、完成第一分类所需应答数评分无差异(P0.05),观察组错误应答数、持续性错误百分数、持续性错误数、持续性应答数评分均高于对照组,概念化水平应答百分数评分高于对照组,P0.05);Spearman相关分析发现RBANS测验中的即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度均与HAMD-17评分具正相关(r=0.39,0.42,0.45,0.38,0.40,P0.05);VFT和WCST测验中的持续性应答因子与HAMD-17评分呈负相关(r=-0.43,-0.51,P0.05)。结论中重度晚发抑郁症患者容易出现神经认知功能损害,认知功能损害与抑郁程度密切相关。     

慢性精神分裂症与脑肿瘤患者认知状况比较分析

目的　探讨慢性精神分裂症患者脑功能缺陷与不同脑叶损伤间的关系。方法　运用威斯康星卡片分类测验、词汇流畅性测验、Stroop测验,对30名正常人、39例精神分裂症及88例脑肿瘤患者(其中左、右额叶各2 4例、颞叶2 0例、顶枕叶2 0例)进行测试。结果　精神分裂症患者与脑肿瘤患者均存在不同程度、不同特征的认知损伤,其中阴性症状为主的精神分裂症与右额叶脑肿瘤患者损伤类似,除完成分类数、总词汇数外,本研究所采用的测查其余指标差异无显著性(P >0 . 0 5)。结论　阴性症状为主的慢性精神分裂症患者右侧额叶功能受损明显,精神分裂症起病的器质性因素可能涉及右额叶。     

阿戈美拉汀联合rTMS对首发抑郁症认知功能的影响

目的探讨阿戈美拉汀联合rTMS治疗首发抑郁症的疗效及认知功能的影响。方法将90例首发抑郁症患者用EpiCalc 2000随机分为两组,各45例,在阿戈美拉汀治疗基础上,研究组给予rTMS治疗,对照组给予伪刺激治疗。分别于治疗第0、1、2、4周末采用汉密尔顿抑郁量表(HAMD-17)评定疗效、用韦氏智力测验(WAIS)中数字符号、数字广度、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)、连线测验(TMT)、词语流畅性测验(VFT)评定认知功能。结果在治疗后第1、2、4周末研究组HAMD评分明显低于对照组;4周末研究组有效率高于对照组;4周末研究组WCST非持续错误数、VFT重复数较治疗前减少,对照组TMT-A提笔次数较治疗前减少。与对照组比较,研究组治疗后第4周末WCST持续错误数、TMT连线时间较少,VFT总数较高,以上均有统计学差异(P0.05)。结论 rTMS联合阿戈美拉汀治疗首发抑郁症安全、快速、有效,并改善认知功能。     

抑郁症患者的认知功能、事件相关电位P300和MR扩散张量成像研究

目的 联合应用事件相关电位P300和MR扩散张量成像(DTI)研究抑郁症患者的认知功能损害,探讨抑郁症合并认知损害的机制. 方法 选取深圳市第二人民医院心理门诊自2008年5月至2009年9月接收的30例首发抑郁症患者作为抑郁症组,同期与抑郁症患者年龄、教育程度相匹配的健康志愿者30名做为对照组.应用威斯康星卡片分类测验(WCST)、P300检查和DTI扫描分别检测WCST各亚项得分、P3潜伏期和P3波幅、脑不同解剖部位的各向异性(FA)值.并对三者进行相关性分析. 结果 抑郁症组患者WCST各亚项得分、P3潜伏期和P3波幅与对照组相比较差异均有统计学意义(P<0.05);与对照组相比,抑郁症组患者双侧额叶、扣带回前部、扣带回压部、胼胝体膝部和压部FA值下降,差异有统计学意义(P<0.05);抑郁症组患者P3潜伏期与持续性错误数呈正相关关系(r=0.677,P=0.009),P3波幅与持续性错误数、不能维持完整分类数数均呈负相关关系(r=0.765,P=0.001;r=0.654,P=0.012),抑郁症组患者左、右侧额叶白质FA值分别与持续性错误数、不能维持完整分类数呈负相关关系(P<0.05). 结论 神经心理学和事件相关电位P300检查反映了抑郁症患者存在认知功能损害,P3潜伏期和P3波幅可作为认知功能的参考指标,DTI结果 揭示了抑郁症患者存在白质区域神经纤维的异常,这可能是抑郁症合并认知损害的神经病理学基础之一.     

