Abstract
Parkinson’s disease (PD) has initially been described as a clinical syndrome, although its exact definition has changed over the past centuries. The identification of the pathological changes added another level of complexity, with Lewy bodies, synuclein deposits and neuronal loss in the substantia nigra being used alternatively as criteria. A third level of complexity was added with the recognition of genetic mutations resulting in Parkinsonism, sometimes with and sometimes without Lewy bodies or synuclein deposition. Lastly, frequent additional important pre-motor manifestations, particularly depression, anosmia and sleep-associated phenomena have been described. These different points of view on the definition of PD have important implications on the study of the etiology and even the therapy of PD. Cognitive impairment is also an important feature of PD, while the spectrum of deficits ranges from none to severe dementia. The no-man land in-between normal cognition and dementia has been termed mild cognitive impairment in PD. At present, this term lacks heuristic value or clinical utility, and remains a target for scientific research.
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References
Aarsland D, Kurz MW (2010) The epidemiology of dementia associated with Parkinson’s disease. Brain Pathol 20:633–639
Aarsland D, Laake K, Larsen JP, Janvin C (2002) Donepezil for cognitive impairment in Parkinson’s disease: a randomised controlled study. J Neurol Neurosurg Psychiatry 72:708–712
Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sorensen P (2003) Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch Neurol 60:387–392
Aarsland D, Bronnick K, Williams-Gray C, Weintraub D, Marder K, Kulisevsky J, Burn D, Barone P, Pagonabarraga J, Allcock L, Santangelo G, Foltynie T, Janvin C, Larsen JP, Barker RA, Emre M (2010) Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 75:1062–1069
Adler CH, Caviness JN, Sabbagh MN, Shill HA, Connor DJ, Sue L, Evidente VG, Driver-Dunckley E, Beach TG (2010) Heterogeneous neuropathological findings in Parkinson’s disease with mild cognitive impairment. Acta Neuropathol 120:827–828
Ash EL, Korczyn AD (2010) Is amnestic mild cognitive impairment a useful concept? Aging Health 7:107–122
Balash Y, Korczyn AD (2007) Vascular Parkinsonism. Handb Clin Neurol 84:417–425
Ballard C, Ziabreva I, Perry R et al (2006) Differences in neuropathologic characteristics across the Lewy body dementia spectrum. Neurology 67:1931–1934
Bläsi S, Zehnder AE, Berres M, Taylor KI, Spiegel R, Monsch AU (2009) Norms for change in episodic memory as a prerequisite for the diagnosis of mild cognitive impairment (MCI). Neuropsychology 23:189–200
Braak H, Braak E (1991) Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 82:239–259
Braak H, Braak E (2000) Pathoanatomy of Parkinson’s disease. J Neurol 247:II3–II10
Braak H, Del Tredici K, Bratzke H, Hamm-Clement J, Sandmann-Keil D, Rüb U (2002) Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson’s disease (preclinical and clinical stages). J Neurol 249(Suppl 3):III/1–5
Cools R, Stefanova E, Barker RA, Robbins TW, Owen AM (2002) Dopaminergic modulation of high-level cognition in Parkinson’s disease: the role of the prefrontal cortex revealed by PET. Brain 125:584–594
Dubois B, Pilon B, Lhermitte F, Agid Y (1990) Cholinergic deficiency and frontal dysfunction in Parkinson’s disease. Ann Neurol 28:117–121
Emre M, Aarsland D, Albanese A et al (2004) Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med 351:2509–2518
Emre M, Tsolaki M, Bonuccelli U et al (2010) Memantine for patients with Parkinson’s disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 9:969–977
Glosser G, Clark C, Freundlich B, Kliner-Krenzel L, Flaherty P, Stern M (1995) A controlled investigation of current and premorbid personality: characteristics of Parkinson’s disease patients. Mov Disord 10:201–206
Janvin CC, Larsen JP, Aarsland D, Hugdahl K (2006) Subtypes of mild cognitive impairment in Parkinson’s disease: progression to dementia. Mov Disord 21:1343–1349
