Parkinson's disease dementia: clinical correlates of brain spect perfusion and treatment.
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 first-line 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).


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 [(99m)Tc]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.
Kramberger
Milica Gregoric
MG
Department of Neurology, University Medical Centre Ljubljana, Zaloska cesta 2, Ljubljana, Slovenia. milica.kramberger@gmail.com
Stukovnik
Vita
V
Cus
Anja
A
Repovs
Grega
G
Tomse
Petra
P
Meglic
Nuska Pecaric
NP
Garasević
Zdenko
Z
Jensterle
Joze
J
Pirtosek
Zvezdan
Z
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001284:Atrophy; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003545:Cysteine / Q000031:analogs & derivatives; D003704:Dementia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D015609:Organotechnetium Compounds; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010865:Pilot Projects; D011594:Psychometrics; D013223:Statistics as Topic; D015899:Tomography, Emission-Computed, Single-Photon
D000978:Antiparkinson Agents; D002800:Cholinesterase Inhibitors; D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine