Centre for Molecular Medicine, Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Lancet Neurol. 2012 Aug;11(8):697-707. doi: 10.1016/S1474-4422(12)70152-7.
Dementia is one of the most common and important aspects of Parkinson's disease and has consequences for patients and caregivers, and has health-related costs. Mild cognitive impairment is also common and frequently progresses to dementia. The underlying mechanisms of dementia associated with Parkinson's disease are only partly known and no mechanism-based treatments are available. Both dysmetabolism of α-synuclein and amyloid-protein and cholinergic deficits contribute to cognitive impairment in Parkinson's disease, and preliminary findings show that imaging and neurophysiological and peripheral biomarkers could be useful in diagnosis and prognosis. Rivastigmine is the only licensed treatment for dementia in Parkinson's disease, but emerging evidence suggests that memantine might also be useful. Whether these or other treatments can delay the progression from mild cognitive impairment to dementia in Parkinson's disease is a key research question.
痴呆是帕金森病最常见和最重要的方面之一，对患者和护理人员都有影响，并产生与健康相关的费用。轻度认知障碍也很常见，并且经常进展为痴呆。与帕金森病相关的痴呆的潜在机制尚不完全清楚，也没有基于机制的治疗方法。α-突触核蛋白和淀粉样蛋白的代谢障碍以及胆碱能不足都导致了帕金森病的认知障碍，初步研究结果表明，影像学、神经生理学和外周生物标志物可能有助于诊断和预后。利伐斯的明是帕金森病痴呆的唯一许可治疗药物，但新出现的证据表明，美金刚可能也有用。这些或其他治疗方法是否可以延缓帕金森病患者从轻度认知障碍到痴呆的进展，是一个关键的研究问题。
