Bocanegra Yamile, Trujillo-Orrego Natalia, Pineda David
Universidad de Antioquia UDEA- Universidad de San Buenaventura USB., Medellin, Colombia.
Rev Neurol. 2014 Dec 16;59(12):555-69.
INTRODUCTION. The cognitive disorders in Parkinson's disease (PD) have traditionally been associated with the presence of dementia in later stages of the disease. Recent studies, however, consider that cognitive impairment can appear as of early stages. Knowing the cognitive profile of PD furthers our understanding of the clinical phenotype, making it easier to reach a timely diagnosis and favouring intervention on the symptoms from the initial stages. AIM. To present a review of the literature on mild cognitive impairment (MCI) and dementia associated with PD. DEVELOPMENT. Several studies report that patients with PD who have a prolonged time to progression develop dementia. Yet, there have also been reports claiming that, as of the early stages, patients can present subtle cognitive alterations known as MCI. The initial neuropsychological profile is mainly of a non-amnesic type, characterised by executive dysfunction, alterations affecting attention, operative memory deficit and faulty retrieval of information. When patients develop dementia, disorders will arise in the storage of information, in semantic fluency, and in visuospatial and visuoperceptual skills. Currently there are criteria available for diagnosing the MCI and dementia associated with PD, as well as valid reliable instruments for detecting those disorders. CONCLUSIONS. Cognitive symptoms are frequent in PD. From the initial stages of the disease onwards patients may present MCI that is mainly characterised by a fronto-subcortical cognitive profile, whereas dementia usually develops at later stages, when a pattern of posterior cortical cognitive disorder is also observed.
引言。帕金森病（PD）中的认知障碍传统上与疾病后期出现的痴呆相关。然而，最近的研究认为认知障碍在疾病早期就可能出现。了解PD的认知特征有助于我们进一步理解临床表型，便于及时做出诊断，并有利于从疾病初期就对症状进行干预。目的。对与PD相关的轻度认知障碍（MCI）和痴呆的文献进行综述。进展。多项研究报告称，病程进展缓慢的PD患者会发展为痴呆。然而，也有报告称，在疾病早期，患者可能会出现称为MCI的细微认知改变。最初的神经心理学特征主要是非遗忘型，其特点是执行功能障碍、注意力改变、操作记忆缺陷和信息检索错误。当患者发展为痴呆时，信息存储、语义流畅性以及视觉空间和视觉感知技能方面会出现障碍。目前有用于诊断与PD相关的MCI和痴呆的标准，以及检测这些障碍的有效可靠工具。结论。认知症状在PD中很常见。从疾病初期起，患者可能会出现主要以额颞叶认知特征为特点的MCI，而痴呆通常在后期出现，此时还会观察到后皮质认知障碍模式。
