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首页> 外文期刊>Brain and cognition >Self-unawareness of levodopa induced dyskinesias in patients with Parkinson's disease
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Self-unawareness of levodopa induced dyskinesias in patients with Parkinson's disease

机译：帕金森病患者左旋多巴引起的运动障碍的自我意识

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摘要

The study analyzes the presence of dyskinesias-reduced-self-awareness in forty-eight patients suffering from Parkinson's disease (PD). As the association with executive dysfunction is a matter of debate and we hypothesize it plays an important role in dyskinesias self-unawareness, we analyzed the role of dopaminergic treatment on the medial-prefrontal-ventral-striatal circuitry using a neurocognitive approach. Special attention was given to metacognitive abilities related to action-monitoring that represent a novel explanation of the phenomenon. PD patients were assessed using different rating scales that we devised to measure movement awareness disorders. In order to ascertain whether each variable measured at a cognitive-clinical level contributes to predicting the scores of the movement-disorder-awareness-scales, we conducted multiple logistic regression models using the latter as binary dependent variables. We used the Wisconsin Card Sorting Test-metacognitive-version to assess the executive functions of the prefrontal-ventral-striatal circuitry. Data showed that a reduction of self-awareness using the Dyskinesia rating scale was associated with global monitoring (p = .04), monitoring resolution (p = .04) and control sensitivity (p = .04). Patients failed to perceive their performance, distinguish between correct and incorrect sorts, be confident in their choice and consequently decide to gamble during the task. We did not find any association with executive functions using the hypo-bradykinesia rating scale. Our findings indicate that when the comparator mechanism for monitoring attentive performance is compromised at a prefrontal striatal level, patients lose the ability to recognize their motor disturbances that do not achieve conscious awareness.
机译：该研究分析了患有帕金森病（PD）的48位患者中运动障碍降低的自我意识的存在。由于与执行功能障碍的关系尚有争议，我们假设它在运动障碍自我意识中起重要作用，因此我们使用神经认知方法分析了多巴胺能治疗在内侧－前额－腹－纹状体回路中的作用。特别关注与动作监测有关的元认知能力，这些新能力代表了对现象的一种新颖解释。使用我们设计用于测量运动意识障碍的不同等级量表对PD患者进行评估。为了确定在认知临床水平上测量的每个变量是否有助于预测运动障碍意识量表的得分，我们使用后者作为二元因变量进行了多个逻辑回归模型。我们使用了威斯康星卡片分类测验的元认知版本来评估前额-腹膜-纹状体回路的执行功能。数据显示，使用运动障碍评定量表降低的自我意识与总体监测（p = .04），监测分辨率（p = .04）和控制敏感性（p = .04）相关。患者无法感知自己的表现，无法区分正确和错误的分类，对自己的选择有信心，因此决定在任务期间进行赌博。使用运动迟缓评定量表，我们未发现与执行功能有任何关联。我们的发现表明，在前额纹状体水平上，用于监视注意力表现的比较器机制受到损害时，患者将失去识别其意识不到的运动障碍的能力。

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  • 来源
    《Brain and cognition》 |2014年第10期|135-141|共7页
  • 作者

    Martina Amanzio; Sara Palermo; Maurizio Zibetti; Daniela Leotta; Rosalba Rosato; Giuliano Geminiani; Leonardo Lopiano;

  • 作者单位

    Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy,Centro Interdipartimentale di Studi Avanzati in Neuroscienze - National Institute of Turin (NTT), Regione Gonzole 10, 10043 Orbassano, Italy,National Institute of Neuroscience (INN), Turin, Italy;

    Department of Neuroscience, Via Cherasco 15, 10126 Turin, Italy;

    Department of Neuroscience, Via Cherasco 15, 10126 Turin, Italy;

    Martini Hospital, Via Tofane 71, 10141 Turin, Italy;

    Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy,Cancer Epidemiology Unit, 'Citta della Salute e della Scienza' Hospital, Turin, Italy;

    Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy,Centro Interdipartimentale di Studi Avanzati in Neuroscienze - National Institute of Turin (NTT), Regione Gonzole 10, 10043 Orbassano, Italy,National Institute of Neuroscience (INN), Turin, Italy;

    Centro Interdipartimentale di Studi Avanzati in Neuroscienze - National Institute of Turin (NTT), Regione Gonzole 10, 10043 Orbassano, Italy,National Institute of Neuroscience (INN), Turin, Italy,Department of Neuroscience, Via Cherasco 15, 10126 Turin, Italy;

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  • 正文语种 eng
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  • 关键词

    Awareness of movement disorders; Dyskinesias; Parkinson's disease; Self-awareness; Metacognitive functions;

    机译：意识到运动障碍;运动障碍;帕金森氏病;自我意识;元认知功能;

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