Neurology:帕金森病轻度认知障碍的自然病程是怎样的?

2017-01-21 xing.T MedSci原创

早期帕金森病轻度认知功能障碍,无论是持续或恢复到正常的认知,对于帕金森病患者预测老年痴呆症具有预后判断价值。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在评估了帕金森病患者5年期间轻度认知功能障碍的发生、发展和逆转。

该研究以帕金森患者人群为基础的队列,研究对象分别在研究之初(n=178)、1年(n=175)、3年(n=163)和5年(n=150)接受重复的神经心理测试,主要包括注意力、执行功能、记忆力、视觉空间能力。患者根据公布的标准被分为帕金森病轻度认知功能障碍患者和已诊断的老年痴呆症患者。

在研究之初共有36名患者(20.2%)复合帕金森病轻度认知功能障碍的标准。在研究之初认知功能正常的患者(n=142)中,帕金森病轻度认知功能障碍的累积发生率随访1年后为9.9%,3年后为23.2%,5年后为28.9%。总体而言,在5年的研究期间39.1%的在研究之初已是帕金森病轻度认知功能障碍的患者或期间发生帕金森病轻度认知功能障碍的患者进展为痴呆。帕金森病轻度认知功能障碍持续1年的痴呆转化率为59.1%,而在第一年认知正常的参与者为7.2%(调整后的比值比为16.6,95%可信区间为5.1–54.7,P<0.001)。在研究结束时27.8%的在研究之初已是帕金森病轻度认知功能障碍的患者和24.2%研究期间发展为帕金森病轻度认知功能障碍的患者恢复正常的认知,但在那些持续帕金森病轻度认知功能障碍的患者中连续随访2次恢复率下降至9.4%。与认知功能正常的患者相比,在随访前3年帕金森病轻度认知功能障碍恢复的患者在随后发生痴呆的风险增加(调整后的比值比为10.7,95%可信区间为1.5–78.5,P=0.019)。

由此可见,早期帕金森病轻度认知功能障碍,无论是持续或恢复到正常的认知,对于帕金森病患者预测老年痴呆症具有预后判断价值。

原始出处:


Kenn Freddy Pedersen,  et al. Natural course of mild cognitive impairment in Parkinson disease. Neurology.2017.http://www.neurology.org/content/early/2017/01/20/WNL.0000000000003634.short

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    2017-09-11 yinhl1978
  3. [GetPortalCommentsPageByObjectIdResponse(id=1740364, encodeId=2a171e403643e, content=<a href='/topic/show?id=6f088626603' target=_blank style='color:#2F92EE;'>#自然病程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86266, encryptionId=6f088626603, topicName=自然病程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e00d34741921, createdName=siiner, createdTime=Thu Apr 06 00:39:00 CST 2017, time=2017-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999810, encodeId=c60b1999810d1, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Sep 11 19:39:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171988, encodeId=31421e1988bb, content=因质疑而辩驳,因辩驳而彰显真理, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Jan 22 13:31:56 CST 2017, time=2017-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171891, encodeId=7cf71e1891f7, content=阅读了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Jan 22 07:17:33 CST 2017, time=2017-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171877, encodeId=b4cd1e1877c5, content=内容很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Sun Jan 22 06:59:31 CST 2017, time=2017-01-22, status=1, ipAttribution=)]
    2017-01-22 虈亣靌

    因质疑而辩驳,因辩驳而彰显真理

    0

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    2017-01-22 刘煜

    阅读了谢谢分享

    0

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    2017-01-22 1dd8aa01m06(暂无匿称)

    内容很好

    0

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