Kalaitzakis ME, Pearce RK (2009) The morbid anatomy of dementia in Parkinson’s disease. Acta Neuropathol 118:587–598
Klein JC, Eggers C, Kalbe E et al (2010) Neurotransmitter changes in dementia with Lewy bodies and Parkinson disease dementia in vivo. Neurology 74:885–892
Korczyn AD (2002) Mixed dementia—the most common cause of dementia. Ann N Y Acad Sci 977:129–34
Korczyn AD (2011) Should we diagnose MCI in Parkinson disease? J Neural Transm 118:1177
Korczyn AD, Gurevich T (2010) Parkinson’s disease: before the motor symptoms and beyond. J Neurol Sci 289:2–6
Lee JE, Park HJ, Song SK, Sohn YH, Lee JD, Lee PH (2010) Neuroanatomic basis of amnestic MCI differs in patients with and without Parkinson disease. Neurology 75(22):2009-2016
Litvan I, Aarsland D, Adler CH, Goldman JG, Kulisevsky J, Mollenhauer B, Rodriguez-Oroz MC, Tröster AI, Weintraub D (2011) MDS Task Force on mild cognitive impairment in Parkinson’s disease: critical review of PD-MCI. Mov Disord 26:1814–1824
Londos E, Passant U, Brun A, Gustafson L (2000) Clinical Lewy body dementia and the impact of vascular components. Int J Geriatr Psychiatry 15:40–49
Nakano I, Hirano A (1984) Parkinson’s disease: neuron loss in the nucleus basalis without concomitant Alzheimer’s disease. Ann Neurol 15:415–418
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56:303–308
Pillon B, Dubois B, Cusimano G, Bonnet AM, Lhermitte 298 F, Agid Y (1989) Does cognitive impairment in Parkinson’s disease result from non-dopaminergic lesions? J Neurol Neurosurg Psychiatry 52:201–206
Poewe W, Gerstenbrand F, Ransmayr G, Plörer S (1983) Premorbid personality of Parkinson patients. J Neural Transm Suppl 19:215–224
Poletti M, Emre M, Bonuccelli U (2011) Mild cognitive impairment and cognitive reserve in Parkinson’s disease. Parkinsonism Relat Disord 17:579–586
Reiff J, Schmidt N, Riebe B, Breternitz R, Aldenhoff J, Deuschl G, Witt K (2011) Subthreshold depression in Parkinson’s disease. Mov Disord 26:1741–1744
Rektorova I, Rektor I, Bares M et al (2005) Cognitive performance in people with Parkinson’s disease and mild or moderate depression: effects of dopamine agonists in an add-on to l-dopa therapy. Eur J Neurol 12:9–15
Saczynski JS, Beiser A, Seshadri S, Auerbach S, Wolf PA, Au R (2010) Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 75:35–41
Salganik I, Korczyn A (1990) Risk factors for dementia in Parkinson’s disease. Adv Neurol 53:343–347
Scatton B, Rouquier L, Javoy-Agid F, Agid Y (1982) Dopamine deficiency in the cerebral cortex in Parkinson disease. Neurology 32(9):1039–1040
Siderowf A, Xie SX, Hurtig H, Weintraub D, Duda J, Chen-Plotkin A, Shaw LM, Van Deerlin V, Trojanowski JQ, Clark C (2010) CSF amyloid {beta} 1-42 predicts cognitive decline in Parkinson disease. Neurology 75(12):1055–1061
Treves TA, Chandra V, Korczyn AD (1993a) Parkinson’s and Alzheimer’s diseases: epidemiological comparison. 1. Descriptive aspects. Neuroepidemiology 12:336–344
Treves TA, Chandra V, Korczyn AD (1993b) Parkinson’s and Alzheimer’s diseases: epidemiological comparison. 2. Persons at risk. Neuroepidemiology 12:345–349
Uemura Y, Wada-Isoe K, Nakashita S, Nakashima K (2013) Depression and cognitive impairment in patients with mild parkinsonian signs. Acta Neurol Scand. doi:10.1111/ane.12089
Walitza S, Melfsen S, Herhaus G, Scheuerpflug P, Warnke A, Müller T, Lange KW, Gerlach M (2007) Association of Parkinson’s disease with symptoms of attention deficit hyperactivity disorder in childhood. J Neural Transm Suppl 72:311–315
Weintraub D, Dietz N, Duda JE, Wolk DA, Doshi J, Xie SX, Davatzikos C, Clark CM, Siderowf A (2012) Alzheimer’s disease pattern of brain atrophy predicts cognitive decline in Parkinson’s disease. Brain 135:170–180
Werner P, Korczyn AD (2008) Mild cognitive impairment: conceptual, assessment, ethical, and social issues. Clin Interv Aging 3:413–420
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Korczyn, A.D. Mild cognitive impairment in Parkinson’s disease. J Neural Transm 120, 517–521 (2013). https://doi.org/10.1007/s00702-013-1006-0
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DOI: https://doi.org/10.1007/s00702-013-1006-0