Sweet R A, Akil M, Mulsant B H, Ulrich R, Pasternak R E, Zubenko G S
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania, USA.
J Neuropsychiatry Clin Neurosci. 1998 Winter;10(1):68-77. doi: 10.1176/jnp.10.1.68.
Extrapyramidal symptoms (EPS) occur more frequently in dementia of the Alzheimer's type (DAT) than in normal aging. Other late-life mental disorders, however, have also been associated with EPS. To examine whether EPS are increased in DAT patients relative to neuropsychiatric control subjects, the authors compared EPS in 127 neuroleptic-free elderly patients diagnosed with either DAT, major depressive disorder (MDD), or a psychotic disorder (SCHIZ/DELUS). They also examined whether depressive or psychotic symptoms were associated with EPS independently of diagnosis. Severity of parkinsonian rigidity was found to be independently associated with DAT. Rank order of rigidity was DAT > MDD > SCHIZ/DELUS. Bradykinesia, although not associated with diagnostic group, was positively correlated with withdrawn depression. These findings suggest that rigidity is associated with DAT independently of any concurrent psychotic or depressive process, whereas bradykinesia does not appear to be specific to DAT among late-life neuropsychiatric illnesses.
锥体外系症状（EPS）在阿尔茨海默病型痴呆（DAT）中比在正常衰老中更频繁出现。然而，其他晚年精神障碍也与EPS有关。为了研究与神经精神对照受试者相比，DAT患者的EPS是否增加，作者比较了127例未服用抗精神病药物的老年患者的EPS，这些患者被诊断为DAT、重度抑郁症（MDD）或精神障碍（精神分裂症/妄想症）。他们还研究了抑郁或精神病症状是否独立于诊断与EPS相关。发现帕金森氏症僵硬的严重程度与DAT独立相关。僵硬程度的排序为DAT>MDD>精神分裂症/妄想症。运动迟缓虽然与诊断组无关，但与退缩性抑郁症呈正相关。这些发现表明，僵硬与DAT独立相关，与任何并发的精神病或抑郁过程无关，而运动迟缓在晚年神经精神疾病中似乎并非DAT所特有。
