The spectrum of cognitive impairment in Lewy body diseases

被引:94
作者
Goldman, Jennifer G. [1 ]
Williams-Gray, Caroline [2 ]
Barker, Roger A. [2 ]
Duda, John E. [3 ,4 ]
Galvin, James E. [5 ,6 ,7 ]
机构
[1] Rush Univ Med Ctr, Sect Parkinson Dis & Movement Disorders, Dept Neurol Sci, Chicago, IL 60612 USA
[2] Univ Cambridge, Dept Clin Neurosci, John Van Geest Ctr Brain Repair, Cambridge, England
[3] Univ Penn Perelman Sch Med, Dept Neurol, Philadelphia, PA USA
[4] Philadelphia Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA
[5] New York Univ Sch Med, Dept Neurol, New York, NY USA
[6] New York Univ Sch Med, Dept Psychiat, New York, NY USA
[7] New York Univ Sch Med, Dept Populat Hlth, New York, NY USA
关键词
dementia; Parkinson's disease; cognition; executive function; mild cognitive impairment; NEWLY-DIAGNOSED PATIENTS; MINI-MENTAL-STATE; 5-YEAR FOLLOW-UP; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; DELUSIONAL MISIDENTIFICATION; NEURODEGENERATIVE DISEASE; COMPLEX ACTIVITIES; MOTOR DYSFUNCTION; ALPHA-SYNUCLEIN;
D O I
10.1002/mds.25866
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Cognitive impairment represents an important and often defining component of the clinical syndromes of Lewy body disorders: Parkinson's disease and dementia with Lewy bodies. The spectrum of cognitive deficits in these Lewy body diseases encompasses a broad range of clinical features, severity of impairment, and timing of presentation. It is now recognized that cognitive dysfunction occurs not only in more advanced Parkinson's disease but also in early, untreated patients and even in those patients with pre-motor syndromes, such as rapid eye movement behavior disorder and hyposmia. In recent years, the concept of mild cognitive impairment as a transitional or pre-dementia state in Parkinson's disease has emerged. This has led to much research regarding the diagnosis, prognosis, and underlying neurobiology of mild cognitive impairment in Parkinson's disease, but has also raised questions regarding the usefulness of this concept and its application in clinical and research settings. In addition, the conundrum of whether Parkinson's disease dementia and dementia with Lewy bodies represent the same or different entities remains unresolved. Although these disorders overlap in many aspects of their presentations and pathophysiology, they differ in other elements, such as timing of cognitive, behavioral, and motor symptoms; medication responses; and neuropathological contributions. This article examines the spectrum and evolution of cognitive impairment in Lewy body disorders and debates these controversial issues in the field using point-counterpoint approaches. (c) 2014 International Parkinson and Movement Disorder Society
引用
收藏
页码:608 / 621
页数:14
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