Diagnosis and management of Parkinson's disease dementia
Identifieur interne : 000B60 ( Pmc/Curation ); précédent : 000B59; suivant : 000B61Diagnosis and management of Parkinson's disease dementia
Auteurs : W. Poewe [Autriche] ; S. Gauthier [Canada] ; D. Aarsland [Norvège] ; J B Leverenz [États-Unis] ; P. Barone [Italie] ; D. Weintraub [États-Unis] ; E. Tolosa [Espagne] ; B. Dubois [France]Source :
- International Journal of Clinical Practice [ 1368-5031 ] ; 2008.
Abstract
Parkinson's disease (PD) has long been considered predominantly a motor disorder. However, its frequent association with dementia, which contributes significantly to the morbidity and mortality of the condition, is gaining increasing recognition. PD dementia (PDD) has a unique clinical profile and neuropathology, distinct from Alzheimer's disease (AD). Cholinergic deficits, a feature of both AD and PDD, underlie the rationale for cholinesterase inhibitor therapy in both conditions. In clinical practice, it is important that PDD should be recognised and appropriately treated. This review aims to outline the recently proposed clinical diagnostic criteria for PDD and to summarise the guidelines/recommendations published since 2006 on the use of cholinesterase inhibitors in the management of PDD. Although the cholinesterase inhibitor rivastigmine has recently been approved for the management of PDD, there remains a need for the development of novel therapies that can affect key mechanisms of the disease or prevent/delay patients with PD and mild cognitive impairment from progressing to PDD.
Url:
DOI: 10.1111/j.1742-1241.2008.01869.x
PubMed: 18822028
PubMed Central: 2658001
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<front><div type="abstract" xml:lang="en"><p>Parkinson's disease (PD) has long been considered predominantly a motor disorder. However, its frequent association with dementia, which contributes significantly to the morbidity and mortality of the condition, is gaining increasing recognition. PD dementia (PDD) has a unique clinical profile and neuropathology, distinct from Alzheimer's disease (AD). Cholinergic deficits, a feature of both AD and PDD, underlie the rationale for cholinesterase inhibitor therapy in both conditions. In clinical practice, it is important that PDD should be recognised and appropriately treated. This review aims to outline the recently proposed clinical diagnostic criteria for PDD and to summarise the guidelines/recommendations published since 2006 on the use of cholinesterase inhibitors in the management of PDD. Although the cholinesterase inhibitor rivastigmine has recently been approved for the management of PDD, there remains a need for the development of novel therapies that can affect key mechanisms of the disease or prevent/delay patients with PD and mild cognitive impairment from progressing to PDD.</p>
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<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
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<title-group><article-title>Diagnosis and management of Parkinson's disease dementia</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Poewe</surname>
<given-names>W</given-names>
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<given-names>S</given-names>
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</name>
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</name>
<xref ref-type="aff" rid="au6">6</xref>
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<given-names>D</given-names>
</name>
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<given-names>E</given-names>
</name>
<xref ref-type="aff" rid="au8">8</xref>
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<contrib contrib-type="author"><name><surname>Dubois</surname>
<given-names>B</given-names>
</name>
<xref ref-type="aff" rid="au9">9</xref>
</contrib>
<aff id="au1"><label>1</label>
<institution>Department of Neurology, Medical University Innsbruck</institution>
<addr-line>Innsbruck, Austria</addr-line>
</aff>
<aff id="au2"><label>2</label>
<institution>Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, Douglas Mental Health University Institute</institution>
<addr-line>Montréal, QC, Canada</addr-line>
</aff>
<aff id="au3"><label>3</label>
<institution>Norweigen Centre for Movement Disorders, Stavenger University Hospital</institution>
<addr-line>Stavenger, Norway</addr-line>
</aff>
<aff id="au4"><label>4</label>
<institution>Institute of Clinical Medicine, University of Bergen</institution>
<addr-line>Bergen, Norway</addr-line>
</aff>
<aff id="au5"><label>5</label>
<institution>Mental Illness and Parkinson's Disease Research Education and Clinical Centers, VA-PSHCS, and Departments of Neurology and Psychiatry and Behavioral Sciences, University of Washington</institution>
<addr-line>Seattle, WA, USA</addr-line>
</aff>
<aff id="au6"><label>6</label>
<institution>Dipartimento di Scienze Neurologiche, Università Federico II di Napoli</institution>
<addr-line>Naples, Italy</addr-line>
</aff>
<aff id="au7"><label>7</label>
<institution>Department of Psychiatry, University of Pennsylvania</institution>
<addr-line>Philadelphia, PA, USA</addr-line>
</aff>
<aff id="au8"><label>8</label>
<institution>Parkinson's Disease and Movement Disorders Unit, Institut Clínic de Neurociències, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona</institution>
<addr-line>Barcelona, Spain</addr-line>
</aff>
<aff id="au9"><label>9</label>
<institution>INSERM-UPMC UMRS 610, Federation of Neurology, Salpêtrière Hospital; University of Paris</institution>
<addr-line>Paris, France</addr-line>
</aff>
</contrib-group>
<author-notes><corresp id="cor1">Correspondence to: Professor Werner Poewe Department of Neurology, Medical University Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria Tel.: + 43 512 504 23850 Fax: + 43 512 504 23852 Email: <email>werner.poewe@uibk.ac.at</email>
</corresp>
<fn><p><bold>Disclosures</bold>
SG has been a consultant and is an investigator in Novartis-sponsored studies, he owns no stock or option; DA has received honoraria and research support from Novartis, Pfizer, Janssen-Cilag, H. Lundbeck, AstraZeneca, he owns no stock or option; JBL has been a consultant for GlaxoSmithKline, and consultant and speaker for Novartis Pharmaceuticals; DW has served as a consultant to Novartis.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>10</month>
<year>2008</year>
</pub-date>
<volume>62</volume>
<issue>10</issue>
<fpage>1581</fpage>
<lpage>1587</lpage>
<history><date date-type="received"><month>5</month>
<year>2008</year>
</date>
<date date-type="accepted"><month>7</month>
<year>2008</year>
</date>
</history>
<copyright-statement>Journal compilation © 2008 Blackwell Publishing Ltd</copyright-statement>
<copyright-year>2008</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.5/"><p>Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.</p>
</license>
<abstract><p>Parkinson's disease (PD) has long been considered predominantly a motor disorder. However, its frequent association with dementia, which contributes significantly to the morbidity and mortality of the condition, is gaining increasing recognition. PD dementia (PDD) has a unique clinical profile and neuropathology, distinct from Alzheimer's disease (AD). Cholinergic deficits, a feature of both AD and PDD, underlie the rationale for cholinesterase inhibitor therapy in both conditions. In clinical practice, it is important that PDD should be recognised and appropriately treated. This review aims to outline the recently proposed clinical diagnostic criteria for PDD and to summarise the guidelines/recommendations published since 2006 on the use of cholinesterase inhibitors in the management of PDD. Although the cholinesterase inhibitor rivastigmine has recently been approved for the management of PDD, there remains a need for the development of novel therapies that can affect key mechanisms of the disease or prevent/delay patients with PD and mild cognitive impairment from progressing to PDD.</p>
</abstract>
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