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帕金森病的轻度认知障碍。

Mild cognitive impairment in Parkinson's disease.

机构信息

Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain.

出版信息

J Neural Transm (Vienna). 2019 Jul;126(7):897-904. doi: 10.1007/s00702-019-02003-1. Epub 2019 Apr 8.

Abstract

Understanding on the clinical features and neural mechanisms leading to cognitive impairment and dementia in Parkinson's disease (PD) has notably increased. At time of diagnosis, nearly all PD patients present some degree of cognitive impairment not enough severe as to significantly affect functional independence. However, even mild cognitive changes have a measurable impact to functional capacity in PD. A clinically practical differentiation is based on the importance of executive deficits in the early phases of cognitive impairment in PD and on the evidence stressing the transitional role of posterior-cortical impairment on the progression of PD-MCI to dementia. However, the pattern of cognitive impairment in PD is variable not just to the extents on which are the affected cognitive domains, but also on which are those domains that became affected first. Specific diagnostic criteria for mild cognitive impairment associated with PD (PD-MCI) and dementia (PDD) and operative guidelines for the cognitive assessment have been developed. In the present review, we will describe general notions regarding the mechanisms and the profile of cognitive deterioration in PD, the diagnostic criteria for PD-MCI, and some of the currently recommended assessment approaches.

摘要

对帕金森病(PD)导致认知障碍和痴呆的临床特征和神经机制的理解显著增加。在诊断时,几乎所有 PD 患者都存在一定程度的认知障碍,但不足以严重影响其功能独立性。然而,即使是轻微的认知改变也会对 PD 患者的功能能力产生可衡量的影响。基于执行功能缺陷在 PD 认知障碍早期阶段的重要性,以及强调后皮质损伤在 PD-MCI 向痴呆进展中的过渡作用的证据,临床上可以进行区分。然而,PD 患者的认知障碍模式不仅因受影响的认知领域的程度而异,而且因首先受影响的领域而异。已经制定了与 PD(PD-MCI)和痴呆(PDD)相关的轻度认知障碍的特定诊断标准和认知评估的操作指南。在本次综述中,我们将描述 PD 中认知恶化的机制和特征、PD-MCI 的诊断标准以及一些目前推荐的评估方法的一般概念。

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