The spectrum of cognitive impairment in Lewy body diseases.
The spectrum of cognitive impairment in Lewy body diseases.
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DOI：
10.1002/mds.25866
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发表时间：
2014-04-15
影响因子：
8.6
通讯作者：
Galvin, James E.
中科院分区：
文献类型：
--
作者：
Goldman, Jennifer G.;Williams-Gray, Caroline;Barker, Roger A.;Duda, John E.;Galvin, James E.
认知功能障碍是路易体病临床综合征的重要组成部分，通常是路易体病的定义性组成部分：帕金森病和路易体痴呆。这些路易体疾病的认知缺陷谱包括广泛的临床特征、损害的严重程度和表现的时间。认知功能障碍现在被认为不仅发生在更晚期的帕金森氏病中，而且发生在早期未经治疗的患者中，甚至发生在那些患有运动前综合征（如REM行为障碍和嗅觉减退）的患者中。近年来，出现了“轻度认知障碍”作为帕金森病的过渡或痴呆前状态的概念。虽然这导致了许多关于帕金森病轻度认知障碍的诊断，预后和潜在神经生物学的研究，但它也提出了关于这一概念及其在临床和研究环境中的应用的有用性的问题。此外，帕金森病痴呆和路易体痴呆是否代表相同或不同的实体的难题仍然没有解决。虽然这些疾病在其表现和病理生理学的许多方面重叠，但它们在其他方面不同，例如认知，行为和运动症状的时间，药物反应和神经病理学贡献。本文探讨了路易体障碍的认知功能障碍的频谱和演变，并使用点对位的方法在该领域辩论这些有争议的问题。
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. Cognitive dysfunction is now recognized to occur 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 REM 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. While this has led to much research regarding the diagnosis, prognosis, and underlying neurobiology of mild cognitive impairment in Parkinson’s disease, it 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. While these disorders overlap in many aspects of their presentations and pathophysiology, they differ in other aspects 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.
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影响因子：
9.9
作者：
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通讯作者：
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发表时间：
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