The Comparison Of Clinical Features And Correlation Analysis Of Neuropsychological Disorder In Early Onset Parkinson’s Disease And Late-onset Parkinson’s Disease

Objective:To investigate the clinical features between Early-onset Parkinson’s disease(EOPD)and Late-onset Parkinson’s disease(LOPD)patients with depression.To investigate the difference of incidence,factors and cognitive impairment sub-area between EOPD and LOPD patients with mild cognitive impairment(MCI).Method:A total of 92 patients(including 38 EOPD patients and 54 LOPD patients)who met the inclusion criteria of primary Parkinson’s disease in our hospital from April 2016 to March 2017.Collected these patients’ detailed information about patients and evaluated their movement,depression and general cognition function by using Hoehn-Yahr stage,United Parkinson’s Disease Rate Scale —III(UPDRS-III),Hamilton depression scale(HAMD),Mini-mental state examination(MMSE)and Montreal Cognitive Assessment(MoCA).Meanwhile,assessed the patients’ attention,memory,executive,language and visual-spatial ability by using Stroop test,Rey auditory verbal learning test(RAVLT),Clock drawing test,Boston naming test(BNT)-30 and trail making test(TMT).Compared the depression and cognitive dysfunction among EOPD and LOPD groups,and analyzed the related factors of two groups’ patients with MCI.Result:(1)23 cases in 38 EOPD patients(57.89%)were with depression,15 cases(42.11%)without depression;26 cases in 38 EOPD patients(48.15%)were with depression,28cases(51.85%)without depression,and the difference wasn’t significant(P=0.241);(2)HAMD scores in EOPD and LOPD groups with depression were 19.74±1.91 vs.18.77±1.18,and the difference was significant(P=0.035);(3)Based on the assessment results in MMSE and MOCA,9 EOPD patients(23.68%)with MCI,29 EOPD patients(76.32%)without cognitive impairment;25 LOPD(46.30 %)with MCI,29 LOPD patients(53.70 %)without MCI,and the difference was significant(P=0.027);(4)MoCA scores of EOPD and LOPD groups were 26.39±2.30 vs.24.48±2.81,and the difference was statistically significant(P=0.001);(5)RAVLT scores of EOPD-MCI and LOPD-MCI groups were as followed: immediate memory: 46.42±11.33 vs.37.57±12.30,and the difference was significant(P=0.046);delayed memory: 5.18± 1.56 vs.4.13±1.17,and the difference was significant(P=0.032);(6)Stroop scores of EOPD-MCI and LOPD-MIC were as followed: part-A: 44.78±1.72 vs.43.17±2.15,the difference was not significant(P=0.055);part-B: 44.78±1.39 vs.40.22±2.89,the difference was statistically significant(P<0.001);part-C: 37.87±1.90 vs.34.17±1.47,the difference was statistically significant(P<0.001);(7)TMT scores of EOPD-MCI and LOPD-MIC groups were as followed: part-A: 70.78±4.32 vs.77.78±4.43,and the difference was statistically significant(P<0.001);part-B: 159.22±2.22 vs.175.21±2.62,and the difference was statistically significant(P<0.001);(8)The other assessment results of EOPD-MCI and LOPD-MCI groups were as followed: Clock drawing test: 6.89±0.78 vs.5.48±1.24,BNT-30: 27.00±1.22 vs.25.91±1.04,these difference were all significant(P=0.004 and p=0.017,respectively);(9)The comparison of normal data between EOPD-MCI and LOPD-MCI groups: age of onset: 45.57±2.27 vs.57.28±3.32,and the difference was statistically significant(P<0.001),the difference of sex ratio,the course of disease,Hoehn-Yahr rate,nature of work and UPDRS-III were not significant(P>0.05);(10)MoCA score of EOPD group was positively correlated with the nature of work(r=-0.466,P=0.03),and was negative correlated with HAMP score(r=0.390,P=0.015),however,it wasn’t correlated with the age of age of onset,the course of disease,age,sex,Hoehn-Yahr stage and UPDRS-III(P>0.05).The MoCA score of LOPD was negative correlated with the course of disease(r=-0.446,P=0.001),age(r=-0.404,P=0.002),Hoehn-Yahr stage(r=-0.430,P=0.001)and UPDRS-III(r=-0.361,P=0.007),however wasn’t correlated with age of onset,nature of work,sex ratio and HAMD score(P>0.05).Conclusions:(1)This study results that,in patients with junior high school degree or above,the depressive symptoms of EOPD patients are more serious than LOPD patients,but there is no significant difference in the incidence of depression;(2)In patients with junior high school degree or above,the incident of MCI in EOPD patients are less than LOPD patients.(3)EODP-MCI patients are mainly featured by the dramatic impairments in the cognitive domains of delayed memory,attention and visual-spatial ability,while five cognitive disorder areas of LOPD-MCI patients are all impaired.(4)The cognitive function of EOPD patients are significantly corrected with working property,cognitive function of EOPD patients with physical labor is bad than EOPD patients with mental labor;while cognitive function of EOPD patients was negatively correlated with depressive symptoms;and the cognitive function of LOPD disease was negatively correlated with course of disease,age and movement disorders.