1 2 3 1 1 2 3 47 22 I II III 106 1 Tel: 02-23627076 E-mail: huams@ntu.edu.tw resting tremor muscular rigidity bradykinesia
postural disturbance
Calne, 2001
Mortimer, Pirozzolo, Hansch, & Webster, 1982
Original Articles
Zetusky, Jankovic, & Pirozzolo, 1985
Alexander DeLong Strick 1986
Lichter & Cummings, 2001
Cooper, Sagar, Jordan, Harvey, & Sullivan, 1991; Dubois & Pillon, 1997; Levin & Katzen, 1995; Levin, Maria, & Weiner, 1989; Stern, Mayeux, Hermann, & Rosen, 1988
duration; Levin, Llabre, Ansley, Weiner, & Sanchez-Ramos, 1990
Hoehn Yahr 1967 Hoehn and Yahr stage
Van Spaendonck, Berger, Horstink, Buytenhuijs, & Cools, 1996
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Cummings & Huber, 1992
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Brown & Marsden, 1986
Pai & Chan, 2001 Cognitive Ability Screening Instrument, CASI
( 1994
2001 Hsieh & Lee, 1999)
1 2 3 4 159 confusional state Clinical Dementia Rating; Morris, 1993
47 Symptoms Check List-90-Revised, SCL-90-R; 1983 22 64.00 6.84 10.45 4.60 27.00 1.57 MMSE; Folstein, Folstein, & McHugh, 1975 95.91 12.71
Unified Parkinson's Disease Rating Scale, UPDRS; Fahn & Elton, 1987
UPDRS
Mentation, Behavior and Mood Activities of Daily Living
Motor Examination Complications of Therapy
Modified Hoehn and Yahr Stage Schwab and England Schwab and England's Activities of Daily Living Scale; Schwab & England, 1961
gait postural stability
speech UPDRS
Herishanu-Naaman, 1998; Van Spaendonck et al., 1996
N =
5 N = 10 N = 32
Dubois & Pillon, 1997
Temporal Orientation, TO; Benton, Sivan, Hamsher, Varney, & Spreen,
1994 Orientation to
Personal Information and Place, OPIP; Hamsher,
1983 1986
2002
2002 Benton Visual
Retention Test, BVRT; Benton, 1974
Judgment of Line Orientation, JLO; Benton et al., 1994 Facial Recognition Test, FRT; Benton et al., 1994
Three-Dimensional Block Construction Test; Benton et al., 1994
Modified Wisconsin Card Sorting Test; Nelson, 1976
Semantic Association of Verbal Fluency Test; Hua, Chang, & Chen, 1997
A Trail Making Test A; Reitan & Wolfson,
1993 Line Cancellation
Test, Hamsher, 1979
1. ANOVA
2.
Scheffe's method 3. Polyserial correlation coeffi cient, r
p < .01
r = .367; r = - .439
[F(1, 66) = 2.36, p = .129; F(1, 66) =
2.12, p = .150) A A r = .613 A [F(1, 66) = 1.62, p = .207] I II III
-Kruskal-Wallis one-way analysis of variance by ranks
WAIS-R
A
A
[ F ( 3 , 6 4 ) = 1.90, p = .139] [F(3, 64) = 1.44, p = .240] [F(3, 64) = 2.94, p = . 0 4 0 ] [F(3, 64) = 4.89, p = .004] A [F(3, 64) = 1.76, p = .163] ( )
UPDRS r = -.341, p = .019 r = -.312, p = .033 r = -.293, p = .045 r = -.337, p = .020 r = -.316, p = .030 r = -.350, p = .016 r = -.331, p = .023 N = 5 N = 10 N = 32 Tsai, Lu, Hua, Lo, & Lo, 1994
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2004 11 10 2005 04 07 2005 04 11
The Relationship between Neuropsychological Functions and Motor Symptoms in
Low-educated Nondemented Patients with Parkinson's Disease: A Preliminary Study
Cheng-Chang Yang
1, Mau-Sun Hua
2, Yih-Ru Wu
3, and Lung Yu
11Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University 2Department of Psychology, National Taiwan University
3Department of Neurology, Chang Gung Memorial Hospital
Abstract
Objective: In the western literature, cognitive decline in the patients with rigidity and bradykinesia features has been
noted to be more remarkable than those with a predominant motor symptom of tremor. Accordingly, it has been suggested that these patients with various predominant motor symptoms might have heterogeneous neuropathological involvements. Nevertheless, few studies have investigated these issues in Taiwan. In addition, most of our patients are low-educated and incompatible with those with high education level in western societies. Thus, our study attempted to examine the relationship between neuropsychological function and motor symptoms in low-educated patients with Parkinson's disease (PD).
Method: Forty-seven nondemented PD patients with low education level received Unified Parkinson Disease
Rating Scale (UPDRS) for rating their motor severity under "on" condition. Twenty-two healthy subjects, matched for age and education level, served as normal controls. Both groups received a series of neu-ropsychological tests consisting of mainly memory, visuospatial and executive functions.
Results: Data analysis revealed that there was no significant correlation between patients' motor severity and
per-formance on neuropsychological tests. However, patients with a predominant symptom of rigidity showed impaired performance on the cognitive tests while there were no significant differences between patients with a remarkable symptom of tremor or bradykinesia and normal controls in cognitive performance. There were no significant differences between performance of patients with motor staging I and that of normal controls on the neurocognitive tests. However, patients with the stagings II and III performed sig-nificantly poorer on the executive function and/or memory tests.
Conclusion: Based on our preliminary results, we noted that only patients with a predominant motor symptom of
rigidity evidenced remarkable neurocognitive deficits. This result seems to further support findings in western literature. We thus suggest that there is a remarkable relationship between the severity of rigidity and neurocognitive impairments regardless of educational levels. However, since our results were based on a small sample, further investigation on a large scale to re-examine this issue is necessary.