Bermejo P E, Ruiz-Huete C, Terrón C
Servicio de Neurología, Clinica Nuestra Señora del Rosario. Hospital de la Zarzuela, Madrid, España.
Rev Neurol. 2007;45(11):689-94.
Although essential tremor (ET), Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are considered to be distinct illnesses, there is a certain overlap between some of their clinical, pathological and genetic features.
To conduct a critical examination of the evidence for and against the association between these three pathological conditions.
The body of evidence supporting the notion of a relation between ET and PD is growing all the time; the same can be said of the fact that a postural tremor may appear years before the onset of other extrapyramidal symptoms, the involvement of common genes in the development of both conditions or the presence of common pathological findings. In addition, it has also been suggested that there are several aspects linking PD and DLB, and it has even been claimed that that they might be part of the clinical spectrum of the same disease. The concept of ET as a benign single-symptom disease has changed in recent years and, since it has been related to cognitive disorders and Lewy bodies in the central nervous system, it is now considered to be a neurodegenerative pathology. CONCLUSIONS. ET, PD and DLB could represent different points on the same clinical spectrum.
尽管特发性震颤(ET)、帕金森病(PD)和路易体痴呆(DLB)被认为是不同的疾病,但它们的一些临床、病理和遗传特征存在一定重叠。
对支持和反对这三种病理状况之间关联的证据进行批判性审查。
支持ET与PD之间存在关联这一观点的证据一直在增加;姿势性震颤可能在其他锥体外系症状出现前数年就出现、两种疾病的发展涉及共同基因或存在共同病理发现等事实也是如此。此外,也有人提出PD和DLB之间存在几个方面的联系,甚至有人声称它们可能是同一疾病临床谱的一部分。近年来,ET作为一种良性单症状疾病的概念已经改变,由于它与认知障碍和中枢神经系统中的路易体有关,现在被认为是一种神经退行性病理学。结论:ET、PD和DLB可能代表同一临床谱上的不同点。