Miray ERDEM, Mehmet BALAL, Meltem DEMİRKIRAN

Erken evre Parkinson hastalığında postural stabilite: kognitif ikili görevin etkisi

Amaç: Bu çalışmanın temel amacı, erken evre Parkinson hastalığında (PH)’da statik posturografi cihazı kullanarak postural stabiliteyi değerlendirmektir. İkincil amaç ise erken evre PH’da ikili görevin postural stabilite üzerindeki etkisini incelemektir. Gereç ve Yöntem: Bu prospektif çalışmaya hastalık süresi en fazla beş yıl olan, klinik PI'sı olmayan, yirmi dokuz erken evre PH ile yaş ve cinsiyet uyumlu yirmi dokuz sağlıklı kontrol grubu alındı. Tüm olgulara hareket bozukluğu uzmanı eşliğinde nörolojik muayene ve mini-mental durum muayenesi (MMSE) yapıldı. Parkinson hastalarında Birleşik Parkinson Hastalığı Değerlendirme Ölçeği (BPHDÖ) ve modifiye Hoehn ve Yahr (H&Y) skorları kaydedildi. Postural stabilite, tüm deneklerde statik posturografi cihazında gözler açık, gözler kapalı ve verilen harflerle kelimeler türetmesi istenerek kognitif görev esnasında olmak üzere üç farklı koşul altında değerlendirildi. Bulgular: PH yaş ortalaması 59,2±10,5 ve kontrol grubunun yaş ortalaması 56,3±7,6 (p>0,05), kadın-erkek oranı PH'da 9/20 ve kontrol grubunda 12/17 olup, demografik özellikler açısından her iki grup arasında anlamlı fark saptanmadı. PH grubunda BPHDÖ ortalama skoru 12,8±4,9 idi. Olgular çoğunlukla politerapi almakta idi. Her iki grupta da göz kapalı tüm ölçümlerde salınım değerlerinin, göz açık ölçümlere göre belirgin olarak arttığı gözlendi. Sonuç: İlaç kullanan erken evre PH’da postural stabilitenin korunduğunu ve kognitif görevin bu hastalarda erken evrede postural stabiliteyi etkilemediğini göstermektedir.

Anahtar Kelimeler:

Çift görev çatışması, kognitif görev, Parkinson hastalığı, postural instabilite, postural stabilite, statik posturografi, Dual-task interference, cognitive task, Parkinson’s disease, postural instability, static posturography

Postural stability in early Parkinson’s disease: effect of cognitive dual-tasking

Purpose: The primary aim of this study is to evaluate postural stability by using a static posturography in patients with early Parkinson’s disease (PD). Secondly, this paper addresses the need for illustrating the effect of dual-tasking on postural stability in early PD patients. Materials and Methods: Twenty-nine early PD patients with maximum 5 years of disease duration were included in this study. The selected group had no clinical PI while their age- and sex-matched healthy controls were carried out. Neurological examination and mini-mental state examination (MMSE) were performed in all subjects. Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoehn and Yahr (H&Y) scores were recorded in PD patients. Postural stability was assessed in all subjects on a static posturography platform under three different conditions: eyes open, eyes closed and a cognitive task of producing words with given letters. Results: The mean age of the PD was 59.2±10.5 whereas the control groups mean age was 56.3±7.6 (p>0.05). The female-male ratio was 9/20 in the PD and 12/17 in the control group. There was no important difference between the two groups in terms of demographic characteristics. In the PD group, the mean UPDRS was 12.8±4.9. The patients were mostly receiving polytherapy. Eye closure and cognitive task caused an increase in most sway parameters in both groups. Conclusion: Early PD patients on medication, postural stability is preserved and cognitive dual-tasking does not affect postural stability in these patients in the early stage.

Keywords:

Dual-task interference, cognitive task, Parkinson’s disease, postural instability, static posturography,

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