Change in perfusion, hallucinations and fluctuations in consciousness in dementia with Lewy bodies
Change in perfusion, hallucinations and fluctuations in consciousness in dementia with Lewy bodies
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DOI：
10.1016/j.pscychresns.2005.04.002
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发表时间：
2005-07-30
影响因子：
2.3
通讯作者：
McKeith, IG
中科院分区：
文献类型：
--
作者：
O'Brien, JT;Firbank, MJ;McKeith, IG
意识波动和幻视是路易体痴呆和帕金森病痴呆的常见神经精神特征。为了研究潜在的神经相关性，我们比较了1年内脑灌注的变化与这些关键临床特征严重程度的变化之间的关系。我们招募了29名帕金森病伴痴呆（15名受试者）或路易体痴呆（14名受试者）受试者。在基线时使用HMPAO SPECT测量脑灌注，并在1年后重复。在两个时间点评估是否存在幻觉（神经精神量表）、意识波动的严重程度（波动评估量表）和认知能力（CAMCOG）。在控制了认知能力的变化和胆碱酯酶药物的作用后，我们发现中线后扣带回灌注增加与幻觉严重程度降低之间存在显著相关性。意识波动增加与丘脑灌注增加和枕下叶灌注减少之间也存在显著相关性。我们已经确定了路易体痴呆症的关键临床特征的重要神经相关性，并假设可以通过胆碱能系统对注意力的影响来理解这种关联。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Fluctuations in consciousness and visual hallucinations are common neuropsychiatric features of dementia with Lewy bodies and Parkinson's disease dementia. To investigate potential neural correlates, we compared how changes in brain perfusion over a 1-year period were related to changes in the severity of these key clinical features. We recruited 29 subjects with either Parkinson's disease with dementia (15 subjects) or dementia with Lewy bodies (14 subjects). Cerebral perfusion was measured using HMPAO SPECT at baseline, and repeated 1 year later. The presence of hallucinations (Neuropsychiatric Inventory), severity of fluctuations in consciousness (fluctuation assessment scale) and cognitive ability (CAMCOG) were assessed at both time points. After controlling for changes in cognitive ability and effect of cholinesterase medication, we found a significant correlation between an increase in perfusion in midline posterior cingulate and decrease in hallucination severity. There was also a significant correlation between increased fluctuations of consciousness and increased thalamic and decreased inferior occipital perfusion. We have identified important neural correlates of key clinical features in Lewy body dementia and postulate that the associations can be understood through the influence of the cholinergic system on attention. (c) 2005 Elsevier Ireland Ltd. All rights reserved.