DURSUN AYGÜN, Çetin Kürşad AKPINAR, Serpil YON, Musa Kazım ONAR

Effect of clinical autonomic dysfunction on cognitive functions in Parkinson's disease

Giriş: Parkinson hastalığı (PH) tremor, rijidite, bradikinezi ve postural instabilite ile karakterize kronik dejeneratif ilerleyici bir hastalıktır. PH ayrıca otonomik yetmezlik, kognitif bozukluk ve uyku bozukluğu gibi nonmotor bulguları da içerir. Bu klinik bulgular PH'lığının başlangıç zamanı, sıklık ve şiddetine göre değerlendirilmemiştir. Biz PH'daki otonomik disfonksiyonun kognisyon üzerine negatif etkisi olup olmadığını değerlendirdik. Yöntemler: Bu prospektif çalışmaya otonomik yetmezliği olan 37 PH dahil edildi. Her bir hasta konstipasyon, uriner inkontinans, ortostatik hipotansiyon ve hiperhidrozis gibi klinik otonomik disfonksiyon ile ilişkili semptomları içeren SCOPA-AUT anketi ve hastaların on durumundaki klinik durumu Hoehn Yahr (H&Y) skalası ile elde edildi. Hastaların kognitif fonksiyonu mini mental durum muayenesi (MMSE), blessed skoru, frontal değerlendirme ölçeği (FAB), ileri (DSTf) ve geri (DSTr) sayı testi ile değerlendirildi. Kognitif test skorları SCOPA-AUT skoru ile karşılaştırıldı. Bulgular:Yaş ortalaması 66,5±11.2 yıldı. Kognitif test skoru ve SCOPA-AUT skoru arasında istatiksel bir ilişki yoktu (p> 0.05). Fakat H-Y skoru ile DSTf, DSTr, FAB ve MMSE skoru arasında negatif bir korelasyon vardı (p=0.005, r:-0.451; p=0.025, r: -0.367; p=0.040, r: -0.340; p=0.044, r:-0.333, sırasıyla). Sonuçlar: Bizim sonuçlarımıza göre, klinik otonomik disfonksiyonun kognisyon üzerine bir etkisi olmadığıdır. İlave olarak kognitif fonksiyonun ciddiyeti hastalığın evresi ile güçlü negatif bir korelasyon gösterdi.

Parkinson hastalarındaki klinik otonomik disfonksiyonun kognitif fonksiyonlar üzerine etkisi

Objective: Parkinson's disease (PD) is a chronic progressive neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, and postural instability. PD also involves nonmotor manifestations such as autonomic failure, cognitive disorders, and sleep disorders. These clinical characteristics are not identical in severity, frequency, and onset time in all PD patients. We assessed whether there is a negative effect on cognition of clinical autonomic dysfunction in PD patients Methods: This prospective study includes 37 PD patients with autonomic failure. From each patient, a questionnaire (SCOPA-AUT) including symptoms associated with clinical autonomic dysfunction such as constipation, urinary incontinence, orthostatic hypotension, and hyperhydrosis was obtained and the patient's clinical condition was rated on the Hoehn and Yahr (H-Y) scale in the ON-medication state. The patients' cognitive function was assessed by the Mini-Mental State Examination (MMSE), Blessed score, Frontal Assessment Battery (FAB), and Digid Span Test (DST) (forward, reverse). Cognitive test scores were compared with SCOPA-OUT scores. Results: Mean age was 66,5±11.2 years. There was no correlation between cognitive test scores and SCOPA-OUT scores (p> 0.05). However, H-Y scores were negatively correlated with the DSTf, DSTr, FAB, and MMSE scores (p50.005, r:-0.451; p50.025, r: -0.367; p50.040, r: -0.340; p50.044, r5-0.333, respectively). Conclusions: According to our results, clinical autonomic dysfunction did not seem to have an effect on cognition. In addition, severity of cognitive dysfunction showed a strong negative correlation with the stage of disease.

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