1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
J Neurol Sci. 2022 Feb 15;433:120015. doi: 10.1016/j.jns.2021.120015. Epub 2021 Oct 2.
The aim of the present review is to summarize literature data on dementia in parkinsonian disorders. Cognitive decline and the gradual development of dementia are considered to be key features in the majority of parkinsonian conditions. The burden of dementia in everyday life of parkinsonian patients and their caregivers is vast and can be even more challenging to handle than the motor component of the disease. Common pathogenetic mechanisms involve the aggregation and spreading of abnormal proteins like alpha-synuclein, tau or amyloid in cortical and subcortical regions with subsequent dysregulation of multiple neurotransmitter systems. The degree of cognitive deterioration in these disorders is variable and ranges from mild cognitive impairment to severe cognitive dysfunction. There is also variation in the number and type of affected cognitive domains which can involve either a single domain like executive or visuospatial function or multiple ones. Novel genetic, biological fluid or imaging biomarkers appear promising in facilitating the diagnosis and staging of dementia in parkinsonian conditions. A significant part of current research in Parkinson's disease and other parkinsonian syndromes is targeted towards the cognitive aspects of these disorders. Stabilization or amelioration of cognitive outcomes represents a primary endpoint in many ongoing clinical trials for novel disease modifying treatments in this field. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
本文旨在综述帕金森病相关痴呆的文献资料。认知能力下降和痴呆的逐渐发展被认为是大多数帕金森病的主要特征。痴呆给帕金森病患者及其照护者的日常生活带来了沉重的负担,其处理难度甚至超过了疾病的运动症状。常见的发病机制包括异常蛋白(如α-突触核蛋白、tau 或淀粉样蛋白)在皮质和皮质下区域的聚集和扩散,随后导致多个神经递质系统的失调。这些疾病的认知恶化程度各不相同,从轻度认知障碍到严重认知功能障碍不等。受影响的认知域的数量和类型也存在差异,可能涉及单一域,如执行或视空间功能,也可能涉及多个域。新型遗传、生物流体或影像学生物标志物在促进帕金森病相关痴呆的诊断和分期方面显示出良好的应用前景。目前帕金森病和其他帕金森综合征的研究很大一部分集中在这些疾病的认知方面。在该领域的新型疾病修饰治疗的许多正在进行的临床试验中,认知结局的稳定或改善是主要终点之一。本文是由 Joseph Jankovic、Daniel D. Truong 和 Matteo Bologna 编辑的“运动障碍及其他神经退行性疾病中的帕金森病”特刊的一部分。
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