Cognitive decline in Parkinson's disease: the complex picture.
Cognitive decline in Parkinson's disease: the complex picture.
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DOI：
10.1038/npjparkd.2016.18
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Antonini A
中科院分区：
文献类型：
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作者：
Biundo R;Weis L;Antonini A
轻度认知障碍（PD-MCI）和痴呆（PDD）是帕金森病（PD）最常见的非运动症状。PD-MCI比年龄匹配的对照组患痴呆症的可能性高6倍，并且在患病15 - 20年后，PDD患病率为80%。因此，研究集中在识别早期痴呆生物标志物，包括特定的认知风险特征，希望在最有可能有效时实施治疗干预。然而，鉴于认知缺陷的神经病理学、神经化学和神经心理学性质的异质性，定义PDD的综合认知模型是一个挑战。来自使用不同方法和技术的神经影像学研究的证据表明，除了多巴胺能系统的变性外，其他机制也有作用，包括β-淀粉样蛋白和tau蛋白沉积，并且特定的认知量表可以帮助识别恶性特征。需要结合神经影像学技术和特定认知测试的前瞻性研究来确定各种神经退行性过程之间的相互作用以及脑功能网络中结构断开的贡献，预示着PD中痴呆的发展。
Mild cognitive impairment (PD-MCI) and dementia (PDD) are among the most frequent non-motor symptoms in Parkinson’s disease (PD). PD-MCI is six times more likely than age-matched controls to develop dementia and the PDD prevalence is 80% after 15–20 years of disease. Therefore, research has focused on the identification of early dementia biomarkers including specific cognitive at-risk profiles hoping to implement therapeutic interventions when they are most likely to be efficacious. However, given the heterogeneous neuropathological, neurochemical, and neuropsychological nature of cognitive deficits, definition of a comprehensive cognitive model of PDD is a challenge. Evidence from neuroimaging studies using different methods and techniques suggests that in addition to degeneration of the dopaminergic system, other mechanisms have a role including β-amyloid and tau deposition, and that specific cognitive scales could help identifying a malignant profile. Prospective studies combining neuroimaging techniques and specific cognitive tests are required to define the interplay between the various neurodegenerative processes and the contribution of structural disconnection in brain functional networks, heralding the development of dementia in PD.