Alzheimer's Disease Research Centre, Novum, Karolinska Institutet, 141 86 Stockholm, Sweden.
Curr Neurol Neurosci Rep. 2012 Oct;12(5):492-501. doi: 10.1007/s11910-012-0290-7.
Despite the frequency and importance of dementia associated with Parkinson's disease (PDD) and dementia with Lewy bodies (DLB), there is relatively little evidence on which to base treatment. Evidence from meta-analysis suggests that rivastigmine can improve cognition and functioning in PDD and also reduce risk of falling. There is also evidence supporting its use in DLB. Recent evidence suggests that memantine may also be effective, particularly for PDD, although evidence is more conflicting. Memantine may also improve parkinsonism and dyskinesias. Few clinical trials of cognition in PD without dementia exist, but there is preliminary evidence for atomoxetine, memantine, and piribedil. There is a lack of systematic evidence for the treatment of visual hallucinations and depression in PDD and DLB. In addition, there is a need for studies of whether potentially disease-modifying agents can prevent or delay the progression to dementia in PD.
尽管帕金森病相关痴呆（PDD）和路易体痴呆（DLB）引起的痴呆较为常见且后果严重，但针对其治疗的证据却相对较少。来自荟萃分析的证据表明，利斯的明可改善 PDD 的认知和功能，降低跌倒风险。其在 DLB 中的应用也有证据支持。最近的证据表明，美金刚可能也有效，尤其是对 PDD，尽管证据存在更多矛盾。美金刚还可能改善帕金森病和运动障碍。存在痴呆的帕金森病患者的认知功能临床试验很少，但托莫西汀、美金刚和吡贝地尔有初步证据。PDD 和 DLB 中视觉幻觉和抑郁的治疗缺乏系统证据。此外，还需要研究潜在的疾病修饰剂是否可以预防或延缓 PD 向痴呆的进展。
