特发性震颤的非运动症状研究

目的对特发性震颤(ET)患者的非运动症状(NMS)进行研究,以期发现其临床和病理解剖特点。方法把60名ET患者和63名对照组分为4组:中青年对照组、中青年ET组、老年对照组和老年ET组,分别对各组进行听力检测和认知功能评估。结果与相应的对照组比较,中青年ET组和老年ET组均有明确的听力下降(P=0.026;P=0.005);中青年ET组无认知功能下降(P=0.061),老年ET组认知功能下降明显(P=0.003)。老年ET组的视空间和执行能力下降幅度较中青年ET组更明显(P=0.012)。ET患者听力下降和认知功能下降有一定相关性(P=0.005)。结论 ET患者的非运动症状中,听力下降出现较早,认知功能下降出现较晚,老年性ET患者在认知功能的视空间和执行能力方面表现更差;二者发病具有一定正相关性。ET的病理解剖基础可能为听神经﹣脑干﹣小脑系统受损较早,而海马﹣边缘系统﹣皮质的退化变性发生较晚。

A study of non-motor symptoms of essential tremor

Objective To investigate the non-motor symptoms (NMSs) of essential tremor (ET), and to explore the clinical and pathological features of ET.Methods A total of 60 patients with ET and 63 controls were divided into young and middle-aged control group, young and middle-aged ET group, elderly control group, and elderly ET group. Audiometry and cognitive function evaluation were performed for all groups.Results Compared with the corresponding control groups, the young and middle-aged ET group and the elderly ET group had a significant reduction in hearing (P=0.026 and 0.005); the young and middle-aged ET group had no reduction in cognitive function (P=0.061), while the elderly ET group had a significant reduction in cognitive function (P=0.003). Compared with the young and middle-aged ET group, the elderly ET group had significantly greater reductions in visual space and executive ability (P=0.012). Hearing loss in ET patients was associated with the reduction in cognitive function (P=0.005).Conclusions Among the NMSs of ET, hearing loss appears earlier and the reduction in cognitive function occurs later. Elderly ET patients have poorer visual space and executive ability than young and middle-aged ET patients. There is a certain association between hearing loss and the reduction in cognitive function. The pathological and anatomical basis for ET may be early injury of the auditory nerve-brainstem-cerebellum system, while degeneration of the hippocampus-limbic system-cortex occurs later.