Giannakis Alexandros, Sioka Chrissa, Kloufetou Eugenia, Konitsiotis Spiridon
Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou Av., University Campus, Ioannina, Greece.
Department of Nuclear Medicine, Faculty of Medicine, University of Ioannina, Stavrou Niarchou Av., University Campus, Ioannina, Greece.
J Neural Transm (Vienna). 2025 Mar;132(3):341-355. doi: 10.1007/s00702-024-02865-0. Epub 2024 Nov 30.
In this narrative review, we address mild cognitive impairment, a frequent complication of Parkinson's disease (PD) and atypical parkinsonian disorders (APDs). Recent diagnostic criteria have blurred the lines between PD and dementia with Lewy bodies (DLB), particularly in the cognitive domain. Additionally, atypical parkinsonian syndromes like progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) often present with significant cognitive decline. Even multiple system atrophy (MSA) can be associated with cognitive impairment in some cases. Several biomarkers, including imaging techniques, such brain magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET), as well as pathological proteins either of the cerebrospinal fluid (CSF), such as Tau, amyloid beta, and synuclein, or of the serum, such as neurofilament light chain (Nfl) are more and more often utilized in the early differential diagnosis of APDs. The complex interplay between these conditions and the evolving understanding of their underlying pathologies highlight the need for further research to refine diagnostic criteria, possibly incorporate the new findings from the biomarker's field into the diagnostic criteria and develop targeted therapeutic strategies.
在这篇叙述性综述中，我们探讨了轻度认知障碍，它是帕金森病（PD）和非典型帕金森综合征（APD）的常见并发症。最近的诊断标准模糊了PD与路易体痴呆（DLB）之间的界限，尤其是在认知领域。此外，非典型帕金森综合征，如进行性核上性麻痹（PSP）和皮质基底节变性（CBD），常伴有显著的认知衰退。甚至在某些情况下，多系统萎缩（MSA）也可能与认知障碍相关。几种生物标志物，包括成像技术，如脑磁共振成像（MRI）和氟脱氧葡萄糖正电子发射断层扫描（FDG-PET），以及脑脊液（CSF）中的病理蛋白，如Tau、淀粉样β蛋白和突触核蛋白，或血清中的病理蛋白，如神经丝轻链（Nfl），越来越多地用于APD的早期鉴别诊断。这些病症之间复杂的相互作用以及对其潜在病理不断演变的认识凸显了进一步研究的必要性，以便完善诊断标准，可能将生物标志物领域的新发现纳入诊断标准，并制定有针对性的治疗策略。
