Parkinson 病の記憶機能 神経心理学的検査と脳血流による検討
Parkinson 病 (PD) 患者の記憶障害を神経心理学的に明らかにし, その記憶障害がPDのどの病巣と関係があるのかについて検討した. 対象はPD 24例 (年齢65.8歳), 健常者12例 (年齢67.0歳) である. 記憶機能検査として Rey's auditory-verbal learning test (RAVLT), Rey-Osterrieth complex figure test (RCFT) を施行した. 関連検査として Mini-Mental State Examination (MMSE), Zung's self-rating depress...
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| Published in | 日本老年医学会雑誌 Vol. 38; no. 2; pp. 193 - 200 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本老年医学会
25.03.2001
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0300-9173 |
| DOI | 10.3143/geriatrics.38.193 |
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| Abstract | Parkinson 病 (PD) 患者の記憶障害を神経心理学的に明らかにし, その記憶障害がPDのどの病巣と関係があるのかについて検討した. 対象はPD 24例 (年齢65.8歳), 健常者12例 (年齢67.0歳) である. 記憶機能検査として Rey's auditory-verbal learning test (RAVLT), Rey-Osterrieth complex figure test (RCFT) を施行した. 関連検査として Mini-Mental State Examination (MMSE), Zung's self-rating depression scale (SDS), Verbal fluency test (VFT), Wisconsin card sorting test (WCST), Hanoi の塔課題 (Hanoi) を施行した. また局所脳血流測定は123I-iodoamphetamine (123I-IMP) をトレーサーとしたSPECTを用いて行い, 局所脳血流は半定量的に脳各部位/小脳の123I-IMP活性比を計算し, rCBF index として評価した. PD群は健常群に比しMMSEスコア低下, SDSスコア高値, VFTおよびWCSTの成績低下が認められた. 記憶機能ではRAVLTで自由再生数は低下していたが再認, 学習率, 忘却率は比較的保たれていた. RCFTでは copy に両群間で差はなかったが, 再生数, %再生スコアがPD群で低下していた. RAVLTの総再生数は Columbia scale スコア, SDSスコア, MMSEスコア, 罹病期間と, RCFTの%再生スコアは Columbia scale スコアと相関していた. またRAVLTの総再生数は前頭前野, 頭頂葉の rCBF index と, RCFTの%再生スコア (30分) は頭頂葉, 後頭葉のrCBF index と相関していた. 以上よりPDの記憶障害 (特に聴覚性)の主な原因は一連の情報処理過程の中の検索過程にあり, またRAVLTにより評価された聴覚性再生障害は主として前頭葉, 頭頂葉機能障害と, RCFTにより評価された視覚性再生障害は頭頂葉, 後頭葉機能障害と関与していることが示唆された. |
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| AbstractList | Parkinson 病 (PD) 患者の記憶障害を神経心理学的に明らかにし, その記憶障害がPDのどの病巣と関係があるのかについて検討した. 対象はPD 24例 (年齢65.8歳), 健常者12例 (年齢67.0歳) である. 記憶機能検査として Rey's auditory-verbal learning test (RAVLT), Rey-Osterrieth complex figure test (RCFT) を施行した. 関連検査として Mini-Mental State Examination (MMSE), Zung's self-rating depression scale (SDS), Verbal fluency test (VFT), Wisconsin card sorting test (WCST), Hanoi の塔課題 (Hanoi) を施行した. また局所脳血流測定は123I-iodoamphetamine (123I-IMP) をトレーサーとしたSPECTを用いて行い, 局所脳血流は半定量的に脳各部位/小脳の123I-IMP活性比を計算し, rCBF index として評価した. PD群は健常群に比しMMSEスコア低下, SDSスコア高値, VFTおよびWCSTの成績低下が認められた. 記憶機能ではRAVLTで自由再生数は低下していたが再認, 学習率, 忘却率は比較的保たれていた. RCFTでは copy に両群間で差はなかったが, 再生数, %再生スコアがPD群で低下していた. RAVLTの総再生数は Columbia scale スコア, SDSスコア, MMSEスコア, 罹病期間と, RCFTの%再生スコアは Columbia scale スコアと相関していた. またRAVLTの総再生数は前頭前野, 頭頂葉の rCBF index と, RCFTの%再生スコア (30分) は頭頂葉, 後頭葉のrCBF index と相関していた. 以上よりPDの記憶障害 (特に聴覚性)の主な原因は一連の情報処理過程の中の検索過程にあり, またRAVLTにより評価された聴覚性再生障害は主として前頭葉, 頭頂葉機能障害と, RCFTにより評価された視覚性再生障害は頭頂葉, 後頭葉機能障害と関与していることが示唆された. |
| Author | 立花, 久大 渋谷, 直美 杉田, 實 川端, 啓太 |
