Psychiatria Danubina, Vol. 22 No. 3, 2010.
Short communication, Note
PARKINSON’S DISEASE DEMENTIA: Clinical correlates of brain SPECT perfusion and treatment
Milica Gregorič Kramberger
orcid.org/0000-0001-8231-1176
; Department of Neurology, University Medical Centre Ljubljana, Slovenia
Vita Štukovnik
; Department of Neurology, University Medical Centre Ljubljana, Slovenia
Anja Čuš
Grega Repovš
; Faculty of Arts, Department of Psychology, Ljubljana, Slovenia
Petra Tomše
; Department of Nuclear medicine, University Medical Centre Ljubljana, Slovenia
Nuška Pečarič Meglič
; Institute of Radiology, University Medical Centre Ljubljana, Slovenia
Zdenko Garašević
; Department of Neurology, University Medical Centre Ljubljana, Slovenia
Jože Jensterle
; Psychiatry Clinic Ljubljana, Ljubljana, Slovenia
Zvezdan Pirtošek
; Department of Neurology, University Medical Centre Ljubljana, Slovenia
Abstract
Background: The main clinical feature of dementia in Parkinson's disease is a dysexecutive syndrome. The neuropathology of
PD dementia (PDD) is likely multifactorial and affects several neuronal populations. There is evidence that Parkinson’s disease
dementia is associated with a cholinergic deficit, supporting the therapeutic role of cholinesterase inhibitors, which are already firstline
agents in the treatment of Alzheimer's disease.
The paper includes short report on a pilot study with description of cognitive and imaging profiles in patients with mild to
moderate stage of Parkinson disease dementia (PDD).
Subjects and methods: A random sample of 16 patients with clinical diagnostic criteria for probable PDD was included in the
study. Patients were characterized with mild to moderate cognitive decline slightly depressive mood and moderate motor
performance. Brain perfusion [99mTc]ECD / SPECT and structural MRI with emphasis on evaluation of the degree of cortical
atrophy and the medial temporal atrophy index was performed. All patients had detailed neuropsychological evaluation using a
“cognitive process approach”. Neuropsychological data were correlated voxel-wise with normalized brain perfusion images,
creating whole-brain correlation maps.
Conclusions: Previously reported generalized cognitive impairment in PDD with predominant executive, visouspatial and
attentional deficits was confirmed. Performance on specific cognitive measures was correlated with perfusion brain SPECT findings.
It could be speculated that different pathological mechanisms underlie widespread significant brain perfusion decrements in
temporal, parietal and frontal regions.
Keywords
Parkinson’s disease dementia; perfusion brain SPECT; cognitive and imaging profile; treatment
Hrčak ID:
76361
URI
Publication date:
29.10.2010.
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