Abstract: Objective To explore the relationship between the characteristics of polysomnography and cognitive dysfunction in patients with Parkinson's disease.Methods A total of 207 patients diagnosed as Parkinson's disease in the Department of Neurology of our hospital from January 2021 to January 2022 were selected.All patients received Parkinson's Sleep Scale (PDSS) to assess their sleep status,and the included patients were divided into two groups according to their final scores:the sleep disorder free group (n=126) and the sleep disorder group (n=81).Clinical data of all patients were collected and monitored by polysomnography.The difference of baseline data,EEG data,polysomnography parameters and sleep-related scores between the two groups were compared to observe the cognitive function of the two groups.Scores related to anxiety and depression and scores of various dimensions of MoCA.Results Results The age and course of disease in sleep disorder group increased significantly than those in no sleep disorder group (all P＜0.05).The amplitude,frequency,index and generalization ratio of EEG parameters in 2 groups were all P＜0.05.The sleep efficiency of patients without sleep disorder group was significantly higher than that of sleep disorder group,the proportion of NREM2 sleep in patients without sleep disorder group decreased significantly than that of sleep disorder group,and the proportion of NREM3 sleep in patients without sleep disorder group increased significantly than that of sleep disorder group (all P＜0.05).The proportion of rapid eye movement sleep in barrier-free sleep group increased significantly than that in sleep disorder group (P＜0.05).The comparison of UPDRS score,H-Y stage and PDSS scores in 2 groups were all P＜0.05.The cognitive function scores including MMSE and MoCA scale scores in the sleep disorder group decreased significantly than those in the non-sleep disorder group,and the anxiety and depression scores in the sleep disorder group increased significantly than those in the non-sleep disorder group (all P＜0.05).Conclusion Analysis was used to show negative associations between age (r=-0.482,P=0.001),H-Y stage (r=-0.414,P=0.005),HAMA score (r=-0.591,P<0.001),HAMD score (r=-0.574,P<0.001),and MoCA scale score (r=-0.583,P<0.001) with sleep disorders Conclusion There is a certain correlation between cognitive dysfunction and sleep structure disorder in PD patients.Sleep structure disorder may lead to increased cognitive impairment.

Key words: Polysomnosia, Eeg analysis diagram, Parkinson's disease, Cognitive dysfunction, Efficiency of prediction

摘要： 目的 探讨多导睡眠脑电分析图特征的变化与帕金森病患者认知功能障碍的关系分析。方法 选取2021年1月至2022年1月期间在本院神经内科就诊并判定为帕金森病的患者共207例。所有患者均接受帕金森睡眠量表(PDSS)量表以评估其睡眠状况,根据其最终得分将纳入的患者进行分组,分别为无睡眠障碍组(n=126)及睡眠障碍组(n=81)。收集所有患者临床资料,并应用多导睡眠脑电监测方法进行监测。对比两组患者基线资料数据差异、脑电波相关数据、多导睡眠参数情况、睡眠相关评分,观察两组患者认知功能、焦虑、抑郁相关评分。结果 睡眠障碍组患者年龄、病程均明显高于无睡眠障碍组(均P＜0.05);两组患者脑电波参数中波幅、频率、脑波指数及泛化占比对比均P＜0.05;无睡眠障碍组患者睡眠效率明显高于睡眠障碍组,无睡眠障碍组患者NREM2期睡眠比例明显低于睡眠障碍组,无睡眠障碍组患者NREM3期睡眠比例明显高于睡眠障碍组(均P＜0.05);无障碍睡眠组患者快速眼球运动睡眠比例明显高于睡眠障碍组(P＜0.05);两组患者H-Y分期、PDSS各条目评分对比均P＜0.05;睡眠障碍组认知功能评分包括MMSE、MoCA量表评分均明显低于无睡眠障碍组,睡眠障碍组焦虑、抑郁评分结果均明显高于无睡眠障碍组(均P＜0.05);采用相关性分析显示年龄(r=-0.482,P=0.001)、H-Y分期(r=-0.414,P=0.005)、HAMA评分(r=-0.591,P＜0.001)、HAMD评分(r=-0.574,P＜0.001)、MoCA量表评分(r=-0.583,P＜0.001)与患者出现睡眠障碍均呈负相关。结论 帕金森病患者认知功能障碍与睡眠结构紊乱存在一定相关性,睡眠结构紊乱会导致认知功能损害加重。

关键词: 多导睡眠, 脑电分析图, 帕金森病, 认知功能障碍, 预测效能