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| References | 9) Jones-Gotman M: Memory for designs: The hippocampal contribution. Neuropsychologia 1986; 24: 193-203. 4) Reitan RM, Walfson D: A selective and critical review of neuropsychological deficits and the frontal lobes. Neuropsychol Rev 1994: 4: 161-198. 12) Tachibana H, Tomino Y, Kawabata K, Sugita M, Fukuchi M: Twelve-month follow-up study of regional cerebral blood flow in Parkinson's disease. Dementia 1995; 6: 89-93. 18) Cooper JA. Sagar HJ: Incidental and intentional recall in Parkinson's disease: An account based on diminished attentional resources. J Clin Exp Neuropsychol 1993; 15: 713-731. 28) Fletcher PC, Frith CD, Rugg MD: The functional neuroanatomy of episodic memory. Trends Neurosci 1997; 20: 213-220. 11) Talairach J, Tournoux P: Co-Planar stereotaxic atlas of the human brain. Thieme Medical Publishers Inc, New York, 1988. 17) Kuzis G, Sabe L, Tiberti C, Leiguarda R, Starkstein SE: Cognitive functions in major depression and Parkinson disease. Arch Neurol 1997; 54: 982-986. 8) Lhermitte F, Agid Y, Signoret JL: Onset and end-of doses levodopa-induced dyskinesias: possible treatment by increasing the daily dose of levodopa. Arch Neurol 1978; 35: 261-263. 20) Hu MTM, Taylor-Robinson SD, Chaudhuri KR, Bell JD, Labbé C, Cunningham VJ, et al.: Cortical dysfunction in non-demented Parkinson's disease patients. A combined 31P-MRS and 13FDG-PET study. Brain 2000; 123; 340-352. 26) Milner B, Petrides M: Behavioural effects of frontal-lobe lesions in man. Trends Neurosci 1984; 7: 403-407. 16) Levin BE, Llabre MM, Weiner WJ: Cogitive impairments associated with early Parkinson's disease. Neurology 1989; 39: 557-561. 2) Owen AM, Roberts AC, Hodges JR, Summers BA, Polkey CE, Robbins TW: Contrasting mechanisms of impaired attentional set-shifting in patients with frontal lobe damage or Parkinson's disease. Brain 1993; 116: 1159-1175. 24) Grasby PM, Frith CD, Friston KJ, Bench C, Frackowiak RSJ, Dolan RJ: Functional mapping of brain areas implicated in auditory-verbal memory function. Brain 1993; 116: 1-20. 22) Ranganath C, Paller KA: Frontal brain activity during episodic and semantic retrieval: Insights from eventrelated potentials. J Cogn Neurosci 1999; 11: 598-609. 21) Shallice T, Fletcher P, Frith CD, Grasby P, Frackowiak RSJ, Dolan RJ: Brain regions associated with acquisition and retrieval of verbal episodic memory. Nature 1994; 368: 633-635. 13) Markus HS, Lees AJ, Lennox G, Marsden CD, Costa DC: Patterns of regional cerebral blood flow in corticobasal degeneration studied using HMPAO SPECT; Comparison with Parkinson's disease and normal controls. Mov Disord 1995; 10: 179-187. 7) Tachibana H, Aragane K, Kawabata K, Sugita M: P3 latency change in aging and Parkinson disease. Arch Neurol 1997; 54; 296-302. 1) Taylor AE, Saint-Cyr JA, Lang AE: Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain 1986; 109: 845-883. 25) Double KL, Halliday GM, McRitchie DA, Reid WGJ, Hely MA, Morris JGL: Regional brain atrophy in idiopathic Parkinson's disease and diffuse Lewy body disease. Dementia 1996; 7; 304-313. 27) Ogden JA, Growdon JH, Corkin S: Deficits on visuospatial tests involving forward planning in high-functioning parkinsonians. Neuropsychiat Neuropsychol Behav Neural 1990; 3: 125-139. 10) 鹿島晴雄, 加藤元一郎: Wisconsin card sorting test (Keio version) (KWCST). 脳と精神の医学 1995; 6: 209-216. 6) Spreen O, Strauss E: A compendium of neuropsychological tests. Administration, norms, and commentary. Oxford Press, New York, 1991; p149-167. 