帕金森认知障碍的研究进展
1. 四川外国语大学, 英语学院/语言脑科学研究中心, 重庆 400031
2. 成都师范学院, 外国语学院, 四川成都 611130
| 摘 要： | 帕金森疾病（PD）是中老年人群体中最容易致残的疾病之一，主要表现为语言障碍和非语言障碍等，大大降低他们的生活质量。本文阐述了帕金森患者在非语言认知障碍，如记忆衰退，执行能力下降和注意力衰退的具体表现以及其背后的神经机制。结果发现，帕金森患者的记忆方面主要表现为工作记忆出现衰退，可能与大脑外侧额叶和顶叶皮质的损伤有关；PD患者的执行能力（即能够完成日常活动）主要体现在身体难以保持平衡，与其大脑皮质的体积和表面积减少有关；PD患者的注意力容易发生转移且出现损伤问题，与中脑多巴胺过度活跃、内侧额叶和外侧前额叶皮质等减少有关。根据PD患者的上述非语言认知障碍的表现，本文还介绍了通过患者手部和语音两方面的诊断方法、运动症状与非运动症状的治疗以及步态干预的方法，以期提高人们对PD患者的认识。 |
| 关 键 词： | 帕金森疾病; 非语言认知障碍; 神经机制 |
| DOI： | 10.57237/j.mrf.2023.01.001 |
View:
Downloads:
收稿日期: 2022-11-26
接受日期: 2023-01-30
在线出版日期: 2023-02-03
The Research Progress of Parkinson's Nonverbal Cognitive Impairment
1. School of English/Language Brain Science Research Center, Sichuan International Studies University, Chongqing 400031, China
2. School of Foreign Languages, Chengdu Normal University, Chengdu 611130, China
| Abstract: | Parkinson's disease (PD) is one of the most disabling diseases in the middle-aged and elderly population. The cognitive decline of the middle-aged and elderly, such as verbal disorder and nonverbal disorder, has severely impacted their life. This paper systematically expounds the specific manifestations of Parkinson's patients with nonverbal cognitive impairment, like memory impairment, executive ability impairment and attention impairment, as well as revealing the neural mechanism behind them. The result shows that the decline of working memory may be related to the damage of the lateral frontal lobe and parietal cortex. PD patients' executive ability is mainly reflected in their difficulty in keeping balance, which is related to the reduction of the volume and surface area of their cerebral cortex. The attention of PD patients is easily diverted and damaged, associating with the hyperactivity of dopamine in midbrain, the decrease of medial prefrontal cortex and lateral prefrontal cortex. Based on these nonverbal cognitive impairment of PD patients, this paper also introduces the diagnosis methods of PD through the patients' hands and voice, the treatment of motor symptoms and non-motor symptoms, and the gait intervention methods, so as to improve people's understanding of PD patients. |
| Keywords: | Parkinson Disease; Nonverbal Cognitive Impairment; Neural Mechanism |
基金
| 1. | 成都师范学院在职攻读博士学位人员科研项目 (ZZBS2020-05) |
参考文献
| [1] | Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008; 79 (4 ): 368 - 376. |
| [2] | Tysnes OB, Storstein A. Epidemiology of parkinson's disease. Journal of neural transmission (Vienna, Austria: 1996) 2017; 124 (8): 901-905. |
| [3] | Olesen J, Gustavsson A, Svensson M, et al. The economic cost of brain disorders in europe. European journal of neurology 2012; 19 (1): 155-162. |
| [4] | Kouli A, Torsney KM, Kuan WL. Parkinson’s Disease: Etiology, Neuropathology, and Pathogenesis. In: Stoker TB, Greenland JC, eds. Parkinson’s Disease: Pathogenesis and Clinical Aspects [Internet]. Brisbane, Australia: Codon Publications; 2018. https://www.ncbi.nlm.nih.gov/books/NBK536722/. Accessed September 6, 2019. doi: 10.15586/codonpublications. parkinsonsdisease.2018.ch1 |
