Perry E K, Curtis M, Dick D J, Candy J M, Atack J R, Bloxham C A, Blessed G, Fairbairn A, Tomlinson B E, Perry R H
J Neurol Neurosurg Psychiatry. 1985 May;48(5):413-21. doi: 10.1136/jnnp.48.5.413.
Dementia in Parkinson's disease has previously been attributed to the presence in the cerebral cortex of Alzheimer-type neuropathological abnormalities. New evidence suggests, however, that dementia in this disease usually occurs in the absence of substantial Alzheimer-type changes in the cortex and may be related to abnormalities in the cortical cholinergic system. Thus, in Parkinsonian patients with dementia there were extensive reductions of choline acetyltransferase and less extensive reductions of acetylcholinesterase in all four cortical lobes. Choline acetyltransferase reductions in temporal neocortex correlated with the degree of mental impairment assessed by a test of memory and information but not with the extent of plaque or tangle formation. In Parkinson's but not Alzheimer's disease the decrease in neocortical (particularly temporal) choline acetyltransferase correlated with the number of neurons in the nucleus of Meynert suggesting that primary degeneration of these cholinergic neurons may be related, directly or indirectly, to declining cognitive function in Parkinson's disease.
帕金森病中的痴呆症以前一直被归因于大脑皮层中存在阿尔茨海默型神经病理异常。然而，新证据表明，该疾病中的痴呆症通常在皮层不存在大量阿尔茨海默型变化的情况下发生，并且可能与皮层胆碱能系统的异常有关。因此，在患有痴呆症的帕金森病患者中，所有四个脑叶中的胆碱乙酰转移酶都有广泛减少，而乙酰胆碱酯酶的减少程度则较小。颞叶新皮层中胆碱乙酰转移酶的减少与通过记忆和信息测试评估的精神损害程度相关，但与斑块或缠结形成的程度无关。在帕金森病而非阿尔茨海默病中，新皮层（特别是颞叶）胆碱乙酰转移酶的减少与迈内特核中的神经元数量相关，这表明这些胆碱能神经元的原发性变性可能直接或间接与帕金森病中认知功能的下降有关。
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