Author/Editor     Gregorič Kramberger, Ljudmila; Štukovnik, Vita; Čuš, Anja; Repovš, Grega; Tomše, Petra; Pečarič-Meglič, Nuška; Garaševič, Zdenko; Jensterle, Jože; Pirtošek, Zvezdan
Title     Parkinson's disease dementia: clinical correlates of brain SPECT perfusion and treatment
Type     članek
Source     Psychiatr Danub
Vol. and No.     Letnik 22, št. 3
Publication year     2010
Volume     str. 446-449
Language     eng
Abstract     Background: The main clinical feature of dementia in Parkinosn'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's 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, visuopatial and attentional deficits were 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.
Descriptors     DOPAMINE AGONISTS