| [5] | Armstrong M J, Okun M S. Diagnosis and Treatment of Parkinson Disease: A Review [J]. JAMA The Journal of the American Medical Association, 2020, 323 (6): 548. |
| [6] | Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003; 24 (2): 197-211. doi: 10.1016/S0197-4580 (02)00065-9. |
| [7] | Galbiati A, Verga L, Giora E, Zucconi M,Ferini-Strambi L. The risk of neurodegeneration in REM sleep behavior disorder: a systematic review and meta-analysis of longitudinal studies. Sleep Med Rev. 2019; 43: 37-46. doi: 10.1016/j.smrv.2018.09.008 |
| [8] | Owen, A. M., McMillan, K. M., Laird, A. R., & Bullmore, E. (2005). Nback working memory paradigm: A meta-analysis of normative functional neuroimaging studies. Human Brain Mapping, 25 (1), 46e59. http://dx.doi.org/10.1002/hbm.20131. |
| [9] | Barbey, A. K., Colom, R., Paul, E. J., & Grafman, J. (2014).Architecture of fluid intelligence and working memory revealed by lesion mapping. Brain Structure & Function, 219 (2),485e494. http: //dx.doi.org/10.1007/s00429-013-0512-z. |
| [10] | Choi, E. Y., Yeo, B. T. T., & Buckner, R. L. (2012). The organization of the human striatum estimated by intrinsic functional connectivity. Journal of Neurophysiology, 108 (8), 2242e2263. http://dx.doi.org/10.1152/jn.00270.2012. |
| [11] | Bezdicek O, Ballarini T, Buschke H, et al. Memory impairment in Parkinson's disease: The retrieval versus associative deficit hypothesis revisited and reconciled.[J]. Neuropsychology, 2019, 33 (3): 391-405. |
| [12] | Li S, Ou R, Yuan X, et al. Executive dysfunctions and behavioral changes in early drug-naïve patients with Parkinson's disease [J]. Journal of Affective Disorders, 2018, 243: 525-530. |
| [13] | Tangen GG, Engedal K, Bergland A, Moger TA, Mengshoel AM. Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and Alzheimer disease. Phys Ther. 2014; 94 (8): 1123-1134. |
| [14] | Lacour M, Bernard-Demanze L, Dumitrescu M. Posture control, aging, and attention resources: models and posture-analysis methods [Review]. Neurophysiol Clin. 2008; 38 (6): 411 - 421. |
| [15] | Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly [Review]. Neurophysiol Clin. 2008; 38 (6 ): 467-478. |
| [16] | Ismail Z, Smith EE, Geda Y, et al. Neuropsychiatric symptoms as early manifestations of emergent dementia: provisional diagnostic criteria for mild behavioral impairment. Alzheimers Dement 2016; 12: 195–202. |
| [17] | Cano J, Chan V, Kan CN, et al. Mild behavioral impairment: prevalence in clinical setting and cognitive correlates. Alzheimers Dement 2018; 14: P639–P640. |
| [18] | Yoon, E. J., Ismail, Z., Hanganu, A., Kibreab, M., Hammer, T., Cheetham, J.,... & Monchi, O. (2019). Mild behavioral impairment is linked to worse cognition and brain atrophy in Parkinson disease. Neurology, 93 (8), e766-e777. |
| [19] | Madureira D Q M, Carvalho L A V, Cheniaux E. Attentional Focus Modulated by Mesothalamic Dopamine: Consequences in Parkinson's Disease and Attention Deficit Hyperactivity Disorder [J]. Cognitive Computation, 2010, 2 (1): 31-49. |
| [20] | Cools R, Rogers R, Barker RA, Robbins TW. Top-down attentional control in Parkinson’s disease: salient considerations. J Cogn Neurosci 2010; 22: 848e59. |