14) Beatty WW: Memory disturbances in Parkinson's disease. In Parkinson's disease. Neurobehavioral aspects, Huber SJ Cummings JL (eds.), Oxford Univ Press, New York, 1992, p49-58. 15) Mitrushina M, Satz P, Chervinsky A, D'elia L: Performance of four age groups of normal elderly on the Rey auditory-verbal learning test. J Clin Psychol 1991; 47: 351-357. 19) Tachibana H, Kawabata K, Tomino Y, Sugita M, Fukuchi M: Brain perfusion imaging in Parkinson's disease and Alzheimer's disease demonstrated by three-dimensional surface display with 123I-iodoamphetamine. Dementia 1993; 4: 334-341. 23) Madden DJ, Gottlob LR, Denny LL, Turkington TG, Provenzale JM, Hawk TC, et al.: Aging and recognition memory: Changes in regional cerebral blood flow associated with components of reaction time distributions. J Cogn Neurosci 1999; 11: 511-520. 5) 博野信次, 山鳥重: 記憶の神経心理学. 医学のあゆみ1990; 155: 149-153. 3) Daum I, Schugens MM, Spieker S, Poser U, Schönle PW, Birbaumer N: Memory and skill acquisition in Parkinson's disease and frontal lobe dysfunction. Cortex 1995; 31: 413-432. |
| References_xml | – reference: 21) Shallice T, Fletcher P, Frith CD, Grasby P, Frackowiak RSJ, Dolan RJ: Brain regions associated with acquisition and retrieval of verbal episodic memory. Nature 1994; 368: 633-635. – reference: 9) Jones-Gotman M: Memory for designs: The hippocampal contribution. Neuropsychologia 1986; 24: 193-203. – reference: 24) Grasby PM, Frith CD, Friston KJ, Bench C, Frackowiak RSJ, Dolan RJ: Functional mapping of brain areas implicated in auditory-verbal memory function. Brain 1993; 116: 1-20. – reference: 23) Madden DJ, Gottlob LR, Denny LL, Turkington TG, Provenzale JM, Hawk TC, et al.: Aging and recognition memory: Changes in regional cerebral blood flow associated with components of reaction time distributions. J Cogn Neurosci 1999; 11: 511-520. – reference: 11) Talairach J, Tournoux P: Co-Planar stereotaxic atlas of the human brain. Thieme Medical Publishers Inc, New York, 1988. – reference: 4) Reitan RM, Walfson D: A selective and critical review of neuropsychological deficits and the frontal lobes. Neuropsychol Rev 1994: 4: 161-198. – reference: 15) Mitrushina M, Satz P, Chervinsky A, D'elia L: Performance of four age groups of normal elderly on the Rey auditory-verbal learning test. J Clin Psychol 1991; 47: 351-357. – reference: 8) Lhermitte F, Agid Y, Signoret JL: Onset and end-of doses levodopa-induced dyskinesias: possible treatment by increasing the daily dose of levodopa. Arch Neurol 1978; 35: 261-263. – reference: 18) Cooper JA. Sagar HJ: Incidental and intentional recall in Parkinson's disease: An account based on diminished attentional resources. J Clin Exp Neuropsychol 1993; 15: 713-731. – reference: 7) Tachibana H, Aragane K, Kawabata K, Sugita M: P3 latency change in aging and Parkinson disease. Arch Neurol 1997; 54; 296-302. – reference: 13) Markus HS, Lees AJ, Lennox G, Marsden CD, Costa DC: Patterns of regional cerebral blood flow in corticobasal degeneration studied using HMPAO SPECT; Comparison with Parkinson's disease and normal controls. Mov Disord 1995; 10: 179-187. – reference: 6) Spreen O, Strauss E: A compendium of neuropsychological tests. Administration, norms, and commentary. Oxford Press, New York, 1991; p149-167. – reference: 10) 鹿島晴雄, 加藤元一郎: Wisconsin card sorting test (Keio version) (KWCST). 