Section of Parkinson Disease and Movement Disorders, Department of Neurological Sciences, Rush University, Chicago, IL 60612, USA.
Minerva Med. 2011 Dec;102(6):441-59.
Parkinson's disease (PD) traditionally has been defined by its characteristic motor hallmarks, but non-motor features such as cognitive impairment and dementia are increasingly recognized as part of PD. Mild cognitive impairment (MCI) is common in non-demented PD patients, occurring in about 20-50%. Frequency estimates and clinical features of mild cognitive impairment in PD (PD-MCI), however, vary across studies due to methodological differences and lack of uniform diagnostic criteria for PD-MCI. Overall, PD-MCI patients exhibit nonamnestic deficits in cognitive domains such as executive function, attention, and visuospatial function; however, the cognitive phenotype of PD-MCI is heterogeneous with some patients demonstrating greater amnestic deficits. PD-MCI patients, particularly those with posterior cortical profiles, may be at high risk for developing dementia. Various biomarkers studied in PD-MCI including cerebrospinal fluid, genetic analyses, and neuroimaging suggest that there may be distinct PD-MCI profiles. Future studies using uniform PD-MCI diagnostic criteria and incorporating biomarkers and longitudinal follow-up of PD-MCI cohorts are needed to understand PD-MCI as a transitional state between normal cognition and dementia.
帕金森病(PD)传统上以其特征性运动标志定义,但认知障碍和痴呆等非运动特征越来越被认为是 PD 的一部分。轻度认知障碍(MCI)在非痴呆 PD 患者中很常见,约占 20-50%。由于方法学差异和 PD-MCI 缺乏统一的诊断标准,PD-MCI 的频率估计和临床特征在不同研究中有所不同。总体而言,PD-MCI 患者在执行功能、注意力和视空间功能等认知领域表现出非遗忘性缺陷;然而,PD-MCI 的认知表型具有异质性,一些患者表现出更大的遗忘性缺陷。PD-MCI 患者,特别是那些具有皮质后位模式的患者,可能有很高的痴呆风险。在 PD-MCI 中研究的各种生物标志物,包括脑脊液、基因分析和神经影像学,表明可能存在不同的 PD-MCI 模式。未来的研究需要使用统一的 PD-MCI 诊断标准,并结合生物标志物和 PD-MCI 队列的纵向随访,以了解 PD-MCI 作为正常认知和痴呆之间的过渡状态。