Janvin Carmen Cristea, Larsen Jan Petter, Salmon David P, Galasko Douglas, Hugdahl Kenneth, Aarsland Dag
Stavanger University Hospital, Section of Geriatric Psychiatry, Stavanger, Norway.
Mov Disord. 2006 Mar;21(3):337-42. doi: 10.1002/mds.20726.
We describe the pattern of cognitive profiles within a community-based sample of patients with Parkinson's disease (PD) and dementia (PDD) using cluster analyses, and compare the results with data from patients with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Fifty patients with PDD and 39 with AD from Stavanger, Norway, and 62 patients with DLB from San Diego, CA, USA were diagnosed by either standardized clinical procedures or criteria (all PDD and all AD cases) or necropsy (all DLB cases). Four subgroups were identified: two subgroups with a subcortical cognitive profile (one with mild and one with moderate dementia severity), one subgroup with global impairment and severe dementia, and one subgroup with a cortical cognitive profile and moderate dementia. Of the patients with PDD and with DLB, 56% and 55%, respectively, had a subcortical cognitive profile, compared with only 33% of the AD patients. Conversely, 30% of the patients with PDD and 26% of those with DLB had a cortical cognitive profile, compared with 67% of the patients with AD. These findings suggest that in some patients with PDD, frontosubcortical changes are the main contributing factor to dementia, whereas in other patients, cortical and hippocampal changes are more important.
我们使用聚类分析描述了帕金森病（PD）和痴呆（PDD）患者社区样本中的认知特征模式，并将结果与阿尔茨海默病（AD）和路易体痴呆（DLB）患者的数据进行比较。来自挪威斯塔万格的50例PDD患者和39例AD患者，以及来自美国加利福尼亚州圣地亚哥的62例DLB患者，通过标准化临床程序或标准（所有PDD和所有AD病例）或尸检（所有DLB病例）进行诊断。识别出四个亚组：两个具有皮质下认知特征的亚组（一个轻度痴呆严重程度，一个中度痴呆严重程度），一个具有整体损害和重度痴呆的亚组，以及一个具有皮质认知特征和中度痴呆的亚组。PDD患者和DLB患者中，分别有56%和55%具有皮质下认知特征，而AD患者中只有33%。相反，PDD患者中有30%，DLB患者中有26%具有皮质认知特征，而AD患者中有67%。这些发现表明，在一些PDD患者中，额颞叶皮质下变化是痴呆的主要促成因素，而在其他患者中，皮质和海马体变化更为重要。
