Journal of Neurology

, Volume 257, Issue 6, pp 1004–1011

Fluctuating cognition and different cognitive and behavioural profiles in Parkinson’s disease with dementia: comparison of dementia with Lewy bodies and Alzheimer’s disease

  • Sara Varanese
  • Bernardo Perfetti
  • Daniela Monaco
  • Astrid Thomas
  • Laura Bonanni
  • Pietro Tiraboschi
  • Marco Onofrj
Original Communication

DOI: 10.1007/s00415-010-5453-3

Cite this article as:
Varanese, S., Perfetti, B., Monaco, D. et al. J Neurol (2010) 257: 1004. doi:10.1007/s00415-010-5453-3

Abstract

To examine the occurrence of fluctuating cognition (FC) in a group of patients with Parkinson’s disease with dementia (PDD), and to determine whether the presence of FC in PDD is associated with a pattern of cognitive and behavioural disturbances similar to the one shown by patients affected by dementia with Lewy bodies (DLB), a cluster analysis was carried out on the scores obtained by 27 PDD patients on the Clinician Assessment of Fluctuation Scale (CAF). The analysis separated the PDD patients into two subgroups, called PDD non-fluctuators (PDDNF; CAF ≤ 2) and PDD fluctuators (PDDF; CAF > 2). The two groups underwent a cognitive and behavioural evaluation. Their scores were compared with those obtained by DLB and Alzheimer’s disease (AD) patients. When exploring the cognitive performance of the patients with the Dementia Rating Scale-2 (DRS-2), PDDF had a similar pattern of impairments compared to DLB, which involved prevalently the attention and initiation/perseveration domains, and which was significantly more pronounced compared to that shown by PDDNF. The main behavioural finding of the study was the similar incidence of visual hallucinations in the PDDF and DLB groups, which was significantly higher compared to PDDNF and AD. Our results confirmed the hypothesis that subgroups with different cognitive profiles exist within PDD and that the occurrence of FC is the clinical variable associated with a DLB pattern of impairment in PDD. In conclusion, our study suggests that when FC occurs in PDD this syndrome becomes clinically undistinguishable from DLB.

Keywords

Parkinsonism Dementia Rating Scale Hallucinations 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Sara Varanese
    • 1
    • 2
  • Bernardo Perfetti
    • 1
    • 3
  • Daniela Monaco
    • 1
  • Astrid Thomas
    • 1
  • Laura Bonanni
    • 1
  • Pietro Tiraboschi
    • 4
  • Marco Onofrj
    • 1
  1. 1.Oncology and Neuroscience DepartmentUniversity “G. d’Annunzio”Chieti-PescaraItaly
  2. 2.Division of Movement Disorders, Department of NeurologyNew York UniversityNew YorkUSA
  3. 3.Department of Physiology and Pharmacology, Sophie Davis Medical SchoolCity College of New YorkNew YorkUSA
  4. 4.Department of NeurologyNiguarda Ca’ Grande HospitalMilanItaly

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