Department of Neurology, University of California San Francisco, 94143, USA.
Alzheimer Dis Assoc Disord. 2009 Oct-Dec;23(4):365-70. doi: 10.1097/WAD.0b013e3181b5065d.
Parkinson disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB) share alpha-synuclein immunoreactivity. These "synucleinopathies" have overlapping signs and symptoms, but less is known about similarities and differences in their cognitive and neuropsychiatric profiles. We compared the cognitive and neuropsychiatric profiles of individuals with PD, MSA, and DLB. Overall, the DLB group showed the most cognitive impairment, the MSA group demonstrated milder impairment, and the PD group was the least cognitively impaired. The DLB and MSA groups showed worse executive function and visuospatial skills than PD, whereas DLB showed impaired memory relative to both PD and MSA. On the neuropsychiatric screening, all groups endorsed depression and anxiety; the DLB group alone endorsed delusions and disinhibition. Consistent with their greater level of cognitive and neuropsychiatric impairment, the DLB group showed the greatest amount of functional impairment on a measure of instrumental activities of daily living (Functional Activities Questionnaire). We found that MSA subjects had cognitive difficulties that fell between the mild deficits of the PD group and the more severe deficits of the DLB group. PD, MSA, and DLB groups have similar neuropsychiatric profiles of increased depression and anxiety. Similar underlying alpha-synuclein pathology may contribute to these shared features.
帕金森病（PD）、多系统萎缩（MSA）和路易体痴呆（DLB）都具有α-突触核蛋白免疫反应性。这些“突触核蛋白病”具有重叠的体征和症状，但对它们认知和神经精神特征的相似性和差异性了解较少。我们比较了 PD、MSA 和 DLB 患者的认知和神经精神特征。总的来说，DLB 组表现出最严重的认知障碍，MSA 组表现出较轻的障碍，PD 组的认知障碍最轻。DLB 和 MSA 组的执行功能和视空间技能比 PD 组差，而 DLB 组的记忆比 PD 和 MSA 组差。在神经精神筛查方面，所有组都有抑郁和焦虑；只有 DLB 组有妄想和去抑制。与认知和神经精神障碍程度较高相一致，DLB 组在一项日常生活活动工具性评估（功能性活动问卷）上表现出最大的功能障碍。我们发现 MSA 患者的认知困难介于 PD 组的轻度缺陷和 DLB 组的更严重缺陷之间。PD、MSA 和 DLB 组有相似的神经精神特征，即抑郁和焦虑增加。类似的α-突触核蛋白病理学可能导致这些共同特征。
