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世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 23-24页

作者： dujardin K. Defebvre L. duhamel A. 江山 neurol. et pathologie du mouvement Neurologie A Centre Hospitalier Universitaire 59037 Lille Cedex France

Objective: To identify features in cognitive functioning and regional cerebral blood flow (rCBF) in newly diagnosed Parkinson’ s disease (PD) patients and to determine whether these factors are able to predict the progression of the disease in general and the development of cognitive decline in particular. Methods: 50 previously treatment- naive PD patients participated in the study. Cognitive assessment and SPECT were performed twice: at the time of diagnosis and then 3 years later. Six patients died or refused to continue. The Mattis dementia rating scale, the WAIS- R digit span test, a word list learning/recall test, a word fluency task and the Stroop word- colour test were used to assess cognitive function. rCBF was measured in 10 pairs of regions of interest. Principal component analysis of the data from the final examination was used to determine which variables allowed the formation of patient subgroups. Thereafter, factorial discriminant analysis (FDA) was performed in order to obtain a predictive model of these final classes. Results: A stepwise procedure enabled the identification of 3 clusters (26, 16 and 2 patients). As the patients in the smallest cluster met the criteria for dementia at the final examination, they were discarded from further analyses. All the cognitive variables contributed to the constitution of the two other clusters. Age, educational level and all the rCBF parameters also contributed but to a lesser extent. Comparison of these groups showed reduced overall cognitive efficiency and an exacerbated subcorticofrontal syndrome in the 16- patient cluster. FDA showed that the best predictive model for the final classes was based on 7 variables: educational level, semantic and alternating word fluency, Stroop interference index and the right medial frontal, left parietal and left lenticular nucleus rCBF findings. Conclusion: Even though both cognitive and rCBF parameters help predict the progression of newly diagnosed PD patients and bearin

关键词：帕金森病 SPECT检查认知功能 rCBF 数字广度预测模型主成分分析局部脑血流量等级量表豆状核

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皮质基底节变性、进行性核上性麻痹、多系统萎缩和帕金森病患者的口面失用症

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世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 20-20页

作者： Ozsancak C. Auzou P. dujardin K. 高中宝 Serv. neurol. Pathol. du mouvement EA 2683 CHU de Lille 59037 Lille Cedex France Dr.

Objectives: To determine whether the assessment of orofacial praxis is useful for the differential diagnosis of parkinsonian syndromes and to understand the neural mechanisms underlying OFA, searching for the respective roles of cortical and subcortical structures. Methods: Forty- four patients were assessed: 12 with idiopathic Parkinson’ s disease (IPD), 8 with multiple system atrophy (MSA), 12 with progressive supranuclear palsy (PSP) and 12 with corticobasal degeneration (CBD). An easy bedside scale was used, exploring single gestures, gestures with noise production and multiple sequential gestures. We searched for group and task effects. Results: Patients with CBD were significantly more impaired than those with IPD, MSA or PSP (p etween the IPD, MSA and PSP groups. There was a clear task effect in CBD with a major impairment in multiple sequential gestures (p etal lobule and the supplementary motor area.

关键词：皮质基底节变性多系统萎缩帕金森病失用症鉴别诊断神经机制辅助运动评价指标临床诊断

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