Suna SARIKAYA, Tahir Kurtuluş YOLDAŞ, Neşe Güngör YAVAŞOĞLU

Evaluation of cognitive functions in Parkinson's patients without dementia with auditory event related potential (P300)

Amaç: İdiyopatik Parkinson hastalığı, dopaminerjik sinir sistemi dejenerasyonuna bağlı olarak gelişen akinezi, rijidite ve tremor ile karakterize bir tablodur. Hareket bozukluğuna zaman içerisinde hastalığın ilerlemesi ile birlikte depresyon, kognitif fonksiyon bozukluğu ve bilişsel fonksiyonlarda etkilenme değişen oranlarda eklenir. P300 bileşeni Parkinson hastalığında bilişsel işleme çalışmaları için yararlı bir parametredir, çünkü motor becerilerden bağımsızdır. Bu çalışmada demansı olmayan idiyopatik Parkinson hastalarının kognitif işlevlerini olaya ilişkin uyarılmış potansiyellerden P300 testi ile değerlendirerek, Parkinson hastalığının kognitif fonksiyonlar üzerine etkisini göstermeyi amaçladık. Yöntem: Yaşları 40 ile 80 arasında değişen (ortalama 58.8) 25 erkek ve 13 kadın olmak üzere toplam 38 hasta ve kontrol grubu olarak da serebrovasküler hastalık öyküsü, demans ve depresyonu olmayan, yaşları 44 ile 84 arasında değişen (ortalama 63.5) 25 erkek ve 14 kadın olmak üzere toplam 39 gönüllü çalışmaya alındı. Katılımcılara çalışmanın içeriği, uygulanışı ile ilgili bilgi verildi ve onam formu alındı. Hastalara, nörolojik muayene, Standardize Mini Mental Test, Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (UPDRS), Hoehn ve Yahr Ölçeği, Hamilton Depresyon Ölçeği (HDÖ) ve P300 testleri uygulandı. Kontrol grubuna Standardize Mini Mental Test, HDÖ ve P300 testleri uygulandı. Bulgular: Parkinson hastalarının P300 latansları, kontrol grubuna göre anlamlı düzeyde daha uzundu. Parkinson hastalarında HDÖ puanları arttıkça P300 amplitüd değerlerinde azalma görülmekteydi. Sonuç: P300 latansı, mental sürecin stimulus sınıflama hızını, dikkat ve zihinsel işlemeyi yansıtır. Parkinson hastalarında demans olmasa da bu işlevlerde bir bozukluk vardır ve bu da motor becerilerden bağımsız bir test olan P300 testi ile gösterilebilir.

Demansı olmayan Parkinson hastalarında işitsel olaya bağlı potansiyel (P300) ile kognitif fonksiyonların değerlendirilmesi

Objective: Idiopathic Parkinson's disease is a clinical situation characterized by akinesia, rigidity, and tremor, and results from the degeneration of the dopaminergic nervous system. As the disease progresses over time, depression, cognitive dysfunction and alterations in cognitive functions are added to the movement disorder at varying rates. The P300 component is a useful parameter for cognitive processing studies on PD patients, as it is independent from motor skills. The current study aimed to show the effects of the PD on the cognitive functions by evaluating the cognitive functions of IPD patients without dementia with the help of an event related potential component, P300 test. Methods: Thirty-eight patients (25 males and 13 females), ranging in age between 40 and 80 years (mean: 58.8 years), were included to the study and the control group consisted of 39 volunteers (25 males and 14 females), ranging in age between 44 and 84 years (mean: 63.5 years), who did not have a history of cerebrovascular disease, dementia, or depression. The participants were informed about the content and the practice of the study, and informed consent forms were obtained. Neurological examination, standardized mini mental test, Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale, Hamilton Depression Rating Scale (HAM-D), and P300 tests were performed on the patients. Standardized mini mental test (SMMT), HAM-D, and P300 tests were performed in the control group. Results: P300 latencies in Parkinson's patients were significantly prolonged compared to the control group. There was a decrease in P300 amplitude values with increasing HAM-D.Conclusion: P300 latency reflects the rate of stimuli classification by mental process, attention, and cognitive processing. Even if no dementia is present in PD patients, there is a dysfunction in these functions, and it can be demonstrated by the P300 test, which is independent from motor skills.

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