Merello M, Sabe L, Teson A, Migliorelli R, Petracchi M, Leiguarda R, Starkstein S
Department of Clinical Neurology, Raul Carrea Institute of Neurological Research, Buenos Aires, Argentina.
J Neurol Neurosurg Psychiatry. 1994 Dec;57(12):1503-9. doi: 10.1136/jnnp.57.12.1503.
The prevalence and clinical correlates of extrapyramidal signs in a consecutive series of 78 patients with Alzheimer's disease attending a neurology clinic, and 20 age comparable normal controls, were examined. Based on the unified Parkinson's disease rating scale (UPDRS) findings, 18 patients (23%) met criteria for parkinsonism, 44 (56%) had isolated extrapyramidal signs, and 16 (21%) had no extrapyramidal signs. Whereas the control group showed a similar prevalence of isolated extrapyramidal signs (57%), none of them showed parkinsonism. No significant differences were found for age, sex, duration of illness, and severity of dementia among the three Alzheimer's disease groups. Patients with Alzheimer's disease-parkinsonism, however, showed a significantly higher frequency of major depression and dysthymia and significantly higher Hamilton depression scores than patients with isolated or no extrapyramidal signs. Patients with Alzheimer's disease-parkinsonism also showed significantly more deficits on frontal lobe related tasks such as the Wisconsin card sorting test, trail making test, and verbal fluency, as well as on tests of constructional praxis and abstract reasoning than patients with Alzheimer's disease but no extrapyramidal signs. In conclusion, the study showed a specific association between Alzheimer's disease and parkinsonism, as well as significant relations between parkinsonism, deficits in executive functions, and depression among patients with Alzheimer's disease.
对一家神经科诊所连续收治的78例阿尔茨海默病患者及20名年龄匹配的正常对照者的锥体外系体征患病率及其临床相关性进行了研究。根据统一帕金森病评定量表（UPDRS）的结果，18例患者（23%）符合帕金森综合征标准，44例（56%）有孤立的锥体外系体征，16例（21%）无锥体外系体征。对照组孤立锥体外系体征的患病率与之相似（57%），但均无帕金森综合征表现。在三组阿尔茨海默病患者中，年龄、性别、病程及痴呆严重程度方面均未发现显著差异。然而，与有孤立锥体外系体征或无锥体外系体征的患者相比，阿尔茨海默病-帕金森综合征患者的重度抑郁和心境恶劣发生率显著更高，汉密尔顿抑郁评分也显著更高。与无锥体外系体征的阿尔茨海默病患者相比，阿尔茨海默病-帕金森综合征患者在额叶相关任务（如威斯康星卡片分类测验、连线测验和言语流畅性测验）以及结构实践和抽象推理测验中的缺陷也显著更多。总之，该研究表明阿尔茨海默病与帕金森综合征之间存在特定关联，且帕金森综合征、执行功能缺陷与阿尔茨海默病患者的抑郁之间存在显著关系。