| [21] | Barrett, M. J., Murphy, J. M., Zhang, J., Blair, J. C., Flanigan, J. L., Nawaz, H.,... & Druzgal, T. J. (2021). Olfaction, cholinergic basal forebrain degeneration, and cognition in early Parkinson disease. Parkinsonism & Related Disorders, 90, 27-32. |
| [22] | 张颖, 徐志京. 基于深度学习的帕金森患者声纹识别 [J]. 计算机工程与设计, 2019, 40 (7): 7. |
| [23] | 崔丽莉, 程刚. PET/CT对帕金森病早期诊断价值的研究 [J]. 中国临床医学影像杂志, 2018, 29 (6): 4. |
| [24] | 谭言丹, 赵阳洋, 赵光财. 基于深度学习的帕金森病诊断[J]. 计算机工程与设计, 2021, 42 (8): 7. |
| [25] | Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and movement disorder society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson’s disease. Mov Disord. 2018; 33 (8): 1248-1266. doi: 10.1002/mds.27372. |
| [26] | Garcia-Ruiz PJ, Martinez Castrillo JC, Alonso-Canovas A, et al. Impulse control disorder in patients with Parkinson’s disease under dopamine agonist therapy: a multicentre study.J Neurol Neurosurg Psychiatry. 2014; 85 (8): 840-844. doi: 10.1136/jnnp-2013-306787 |
| [27] | Factor SA, Bennett A, Hohler AD, Wang D, Miyasaki JM. Quality improvement in neurology: Parkinson disease update quality measurement set: executive summary. Neurology. 2016; 86 (24): 2278-2283. doi: 10.1212/WNL.0000000000002670. |
| [28] | Marinelli L, Trompetto C, Canneva S, et al. Learning "How to Learn": Super Declarative Motor Learning Is Impaired in Parkinson's Disease. Neural Plast 2017; 2017: 3162087. |
| [29] | Nóbrega-Sousa P, Gobbi LTB, Orcioli-Silva D, Conceição NR da, Beretta VS, Vitório R. Prefrontal cortex activity during walking: effects of aging and associations with gait and executive function. Neurorehabil Neural Repair. 2020; 34: 915-924. doi: 10.1177/1545968320953824. |
| [30] | Fiorelli CM, Ciolac EG, Simieli L, et al. Differential acute effect of high-intensity interval or continuous moderate exercise on cognition in individuals with Parkinson’s disease. J Phys Act Health. 2019; 16: 157-164. doi: 10.1123/jpah.2018-0189. |
| [31] | Boggio PS, Ferrucci R, Rigonatti SP, et al. Effects of transcranial direct current stimulation on working memory in patients with Parkinson’s disease. J Neurol Sci. 2006; 249: 31-38. doi: 10.1016/j.jns.2006.05.062 |
| [32] | Nitsche M, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000; 527 (pt 3): 633-639. |
| [33] | Zheng X, Alsop DC, Schlaug G. Effects of transcranial direct current stimulation (tDCS) on human regional cerebral blood flow. Neuroimage. 2011; 58: 26-33. doi: 10.1016/j.neuroimage.2011.06.018. |
| [34] | Núbia Ribeiro Conceio, Gobbi L T B, Priscila Nóbrega-Sousa, et al. Aerobic Exercise Combined With Transcranial Direct Current Stimulation Over the Prefrontal Cortex in Parkinson Disease: Effects on Cortical Activity, Gait, and Cognition [J]. Neurorehabilitation and Neural Repair, 2021: 15459683211019344. |
| [35] | Rose T, Nam CS, Chen KB. Immersion of virtual reality for rehabilitation - Review. Appl Ergon 2018; 69: 153-161. |
| [36] | Canning, C. G., Allen, N. E., Nackaerts, E., Paul, S. S., Nieuwboer, A., & Gilat, M.. Virtual reality in research and rehabilitation of gait and balance in parkinson disease. Nature Reviews Neurology, 2020. |
