Movement Disorders Unit, Neurosciences Institute, IDIBAPS, CIBERNED, Hospital Clínic, Barcelona, Catalonia, Spain.
J Neurol Sci. 2011 Nov 15;310(1-2):25-30. doi: 10.1016/j.jns.2011.06.046. Epub 2011 Jul 20.
Dementia is a frequent and devastating non-motor complication of advanced Parkinson's disease (PD). There is growing evidence of a synergistic role of Alzheimer's-type brain lesions containing τ and amyloid-β (Aβ) proteins and cortical Lewy aggregates in PD-related dementia (PDD). Therefore, biomarkers of both τ and Aβ may be seen as diagnostic and predictive markers of PDD. Here, we review the available studies in PD and PDD using cerebrospinal fluid (CSF) total τ, phospho-τ, and/or Aβ levels, and PET probes targeting Alzheimer's-type lesions. Overall, high CSF τ and phospho-τ levels and/or low CSF Aβ levels have been found in part of PDD patients, and a longitudinal study has found greater worsening in cognitive performance over time in non-demented PD patients with low baseline CSF Aβ levels. Few studies are available on the use of PET imaging in PD, all of them using the Pittsburgh B compound (PIB), and with figures of about 30% of scans with PIB uptake in the AD-range in PDD. We conclude that these CSF and PET markers deserve further evaluation as candidate biomarkers of dementia in PD. According to this, we are currently undertaking a longitudinal project on the predictive value of dementia of the combined use of CSF τ and Aβ and (18)F-FDDNP PET in PD.
痴呆是晚期帕金森病（PD）常见且具有破坏性的非运动并发症。越来越多的证据表明，阿尔茨海默病型脑损伤中含有τ和淀粉样蛋白-β（Aβ）蛋白以及皮质路易小体与 PD 相关痴呆（PDD）有协同作用。因此，τ和 Aβ的生物标志物可以被视为 PDD 的诊断和预测标志物。在这里，我们回顾了使用脑脊液（CSF）总 τ、磷酸化 τ 和/或 Aβ 水平以及针对阿尔茨海默病型病变的 PET 探针在 PD 和 PDD 中进行的现有研究。总的来说，部分 PDD 患者的 CSF τ 和磷酸化 τ 水平升高和/或 CSF Aβ 水平降低，一项纵向研究发现，基线 CSF Aβ 水平较低的非痴呆 PD 患者认知功能随时间的恶化程度更大。关于 PET 成像在 PD 中的应用的研究很少，所有这些研究都使用了匹兹堡 B 化合物（PIB），并且在 PDD 中，大约有 30%的扫描显示 PIB 摄取在 AD 范围内。我们得出的结论是，这些 CSF 和 PET 标志物值得进一步评估，作为 PD 痴呆的候选生物标志物。基于此，我们目前正在进行一项关于 CSF τ 和 Aβ联合使用以及（18）F-FDDNP PET 在 PD 中的预测价值的纵向研究。
