Current treatment of dementia with Lewy bodies and dementia associated with Parkinson's disease
Identifieur interne : 004140 ( Main/Exploration ); précédent : 004139; suivant : 004141Current treatment of dementia with Lewy bodies and dementia associated with Parkinson's disease
Auteurs : David J. Burn [Royaume-Uni] ; Ian G. Mckeith [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Chemotherapy, Cholinesterase, Cholinesterase Inhibitors (adverse effects), Cholinesterase Inhibitors (therapeutic use), Clinical Trials as Topic, Dementia (diagnosis), Dementia (drug therapy), Enzyme inhibitor, Human, Humans, Lewy Body Disease (diagnosis), Lewy Body Disease (drug therapy), Lewy body dementia, Neurologic Examination, Neuropsychological Tests, Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson disease, Parkinson's disease, Treatment, Treatment Outcome, cholinesterase inhibitor, dementia, dementia with Lewy bodies, treatment.
- MESH :
- chemical , adverse effects : Cholinesterase Inhibitors.
- chemical , therapeutic use : Cholinesterase Inhibitors.
- diagnosis : Dementia, Lewy Body Disease, Parkinson Disease.
- drug therapy : Dementia, Lewy Body Disease, Parkinson Disease.
- Clinical Trials as Topic, Humans, Neurologic Examination, Neuropsychological Tests, Treatment Outcome.
Abstract
Dementia in Parkinson's disease (PDD) is a frequent and distressing complication with major consequences. Clinical and pathological features closely link PDD and dementia with Lewy bodies (DLB), suggesting they represent part of the same disease spectrum. Although dopaminergic deficiency primarily determines the akinetic–rigid symptoms of PDD and DLB, there is overwhelming evidence that cholinergic dysfunction underpins many of the cognitive impairments and psychotic features. Open‐label studies have suggested that cholinesterase inhibitor drugs may exert positive effects upon all aspects of the neuropsychiatric syndrome in PDD and DLB but particularly apathy, anxiety, impaired attention, hallucinations, delusions, sleep disturbance, and cognitive test performance. Worsening of extrapyramidal motor features is reported only rarely. Initial double‐blind, placebo‐controlled studies in PDD and DLB have so far confirmed these encouraging results. Early identification of PD patients at greatest risk of developing dementia would permit early use of disease modifying treatments which represent the “golden fleece” management approach to these groups. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10566
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">Dementia in Parkinson's disease (PDD) is a frequent and distressing complication with major consequences. Clinical and pathological features closely link PDD and dementia with Lewy bodies (DLB), suggesting they represent part of the same disease spectrum. Although dopaminergic deficiency primarily determines the akinetic–rigid symptoms of PDD and DLB, there is overwhelming evidence that cholinergic dysfunction underpins many of the cognitive impairments and psychotic features. Open‐label studies have suggested that cholinesterase inhibitor drugs may exert positive effects upon all aspects of the neuropsychiatric syndrome in PDD and DLB but particularly apathy, anxiety, impaired attention, hallucinations, delusions, sleep disturbance, and cognitive test performance. Worsening of extrapyramidal motor features is reported only rarely. Initial double‐blind, placebo‐controlled studies in PDD and DLB have so far confirmed these encouraging results. Early identification of PD patients at greatest risk of developing dementia would permit early use of disease modifying treatments which represent the “golden fleece” management approach to these groups. © 2002 Movement Disorder Society</div>
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