伴发与非伴发迟发性运动障碍的慢性精神分裂症患者认知状况比较分析

目的探讨伴发与非伴发迟发性运动障碍(TD)的慢性精神分裂症患者认知状况间存在的差异及可 能的机理。方法采用成人书氏智力(WAIS)、韦氏记忆(WMS)、威斯康星卡片分类测验(WCST)、词汇流畅性 (VFT)、Stroop测验(WCT),对一般状况匹配的伴发(53例,TD组)与非伴发(55例,非TD组)TD慢性精神分裂症 患者进行检测,以综合评定2组患者认知功能,比较其认知损伤的差异。结果在WAIS操作、言语及全量表智商、 WMS的记忆商、VFT的所有指标上,TD组显著差于非TD组(P<0．05);而2组在WCST除完成分类数外的其他指 标及WCT的各指标的差异均未达到显著水平(P>0．05)。结论伴发TD的慢性精神分裂症患者的认知功能损伤 更明显,这可能与抗精神病药导致的神经元改变有关。     

抑郁症患者抗抑郁剂治疗前后脑动脉血流速度的改变及与认知功能的关系

目的:探讨短期治疗后抑郁症患者脑动脉血流速度的变化及其与注意力、执行功能的关系。方法:采用汉密尔顿抑郁量表(HAMD)评估70例抑郁症患者(抑郁症组)抑郁情绪,采用划销测验、威斯康星卡片分类测验(WCST)测试抑郁症组和65名健康对照者(健康对照组)的认知功能;运用经颅多普勒超声检测两组脑动脉血流速度,抑郁症组在抗抑郁治疗4~8周后再次重测。结果:短期治疗后抑郁症组基底动脉血流速度较治疗前增快(t=2.45,P0.05),但左、右大脑中动脉、左、右大脑前动脉血流速度仍低于健康对照组(t=-6.07~-12.14;P均0.01);治疗后抑郁症组划销测验成绩较治疗前明显提高,但除净分IV外仍低于健康对照组(t=-2.54~-17.33;P0.05或P0.01);WCST错误应答数、持续性错误数均较治疗前减少,但仍多于健康对照组(t=9.33~15.13;P均0.01)。相关分析显示,治疗后大脑动脉平均血流速度与划销测验、WCST成绩显著相关(P0.05或P0.01);椎动脉血流速度差值与划销测验总净分差值、WCST错误应答数差值及持续性错误数差值呈正相关(r=0.454,0.270,0.378;P均0.01)。结论:短期治疗后抑郁症患者脑动脉平均血流速度与注意力、执行功能均得到一定程度的改善,但仍未恢复到正常状态;注意力与执行功能受损可能与脑动脉平均血流速度的改变有关。     

抑郁症患者弥散张量成像与认知功能的关系

目的:探讨抑郁症患者全脑白质纤维受损状况及其与认知功能的关系.方法:对 24 例抑郁症患者及 30 名健康对照者进行临床测评、常规磁共振成像(MRI)、弥散张量成像(DTI)及神经心理学检查.结果:抑郁症组在左额中回、左额上回、右额内侧回、左楔前叶、左颞上回、右扣带回等区域各向异性(FA)值较对照组显著下降(P＜0.001).抑郁症组威斯康星卡片分类测验(WCST)的分类数、总错误率明显高于对照组(P＜0.01 或 P＜0.05).两组持续注意操作测试(CPT)差异无显著性;抑郁症组 CPT 与 WCST 部分结果均呈负相关(P均＞0.05).结论:DTI 与 WCST 结果的相互印证反映重性抑郁症患者可能存在白质区域神经功能的异常,DTI 技术有助于发现影响认知改变的脑微细结构和功能的异常.     

