事件性誘發電位與巴金森氏症患者智能缺損之相關研究

巴金森氏症是一種基底核的退化性疾病，臨床症狀除了震顫、運動不能及僵直外，常伴隨類似額葉損傷的認知功能障礙，這些認知障礙一般以為是額葉-皮質下神經迴路受損所導致。P300-事件性誘發電位，可以反應出人類的認知歷程，常被用來檢測大腦高級皮質功能的異常。本研究旨在為非失智巴金森氏症患者施以額葉功能測驗及P300檢測，藉以瞭解此病之認知功能障礙與P300之關聯性，進而釐清額葉-皮質下組織間神經迴路受損之解剖學病變與心智變化之可能對應關係。我們收集27個Hoehn & Yahr score≦3的非失智巴金森氏症患者（女：男＝10：17；平均年齡為63.3±10.5歲）與27個年齡配對之正常人（女：男＝14：13；平均年齡為63.5±9.2歲）作為控制組，接受額葉功能測驗及P300的評估。與控制組比較，非失智巴金森氏症患者之額葉認知功能有顯著降低。非失智巴金森氏症患者之P300潛時較正常組延長，振幅降低，但並無統計學上顯著的差異。P300的潛時與記憶力、語言流暢及高級執行功能呈現顯著負相關而其振幅與注意力、視覺建構能力、語言流暢及高級執行功能則有顯著正相關。本研究發現，非失智巴金森氏症患者可能出現與額葉功能相關之認知缺損，而此額葉功能障礙與P300存有顯著的相關性。

關鍵字

巴金森氏症； P300 ；額葉功能測驗

並列摘要

Parkinson’s disease（PD）is basically a degeneration disorder of basal ganglia, and is characterized by tremor, akinesia, and rigidity, and sometimes may accompany with cognitive impairment similarity frontal lobe dysfunction. This cognitive impairment was ever explained to be due to the interruptions of frontal-subcortical neural circuits, or the dysregulation of neurotransmitters. The P300, an event-related potential that reflects human cognitive process, has been used to test higher brain functions in neurological dysfunction. To evaluate the correlation between P300 and cognitive impairment in PD patients, 27 non-demented PD patients （female：male＝10：17；age＝63.3±10. 5 y/o；Hoehn & Yahr score≦3） and 27 age-matched controls （female：male＝14：13；age＝63.5±9.2 y/o）were rendered for The Frontal Lobe Battery Test and P300. Comparing with controls, the non-demented PD patients manifested with significant cognitive impairment, but did not P300 abnormality, although P300 latency delay and P300 amplitude decrease were apparent. In non-demented PD patients, there was significant negative correlation between P300 latency and memory, verbal fluency, and higher executive function, and significant positive correlation between P300 amplitude and attention, concentration, visuo-constructional ability, verbal fluency and higher executive function. We conclude that the non-demented PD patients may manifest with significant cognitive impairment related to frontal lobe dysfunction. These significant correlation between cognitive impairment and P300 in these patients.