摘要
目的探讨早期帕金森病（PD）患者汉语视觉语言工作记忆损害特点。方法仿制并修订了Smith工作记忆检查软件，对确诊的早期PD患者和对照组进行汉字字形和语音性语言工作记忆检查。结果PD组（20例）字形性语言工作记忆检查的成绩（91．8％±1．9％）与对照组（25例）成绩（正确率91．3％±1．4％）相似，差异无统计学意义（t=0．224，P=0．823）。PD组（25例）语音性语言工作记忆检查的成绩（正确率89．3％±6．3％）明显低于对照组（25例）成绩（正确率94．1％±5．1％），差异有统计学意义（t=2．96，P=0．007）。根据声调和音节两个要素将测试汉字细分为同音同调、同音不同调、同调不同音、音调都不同4种情况，分别统计汉字语音性语言工作记忆的正确率，结果表明仅在同音不同调的情况下PD组的成绩（80．2％±2．5％）明显低于对照组成绩（86．3％±1．8％），差异有统计学意义（t=2．66，P=0．01）。左侧肢体起病的患者语音性语言工作记忆的成绩低于对照组成绩，差异有统计学意义（左侧肢体起病PD患者正确率为88．0％±6．5％，对照组正确率为94．1％±5．1％，t=3．197，P=0．003）。结论早期PD患者存在语音性语言工作记忆的损害，声调对于语音性语言工作记忆受损起着重要的作用；字形性语言工作记忆相对保留。推测字形和语音性语言工作记忆加工应用不同的神经环路。
Objective To investigate the characteristics of Chinese characters morphological and phonetic working memory in early Parkinson disease （PD） patients and the underlying neuropsychological and patho-physiological mechanisms. Methods The Smith working memory software was modified and further developed to be used to investigate the Chinese characters morphological and phonetic working memory in early PD patients and healthy controls. Results Twenty early PD patients, 10 males and 10 females, aged （62.2 ± 2.3）, with （13.6 ± 0.6） years of full-time study and the MMSE score of （28.2 ± 0. 5）, and 25 sex, age, schooling time, and MMSE score-matched healthy controls underwent Chinese characters morphological working memory test. The correct rate of Chinese characters morphological working memory of the PD patients was 91.8% ± 1.9%, not significantly different from that of the healthy controls （91.3% ± 1.4%, P = 0. 823）. Twenty-five early PD patients, 13 males and 12 females, aged （64 ± 11 ）, with （ 14.4 ± 2. 2） years of full-time study and the MMSE score of （28.9 ±0.4）, and 25 sex, age, schooling time, and MMSE score-matched healthy controls underwent Chinese characters phonetic working memory test. The correct rate of Chinese characters phonetic working memory of the PD patients was 89.3% ±6.3%, significantly lower than that of the healthy controls （94. 1% ± 5.1%, P = 0. 007 ）. Further more the Chinese characters in the test were classified into four groups according to the syllable and intonation： with same syllable and same intonation, with same syllable and different intonation, with different syllable and same intonation, and with both different syllable and intonation. The correct rates to these groups were recorded separately. The correct rate to Chinese character group of the same syllable with different intonation of the PD patients was 80.2% ± 2. 5% , significantly lower than that of the healthy controls （86. 3% ± 1.8%, P=0. 01 ）, and there were not significant differences in the correct rate to other Chinese character groups. The correct rate of phonetic working memory of the PD patients with left extremity onset was 88.0% ±6.5%, significantly lower than that of the healthy controls （94. 1% ± 5.1%, P = 0. 003）. Conclusion Phonetic verbal working memory impairment exists in early PD patients. Intonation may play a role in the phonetic verbal working memory impairment in the early PD patients. Different verbal working memory subsystems may use different neurocircuits.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第7期438-441,共4页
National Medical Journal of China
关键词
帕金森病
记忆障碍
认知
Parkinson disease
Memory disorders
Cognition