脳と精神の医学 1995; 6: 209-216. – reference: 12) Tachibana H, Tomino Y, Kawabata K, Sugita M, Fukuchi M: Twelve-month follow-up study of regional cerebral blood flow in Parkinson's disease. Dementia 1995; 6: 89-93. – reference: 20) Hu MTM, Taylor-Robinson SD, Chaudhuri KR, Bell JD, Labbé C, Cunningham VJ, et al.: Cortical dysfunction in non-demented Parkinson's disease patients. A combined 31P-MRS and 13FDG-PET study. Brain 2000; 123; 340-352. – reference: 2) Owen AM, Roberts AC, Hodges JR, Summers BA, Polkey CE, Robbins TW: Contrasting mechanisms of impaired attentional set-shifting in patients with frontal lobe damage or Parkinson's disease. Brain 1993; 116: 1159-1175. – reference: 22) Ranganath C, Paller KA: Frontal brain activity during episodic and semantic retrieval: Insights from eventrelated potentials. J Cogn Neurosci 1999; 11: 598-609. – reference: 19) Tachibana H, Kawabata K, Tomino Y, Sugita M, Fukuchi M: Brain perfusion imaging in Parkinson's disease and Alzheimer's disease demonstrated by three-dimensional surface display with 123I-iodoamphetamine. Dementia 1993; 4: 334-341. – reference: 5) 博野信次, 山鳥重: 記憶の神経心理学. 医学のあゆみ1990; 155: 149-153. – reference: 27) Ogden JA, Growdon JH, Corkin S: Deficits on visuospatial tests involving forward planning in high-functioning parkinsonians. Neuropsychiat Neuropsychol Behav Neural 1990; 3: 125-139. – reference: 25) Double KL, Halliday GM, McRitchie DA, Reid WGJ, Hely MA, Morris JGL: Regional brain atrophy in idiopathic Parkinson's disease and diffuse Lewy body disease. Dementia 1996; 7; 304-313. – reference: 17) Kuzis G, Sabe L, Tiberti C, Leiguarda R, Starkstein SE: Cognitive functions in major depression and Parkinson disease. Arch Neurol 1997; 54: 982-986. – reference: 1) Taylor AE, Saint-Cyr JA, Lang AE: Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain 1986; 109: 845-883. – reference: 3) Daum I, Schugens MM, Spieker S, Poser U, Schönle PW, Birbaumer N: Memory and skill acquisition in Parkinson's disease and frontal lobe dysfunction. Cortex 1995; 31: 413-432. – reference: 14) Beatty WW: Memory disturbances in Parkinson's disease. In Parkinson's disease. Neurobehavioral aspects, Huber SJ Cummings JL (eds.), Oxford Univ Press, New York, 1992, p49-58. – reference: 26) Milner B, Petrides M: Behavioural effects of frontal-lobe lesions in man. Trends Neurosci 1984; 7: 403-407. – reference: 16) Levin BE, Llabre MM, Weiner WJ: Cogitive impairments associated with early Parkinson's disease. Neurology 1989; 39: 557-561. – reference: 28) Fletcher PC, Frith CD, Rugg MD: The functional neuroanatomy of episodic memory. Trends Neurosci 1997; 20: 213-220. |
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| Snippet | Parkinson 病 (PD) 患者の記憶障害を神経心理学的に明らかにし, その記憶障害がPDのどの病巣と関係があるのかについて検討した. 対象はPD 24例 (年齢65.8歳), 健常者12例... |
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| StartPage | 193 |
| SubjectTerms | パーキンソン病 局所脳血流 聴覚性記憶 視覚性記憶 |
| Subtitle | 神経心理学的検査と脳血流による検討 |
| Title | Parkinson 病の記憶機能 |
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