A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia
A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia
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DOI：
10.1002/gps.389
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发表时间：
2001-05-01
影响因子：
4
通讯作者：
McKeith, I
中科院分区：
文献类型：
--
作者：
Aarsland, D;Ballard, C;McKeith, I
目的比较伴有和不伴有痴呆的帕金森病（PD）患者及伴路易体痴呆（DLB）患者神经精神症状的发生频率及临床相关因素。方法采用标准化仪器对临床诊断为PD合并痴呆（PDD, n =48）和无痴呆（PDD, n = 83）的PD患者以及98例DLB患者（33%尸检证实）评估前一个月的神经精神症状进行评估。结果DLB患者妄想和幻觉发生率分别为57%和76%，显著高于PDD患者（29%和54%）和pnd患者（7%和14%）（p < 0.001）。在所有组中，听觉和视觉幻觉以及偏执和幽灵寄宿生妄想是最常见的精神病症状。重度抑郁和轻度抑郁的频率在三组之间没有显著差异。PD患者幻觉的临床相关因素是痴呆(优势比(OR)= 3.9；95%可信区间（CI） 1.5-10.4)和Hoehn-Yahr 3期或以上（or 3.3; 95% CI 1.0-12.0），而在DLB患者中未发现显著的幻觉临床相关性。结论PDD、PDD和DLB患者出现妄想和幻觉的频率增加，但症状表现相似。这些发现支持了精神症状与这两种疾病的皮质路易体或胆碱能缺陷有关的假设。版权所有John Wiley & Sons， Ltd。
Objectives To compare the frequency and clinical correlates of neuropsychiatric symptoms in patients with Parkinson's disease (PD) with and without dementia and in those with dementia with Lewy bodies (DLB).Methods Neuropsychiatric symptoms during the month prior to assessment were assessed in clinically diagnosed PD patients with dementia (PDD; n =48) and without dementia (PDND; n = 83) and in 98 DLB patients (33% autopsy confirmed) using standardized instruments.Results Delusions and hallucinations were significantly more common in DLB (57% and 76%) than PDD (29% and 54%) and PDND (7% and 14%) patients (p < 0.001). In all groups, auditory and visual hallucinations and paranoid and phantom boarder delusions were the most common psychotic symptoms. Frequency of major depression and less than major depression did not differ significantly between the three groups. Clinical correlates of hallucinations in PD were dementia (odds ratio (OR)= 3.9; 95% confidence interval (CI) 1.5-10.4) and Hoehn-Yahr stage 3 or more (OR 3.3; 95% CI 1.0-12.0), whereas no significant clinical correlates of hallucinations were found in DLB patients.Conclusions Delusions and hallucinations occur with increasing frequency in PDND, PDD and DLB patients, but the presentation of these symptoms is similar. These findings support the hypothesis that psychiatric symptoms are associated with cortical Lewy bodies or cholinergic deficits in the two disorders. Copyright (C) 2001 John Wiley & Sons, Ltd.