帕金森病相关痴呆的临床诊断标准。
Clinical diagnostic criteria for dementia associated with Parkinson's disease.
作者信息
Emre Murat, Aarsland Dag, Brown Richard, Burn David J, Duyckaerts Charles, Mizuno Yoshikino, Broe Gerald Anthony, Cummings Jeffrey, Dickson Dennis W, Gauthier Serge, Goldman Jennifer, Goetz Christopher, Korczyn Amos, Lees Andrew, Levy Richard, Litvan Irene, McKeith Ian, Olanow Warren, Poewe Werner, Quinn Niall, Sampaio Christina, Tolosa Eduardo, Dubois Bruno
机构信息
Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
出版信息
Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837. doi: 10.1002/mds.21507.
Dementia has been increasingly more recognized to be a common feature in patients with Parkinson's disease (PD), especially in old age. Specific criteria for the clinical diagnosis of dementia associated with PD (PD-D), however, have been lacking. A Task Force, organized by the Movement Disorder Study, was charged with the development of clinical diagnostic criteria for PD-D. The Task Force members were assigned to sub-committees and performed a systematic review of the literature, based on pre-defined selection criteria, in order to identify the epidemiological, clinical, auxillary, and pathological features of PD-D. Clinical diagnostic criteria were then developed based on these findings and group consensus. The incidence of dementia in PD is increased up to six times, point-prevelance is close to 30%, older age and akinetic-rigid form are associated with higher risk. PD-D is characterized by impairment in attention, memory, executive and visuo-spatial functions, behavioral symptoms such as affective changes, hallucinations, and apathy are frequent. There are no specific ancillary investigations for the diagnosis; the main pathological correlate is Lewy body-type degeneration in cerebral cortex and limbic structures. Based on the characteristic features associated with this condition, clinical diagnostic criteria for probable and possible PD-D are proposed.
越来越多的人认识到,痴呆是帕金森病(PD)患者的常见特征,尤其是在老年患者中。然而,此前一直缺乏与帕金森病相关的痴呆(PD-D)的临床诊断具体标准。由运动障碍研究组织的一个特别工作组负责制定PD-D的临床诊断标准。特别工作组成员被分配到各个小组委员会,并根据预先确定的选择标准对文献进行了系统回顾,以确定PD-D的流行病学、临床、辅助和病理特征。然后根据这些发现和小组共识制定了临床诊断标准。PD患者中痴呆的发病率增加了多达六倍,时点患病率接近30%,老年和运动迟缓-强直型与更高风险相关。PD-D的特征是注意力、记忆力、执行功能和视觉空间功能受损,情感变化、幻觉和冷漠等行为症状很常见。目前尚无用于诊断的特定辅助检查;主要的病理相关因素是大脑皮层和边缘结构中的路易体样变性。基于与这种情况相关的特征,提出了可能的和疑似的PD-D的临床诊断标准。