首发与复发抑郁症患者的认知功能特征比较

目的 探讨首发与复发抑郁症患者的认知功能特征及两者间的差异,以及与疾病严重程度的相关性.方法 招募符合DSM-Ⅳ中抑郁症诊断标准的首发抑郁症患者共31例为首发组,复发性抑郁症患者30例为复发组,健康志愿者31名为对照组,对3组进行韦氏数字广度(DS)测验、威斯康星卡片分类测验(WCST)和爱荷华赌博任务(IGT)测验,比较3组被试在各测量指标上的差异,同时用HAMD-24评估患者组的抑郁程度,并分析其与认知功能各指标的相关性.结果 (1)3组患者DS评分的差异有统计学意义(P<0.05),其中复发组低于对照组(P<0.05),首发组与复发组及首发组与对照组差异均无统计学意义(P>0.05).(2)3组患者WCST评分的差异有统计学意义,其中复发组与对照组及复发组与首发组间差异均有统计学意义(P<0.05),首发组和对照组差异无统计学意义(P>0.05).(3)3组患者IGT评分的差异有统计学意义(P<0.05),其中复发组除第二模块外,其余各项指标均高于对照组(P<0.05),复发组的总分、第三模块和第五模块评分均高于首发组(P<0.05).(4)患者组(首发组+复发组)的HAMD总分与DS评分、WCST分类数呈负相关(r=-0.373,P=0.003;r=-0.299,P=0.019),与WCST的错误应答数、持续性错误应答数、非持续错误应答数和IG T的总分、第三模块评分、第五模块评分呈正相关(r=0.265~0.461,P<0.05),与IG T第一模块、第二模块和第四模块无相关性(P>0.05).结论 首发抑郁症患者无明显短时记忆和执行功能损害,在情感决策方面,其倾向于低收益,低风险决策;而复发抑郁症患者的短时记忆、执行功能均有明显损害,且在情感决策上比首发患者对损失更为敏感;抑郁症患者的抑郁程度与认知损害呈正相关.疾病复发和病情加重都会对抑郁症患者的认知损害造成不良影响.     

伴与不伴述情障碍抑郁症患者认知功能的比较

目的:探讨伴与不伴述情障碍的抑郁症患者认知功能的差异。方法:按20条目多伦多述情障碍量表(20-item Toronto alexithymia scale,TAS-20)评分,收集56例伴述情障碍的抑郁症患者(述情障碍组)和51例不伴有述情障碍的抑郁症患者(非述情障碍组);采用词汇流畅、视觉再生、数字广度、连线试验A、木块图、威斯康星卡片分类测验(Wisconsin card sorting test,WCST) 6项神经心理测试工具评测认知功能;对两组患者的认知功能进行比较,分析TAS-20评分与认知功能的相关性。结果:述情障碍组的认知功能评测成绩均较非述情障碍组差(t/Z=-7. 13～6. 99,P均0. 01); TAS-20总分及各因子分与词汇流畅、视觉再生、数字广度、木块图、WCST正确数、WCST完成分类数呈负相关(r=-0. 758～-0. 195,P 0. 01或P 0. 05),TAS-20总分及各因子分与连线A、WCST错误总数、WCST持续错误数呈正相关(r=0. 286～0. 739,P均0. 01)。结论:述情障碍对抑郁症的认知功能有负面影响。     

激越/迟滞型抑郁症首次发作患者的认知功能

目的:探讨激越型和迟滞型抑郁症首次发作患者的认知功能特征及其影响因素。方法:77例抑郁症首次发作患者根据汉密尔顿抑郁量表(HAMD-17)激越项目单项≥3分者进入激越组(n=20例);迟滞项目单项≥3分者进入迟滞组(n=24例);上述2项同时<3分者则进入混合组(n=33例)以及40名正常人(正常对照组)进行威斯康星卡片分类测试(WCST)、持续性操作测验(CPT)、韦氏记忆测验(WMS)测试,记录相应观测指标,并与临床症状、精神药物剂量进行相关性分析。结果:①与正常对照组相比,抑郁症患者存在着广泛的认知功能损害(P<0.05或P<0.01);②激越组和迟滞组在WCST所有指标、CPT舍弃数、误答数、平均反应时间、WMS记忆商数、短时记忆、瞬时记忆上与混合组差异有统计学意义(P<0.05或P<0.01);③激越组与迟滞组在WCST中的非持续性错误答案数、CPT中的误答数、平均反应时间、WMS中的短时记忆方面差异有统计学意义(P<0.05或P<0.01);④大部分观测指标与临床症状以及抗抑郁药丙咪嗪等效剂量、镇静催眠药地西泮等效剂量和抗精神病药氯丙嗪等效剂量之间无显著相关。结论:激越和迟滞型抑郁症患者的认知损害不尽相同,提示抑郁症是一种异源性疾病。     

