[Cognitive and behavioral disorders in Parkinson disease].
BACKGROUND
Most patients with Parkinson's disease have cognitive and behavior disorders during the course of their illness.


OBJECTIVE
In this study we consider practical aspects of the treatment of patients with Parkinson's disease who have such problems.


METHODS
Better understanding of both normal and abnormal physiology of the basal ganglia and their connections makes it possible to suggest hypotheses regarding the cause of these disorders. The combination of lesions of multiple subcorticocortical systems with different degrees of direct cortical pathology due to Lewy bodies and neuritic plaques may explain most of the changes, from depression to dementia.


CONCLUSIONS
It is necessary to test these concepts using studies based on specific predictions derived from pathophysiological models. Until this is done, the clinical treatment of cognitive and compartmental disorders in Parkinson's disease will continue to be symptomatic, complex and controversial.
Pascual-Leone
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Unidad de Neurología del Comportamiento, Universidad de Harvard, Boston, MA, USA. apleone@caregroup.harvard.edu
Press
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D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology*; D009415:Nerve Net / Q000503:physiopathology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D011596:Psychomotor Disorders / Q000188:drug therapy / Q000209:etiology; D012720:Severity of Illness Index
D018491:Dopamine Agonists