Caltagirone C, Masullo C, Benedetti N, Gainotti G
Int J Neurosci. 1985 Apr;26(1-2):15-26. doi: 10.3109/00207458508985599.
We carried out a neuropsychological study on cognitive impairment in 57 subjects affected by idiopathic Parkinson's Disease (PD) and 32 subjects affected by Alzheimer's Disease (AD). First, we found two different subgroups of Parkinsonian patients, the first one with and the second without dementia. We clearly identified these two distinct subclinical entities regardless of mean age, age of onset, duration of treatment; on the contrary, the type of treatment seems to play a specific role in the appearance of dementia in PD, anticholinergics being assumed almost exclusively by demented Parkinsonian patients. Second, we observed two main differences for cognitive impairment between PD with dementia and AD. In fact, cognitive impairment is consistently more evident in Alzheimer patients than in Parkinsonian ones with dementia; in addition, demented Parkinsonians show a pattern of impairment similar to that exhibited by patients affected by frontal lobe lesions. This result supports neuroanatomical and neurochemical data on the involvement of the whole dopaminergic system in PD and the role played by the ventromedial tegmental area projecting to the frontal cortex in causing cognitive dysfunction in this disease.
我们对57名特发性帕金森病（PD）患者和32名阿尔茨海默病（AD）患者的认知障碍进行了一项神经心理学研究。首先，我们发现帕金森病患者存在两个不同的亚组，第一组有痴呆，第二组无痴呆。无论平均年龄、发病年龄、治疗时长如何，我们都能清楚地识别出这两个不同的亚临床实体；相反，治疗类型似乎在帕金森病痴呆的出现中起特定作用，抗胆碱能药物几乎仅被患有痴呆的帕金森病患者使用。其次，我们观察到帕金森病痴呆患者和阿尔茨海默病患者在认知障碍方面存在两个主要差异。事实上，认知障碍在阿尔茨海默病患者中始终比在患有痴呆的帕金森病患者中更明显；此外，患有痴呆的帕金森病患者表现出的损伤模式与额叶病变患者相似。这一结果支持了关于整个多巴胺能系统参与帕金森病的神经解剖学和神经化学数据，以及腹内侧被盖区投射到额叶皮质在该疾病导致认知功能障碍中所起的作用。