儿童额叶肿瘤的执行功能评价

目的探索额叶肿瘤对儿童患者的认知功能影响，确定额叶肿瘤患儿的执行功能损害特点。方法研究对象为45例儿童颅内肿瘤，年龄10～14岁，其中有25例额叶肿瘤，位于左额10例，右额15例；非额叶（颞叶、顶叶、脑室内或颞顶区）20例。所有患者均采用全麻下显微外科手术。术后病理证实：星形细胞瘤13例，室管膜瘤6例，少枝胶质细胞瘤4例，神经细胞瘤2例。运用威斯康星卡片分类测试系统对患者进行临床评价，并与30例同龄正常儿童作对照。结果威斯康星卡片（WCST）分类测试中的完成分类数（categories achieved）和持续性错误（preservative errors）两个指标在额叶肿瘤组和非额叶肿瘤组之间有统计学意义，而左额肿瘤组患者的执行功能损害较右额肿瘤组、非额叶肿瘤组和正常组差异有统计学意义，耐右额肿瘤组与非额叶肿瘤组和正常组没有统计学意义。结论左额叶肿瘤患儿存在明显的执行功能障碍，而右额肿瘤引起损害则不明显。     

抑郁患者对情绪刺激的注意偏向及其大脑功能磁共振成像证据

目的 探讨抑郁患者的注意偏向及其大脑功能磁共振成像证据.方法 采用17项汉密尔顿抑郁评定量表( HRSD17)并结合中国精神障碍分类与诊断标准筛选被试,分为患者组(9例,HRSD17评分≥17分)、康复组(9例,7分≤HRSD17评分＜17分)和对照组(10名,HRSD17评分＜7分),采用情绪斯特鲁普范式和功能磁共振成像技术,考察抑郁症患者对情绪面孔刺激的注意偏向及其大脑功能磁共振成像证据.结果 (1)康复组在消极、积极及中性条件下对情绪面孔刺激的颜色命名反应时[(701.85± 180.70)、( 635.58±119.79)、(598.88±130.41)ms]短于患者组[(991.04±194.23)、(888.22±184.16)、(745.59±165.38) ms],2组比较差异有统计学意义(P＜0.05),但与对照组[(649.40±143.35)、(633.28±120.50)、(565.69 ±89.87)ms]的差异无统计学意义(P＞0.05);(2)在消极情绪面孔刺激下,康复组比患者组被激活更多的脑区,包括左右额上回和中回、右颞叶、左舌回和左枕叶等.结论 抑郁患者对负性刺激的注意偏向及其脑功能可能随临床康复进程获得改善.     

Stroop performance in focal lesion patients: dissociation of processes and frontal lobe lesion location

There were three primary objectives: to examine the usefulness of the Stroop interference effect as a measure of frontal lobe function; to investigate the possibility of distinct lesion effects for word reading or color naming; and to specifically determine the brain regions necessary for the performance of the incongruent condition. Fifty-one patients with single focal brain lesions in frontal and non-frontal regions and 26 normal control subjects (CTL) were administered the word reading, color naming and incongruent conditions of the Stroop task. Only frontal lesions produced significant impairment. Patients with posterior lesions were not significantly deficient in any condition. Damage to the left dorsolateral frontal lobe resulted in increased errors and slowness in response speed for color naming. Contrary to Perret (Neuropsychology, 1974; 12: 323-330), lesions of the left frontal lobe did not result in a selective interference deficit on the Stroop incongruent condition. Rather, bilateral superior medial frontal damage was associated with increased errors and slowness in response time for the incongruent condition. This result is interpreted as failure of maintenance of consistent activation of the intended response in the incongruent Stroop condition. The results and conclusion are compatible with the prevalent theories of both the Stroop effect and the role of the superior medial frontal regions. The role of the anterior cingulate cortex on performance of the Stroop task is likely related to task and patient context.     

