抑郁对早期帕金森病患者认知功能的影响

摘要

Objective To assess the effect of depression on cognitive function in patients with early Parkinson 's disease.Methods Hamilton depression rating scale ( HAMD) was used to divide the 60 patients with early Parkinson's disease into two groups ,namely,depressed Parkinson's disease (DPD) group and non depressed Parkinson's disease (NPD) group.They were investigated by the clinical evaluation and a series of neuropsychological tests which included the Unified Parkinson Disease Rating Scale(UPDRS-III),Revised Hoehn and Yahr Staging Scale(H-Y),mini mental scale examination (MMSE),Wechsler Adult Intelligence Scale Digit Span Test (DST),Digit Symbol Substitution Test ( DSST) ,Animal Fluency Test ( AFT) ,Trail Making Test A ( TMA) ,Clock Drawing Test ( CDT) and Stroop Color Word Test (CWT).Results Compared with healthy controls(HC),NPD group achieved significantly lower scores only in DST backwards, TMA,CWT-C,SIE(P<0.05),while DPD group did in all neuropsychological tests(P<0.05).The score of HAMD was higher in DPD group than in NPD group(P<0.05).All neuropsychological tests except MMSE,DST total score,DST forward score and CWT-B in DPD group were significantly lower than those in NPD group (P<0.05).However,no results were significantly deferent between mild to moder-ate depression group and NPD group ( P>0 .05 ) .Conclusion The depression in early Parkinson's disease might exacerbate cognitive function damage.%目的：探讨抑郁对早期帕金森病（ PD）患者认知功能的影响。方法对60例早期PD患者，依据汉密尔顿抑郁量表（ HAMD）分为抑郁组和非抑郁组。对两组进行临床评估和神经心理学测验，包括统一帕金森病评分量表第3部分（UPDRS-III）、H-Y分期、简易精神状态检查量表（ MMSE）、韦氏成人智力量表数字广度测验（ DST）、数字符号替换测验（DSST）、动物流畅性测验（AFT）、连线测验A（TMA）、画钟测验（CDT）和Stroop色词测验（CWT）。结果非抑郁组仅 DST倒背、TMA 、CWT-C、SIE耗时测验评分差于正常对照组（ P＜0．05），而抑郁组各项神经心理学测验评分均差于正常对照（ P＜0．05）；与非抑郁组比，抑郁组HAMD评分高（P＜0．05），抑郁组除MMSE、DST总分、顺背分、CWT-B测验外，余各项测验评分差（P＜0．05）。轻中度抑郁组与非抑郁组间各项认知测验差异无统计学意义（P＞0．05）。结论抑郁加重早期帕金森病患者多个认知功能领域损害。