2004 97-106 Original Articles 1 2 3 1 1 2 3 47 22 III I II muscular rigidity postural disturbance resting tremor bradykinesia Calne, 2001 Mortimer, Pirozzolo, Hansch, & Webster, 1982 Tel: 02-23627076 E-mail: huams@ntu.edu.tw 106 1
98 Zetusky, Jankovic, & Pirozzolo, 1985 Alexander DeLong Strick 1986 2001 Lichter & Cummings, 159 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 frontal-striatal circuit; Dubois & Pillon, 1997 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 Cummings & Huber, 1992 Levin, Llabre, Reisman, Weiner, Sanchez-Ramos, & Singer, 1991 Brown & Marsden, 1986 Pai & Chan, 2001 Cognitive Ability Screening Instrument, CASI ( 1994 2001 Hsieh & Lee, 1999) 2 1 3 4 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 Vakil &
99 ( ) Herishanu-Naaman, 1998; Van Spaendonck et al., 1996 5 N = 10 N = 32 Dubois & Pillon, 1997 N = 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) =
100 2.12, p =.150) A r =.613 A - Kruskal-Wallis one-way analysis of variance by ranks WAIS-R.207] A [F(1, 66) = 1.62, p = A III I II A ( )
101 [ F (3, 64) = 1.90, p =.139] [F(3, 64) = 1.44, p =.240] [F(3, 64) = 2.94, p =.040] [F(3, 64) = 4.89, p =.004] A [F(3, 64) = 1.76, p =.163] ( )
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106 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 1 1 Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University 2 Department of Psychology, National Taiwan University 3 Department of Neurology, Chang Gung Memorial Hospital Abstract Objective: Method: Results: Conclusion: Key words: 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). 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 neuropsychological tests consisting of mainly memory, visuospatial and executive functions. Data analysis revealed that there was no significant correlation between patients' motor severity and performance 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 significantly poorer on the executive function and/or memory tests. 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. Parkinson's Disease; Neuropsychological Function; Motor Disability