Neuropsychological frontal lobe tests indicate that bipolar depressed patients are more impaired than unipolar

Objectives: The aim of this study was to compare the neuropsychological performance of patients with bipolar or unipolar mood disorders during acute episodes of depression using intelligence and frontal lobe tests. Methods: Fifteen patients with bipolar depression (BP) and 30 with unipolar depression (UP) were studied. For the neuropsychological assessment, the following tests: the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Trail Making Test (TMT), the Stroop test, the verbal fluency test and the Wisconsin Card Sorting Test (WCST) were used. Results: The mean intensity of depression and mean duration of illness were similar in both groups. Patients in the BP group achieved significantly lower levels of performance in the non-verbal part of WAIS-R, in both parts of the Stroop test, in the verbal fluency test and also showed a tendency to achieve poorer results in TMT-B than those in the UP group. Bipolar depressed patients also produced significantly poorer results with the WCST as they made twice as many perseverative errors and only completed half of the correct categories compared with the UP patients. The results of the TMT-A tests, which measure psychomotor slowness, were similar in BP and UP patients. No differences between the results of male and female patients were noted in either group. Deterioration of the results associated with duration of the illness was only observed in the UP patients. Conclusions: A higher degree of cognitive dysfunction connected with frontal lobe activity during an acute depressive episode was found in bipolar compared with unipolar depressed patients. These results may corroborate other findings pointing to pathogenic distinctions between bipolar and unipolar affective illness and to some similarities between bipolar illness and schizophrenia.     

老年期抑郁症的单光子发射计算机断层扫描研究

目的 了解老年期抑郁症(ED)的脑血流灌注特点,为相关神经科学理论提供实验室数据。方法 对26名健康老人、22例ED及26例阿尔茨海默病(Alzheimer’s disease,AD)患者作脑血流灌注检查。结果 与健康老人相比,ED存在右顶叶、双侧额叶和双侧枕叶低灌注(P<0.05),与AD相比,ED的扣带回、双侧颞叶、双侧基底节和双侧丘脑灌注明显较高(P<0.05)。ED在颞叶、额叶、枕叶和丘脑处的双侧灌注不对称(P<0.05),除丘脑灌注为左侧高于右侧外,其余均为左侧低于右侧。判别分析结果为右顶叶、左颞叶、左额叶、左枕叶和扣带回进入判别方程,ED的判别方程对ED诊断的敏感性和特异性分别为100％和94.2％。结论 ED脑血流灌注兼具一般抑郁症和本身的特点,右顶叶、左颞叶、左额叶、左枕叶和扣带回灌注对ED的诊断有重要意义,支持额叶、边缘系统及其它相关区域共同构成情绪调节回路的假设。     

Frontal lobe damage and tests of executive processing: a meta-analysis of the category test, stroop test, and trail-making test

The Category Test, Trails B, and the interference task of the Stroop Test are among the most commonly administered measures of frontal lobe functioning and are thought to tap different cognitive functions mediated by these brain regions. Two meta-analyses were conducted on these tests to determine their sensitivity to frontal and lateralized frontal brain damage. Study 1 compared participants with frontal lobe damage to those with damage to posterior brain regions, whereas Study 2 compared participants with left and right frontal lobe damage. For each study, effect sizes based on performance differences between the above groups were calculated for the Category Test, Trail-Making Test Parts A and B, and the Stroop Test, including Word, Color, and Color-Word subtests. In Study 1 significant differences between groups were found for Trails A and all Stroop tasks, but in Study 2 the only difference between left and right frontal participants was on the Stroop Color-Word task. Potential reasons why Trails A and the Stroop Test are sensitive to frontal lobe damage are discussed, such as novelty and processing speed, as are clinical implications of these findings. The challenges of research on assessment of frontal lobe functioning are discussed and new developments in this area are highlighted.     

The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease

The effects of subthalamic nucleus (STN) stimulation on cognition and mood have not been well established. The authors estimated cognitive and mood effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson's disease (PD) at 6 months and 1 year postoperatively. Forty-six patients were recruited from the Movement Disorder Center at Seoul National University Hospital. Neuropsychologic tests were performed three times, before, 6 months after, and 1 year after surgery. Mean patient age was 58 and mean education duration 8 years. Eighteen of the 46 patients were men. The instruments used for assessing cognitive functions were; the Mini-Mental Status Examination (MMSE), the Trail Making Test (TMT), the Korean Boston Naming Test (K-BNT), the Rey-Kim Memory Battery, the Grooved pegboard test, the Stroop test, a fluency test, the Wisconsin Card Sorting test (WCST), and the Beck depression inventory (BDI). Of these tests, the verbal memory test, the Stroop test, and the fluency test showed statistically significant changes. The verbal memory test using the Rey-Kim memory battery showed a decline in delayed recall and recognition at 6 months and 1 year postoperatively, whereas nonverbal memory showed no meaningful change. In terms of frontal lobe function tests, Stroop test and fluency test findings were found to be aggravated at 6 months and this continued at 1 year postoperatively. Previous studies have consistently reported a reduction in verbal fluency and improvements in self-reported symptoms of depression after STN DBS. However, in the present study, Beck depression inventory (B.D.I.) was not significantly changed. Other tests, namely, MMSE, TMT, K-BNT, Grooved pegboard test, and the WCST also failed to show significant changes. Of the baseline characteristics, age at onset, number of years in full-time education, and l-dopa equivalent dosage were found to be correlated with a postoperative decline in neuropsychological test results. The correlation of motor improvement and cognitive deterioration was not significant, which suggests that the stimulation effect is rather confined to the motor-related part in the STN. In conclusion, bilateral STN DBS in Parkinson's disease did not lead to a significant global deterioration in cognitive function. However, our findings suggest that it has minor detrimental long-term impacts on memory and frontal lobe function.     

Mood state in unilateral temporal lobe epilepsy

The purpose of this investigation was to reexamine the relationship between self-reported depression and laterality of temporal lobe epilepsy and to determine the contribution of associated frontal lobe dysfunction in predisposing patients to depression. Sixty-four patients with complex partial seizures of left (n = 26) or right (n = 38) temporal lobe origin were administered several self-report measures of mood state (Beck Depression Inventory, Center for Epidemiological Studies-Depression scale, Beck Anxiety Inventory), and a test of frontal lobe function [Wisconsin Card Sorting Test (WCST)]. There were no overall differences between the left and right temporal lobe groups on the measures of depression and anxiety. However, the left temporal lobe group exhibited a significant relationship between the degree of associated frontal lobe dysfunction (as indicated by increased perseverative responding on the WCST) and dysphoric mood state. For the right temporal lobe group there was a nonsignificant inverse relationship between mood state and indices of frontal lobe dysfunction. These results (1) are consistent with the broader psychiatric literature, which has implicated a relationship between depression and left frontal lobe dysfunction, (2) suggest that previous conflicting reports of depression/left temporal lobe epilepsy relationship are due in part to variations in the intactness of frontal lobe function, and (3) suggest that the presence of associated frontal lobe dysfunction may be a consideration in understanding interictal psychopathology in epilepsy.     

Frontal functions in depressed and nondepressed Parkinson's disease patients: impact of severity stages

Severity of Parkinson's disease (PD) and frontal impairment are positively correlated. Testing frontal functions in depressed/nondepressed PD patients with different severity stages may reveal whether depression leads to this impairment. We aimed to relate severity of PD to frontal functional impairment and to test if negative stimuli/depressive symptoms interfered with frontal tasks. The Stroop test and the Emotional Stroop test were performed by 46 PD patients, 18 of whom were depressed. The Hoehn and Yahr scale assessed severity of the disease. We calculated the difference in seconds for each Stroop card and the interference index (C/D) between depressed and nondepressed patients sharing the same severity of disease. The differences among the groups (depressed and nondepressed) according to the severity of the disease (mild and moderate) were compared using the Mann-Whitney test. The depressed patients had a poorer performance on the test than the nondepressed PD patients, although the difference was not statistically significant. In conclusion, there is a clinically relevant but not statistically significant difference on the performance of frontal tasks between depressed and nondepressed PD patients. Neither depression nor the severity of the disease were determinant to the poorer performance on the Stroop and the Emotional Stroop tests.