Full Text:


영남의대학술지 Vol.24_No.2 Suppl. P.S159-169, Dec. 2007


파킨슨병 치매의 진단과 치료에 대한 최신 지견

Diagnosis and Treatment of Parkinson's Disease Dementia: An Update

영남대학교 의과대학 신경과학교실
책임저자:박미영, 대구광역시 남구 대명동 317-1, 영남대학교 의과대학 신경과학교실
Tel: (053) 620-3682, Fax: (053) 627-1688
E-mail: mypark@med.yu.ac.kr

December 30, 2007


Dementia in the Parkinson’s disease has been increasingly recognized especially in old age. And akinetic-rigid symptoms or cognitive impairment at onset of Parkinson’s disease (PD) are also high risk factors for dementia. However, there have been no gold standard guideline in order to identify the Parkinson’s disease dementia (PDD). Recently, the Movement Disorder Society developed a new diagnostic criteria for PDD in December 2007. I introduce a new PDD diagnostic criteria proposal with a review of treatment strategy of PDD. After the sensitivity and specificity of these criteria ascertained, a revision may be need. But they promising clinical and prospective research baselines in the future.

Key Words: Parkinson’s disease dementia(PDD), Diagnostic criteria, Treatment of PDD


1. Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts D, Mizuno Y, et al. Clinical diagnostic for dementia associated with Parkinson's disease. Movement Disorders 2007; 22:1689-707.

2. Dubois B, Burn D, Goetz C, Aarsland D, Brown RG, Broe GA, et al. Diagnostic procedures for Parkinson's disease dementia: recommendations from the Movement Disorder Society Task Force. Movement Disorders 2007;22:2314-24.

3. Parkinson J(1817) An Essay on the Shaking Palsy. London:Whittingham & Rowland.

4. Hietanen M, Teravainen H. The effect age of disease onset on neuropsychological perfomance in Parkinson's disease. J Neurol Neurosurg Psychiatry 1988;51:244-9.

5. Martin WE, Loewenson RB, Resch JA, Baker AB. Parkinson's disease: clinical analysis of 100 patients. Neurology 1973;23:783-90.

6. Cummings JL. Intellectual impairment in Parkinson's disease: clinical, pathologic, and biochemical correlates. J Geriatr Psychiatry Neurol 1988;1:24-36.

7. Aarsland D, Zaccia J, Brayne C. A systematic review of prevalence studies of dementia in Parkinson's disease. Mov Disord 2005;1255-63.

8. Aarsland D, Andersen K, Larsen JP, Lolk A, Nielsen H, Kragh-Sorensen P, et al. Risk of dementia in Parkinson's disease: a community- based, prospective study. Neurology 2001;56: 730-6.

9. Rogers RD, Sahakian BJ, Hodges JR, Polkey CE, Kennard C, Robins TW. Dissociating executive mechanisms of task control following frontal lobe damage and Parkinsons' disease. Brain 1998;121:815-42.

10. Mildworf B, Treves TA, Korczyn AD(1993) Differentiation of memory dificits in Alzheimer's disease and in Parkinson's disease with dementia. Neurology 1993;43:A172.

11. Robbins TW, James M, Owen AM, Lange KW, Lees AJ, Leigh PN, et al. Cognitive deficits in progressive supranuclear palsy, Parkinson's disease and multiple system atrophy in tests sensitive to frontal lobe dysfunction. J Neurol Neurosurg Psychiatry 1994;57:79-88.

12. Lees AR, Smith E Cognitive deficits in the early stages of Parkinson's disease. Brain 1983; 106:257-70.

13. Rinne JO, Portin R, Ruottinen H, Nurmi E, Bergman J, Haaparanta M, et al. Cognitive impairment and the brain dopaminergic system in Parkinson's disease. Arch Neurol 2000;57: 470-5.

14. Korczyn AD. Dementia in Parkinson's disease. J Neurol 2001;248(s3):Ⅲ/1-Ⅲ/4.

15. Hietanen M, Teravainen H. Dementia and treatment with L-dopa in parkinson's disease. Mov Disord 1988;3:263-70.

16. Whitehouse PJ, Hedreen SC, White CL, Price DL. Basal forebrain neurons in the nucleus of Meynert in dementia of Parkinson's disease. Ann Neurol 1983;13:243-8.

17. Jellinger KA, Bancher CH, Fischer P. Neuropathological correlates of mental dysfunction in Parkinson's disease. In:Wolters E.C. Scheltens P.H.(Eds). Mental dysfunction in Parkinson's disease. ICG Printing, Dordrecht, 1994.pp.141-61.

18. Tiraboschi P, Hansen LA, Alford M, Sabbagh MN, Schoos B, Masliah E, et al. Cholinergic dysfunction in diseases with Lewy bodies. Neurology 2000;54:407-11.

19. Hurtig HI, Trojanowski JQ, Galvin J, Ewbank D, Schmidt ML, Lee VM-Y, et al. Alpha- synuclein cortical Lewy bodies correlate with dementia in Parkinson's disease. Neurology 2000;54:1916-21.

20. Hughes AJ, Daniel SE, Blankson S, Lees AJ. A clinicopathologic study of 100 cases of Parkinson's disease. Arch Neurol 1993;50: 140-8.

21. Maidment ID, Fox C, Boustani M. A review of studies describing the use of acetyl cholinesterase inhibitors in Parkinson's disease dementia. Acta Psychiatr Scand 2005:111:403-9.

22. Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, Dedeyn PP, et al. Rivastigmine for Dementia Associated with Parkinson's disease. New Engl J Med 2004;351:2509-18.

23. Aarsland D, Hutchinson M, Larsen JP. Cognitive, psychiatric and motor response to galantamine in Parkinson's disease with dementia. Int J Geriatr Psychiatry 2003;18:937-41.

24. Brashear A, Kuhn ER, Lane KA, Farlow MR, Unverzagt FW. A double-blind placebo-controlled trial of donepezil in patients with Parkinson's disease and related dementia. Neurology 2004; 62(s5):A524-5.

25. Aarsland D, Laake K, Larsen JP, Janvin C. Donepezil for cognitive impairment in Parkinson's disease: a randomized controlled trial. J neurol Neurosurg Psychiatry 2002;72:708-12.

26. Leroi I, Brandt J, Reich SG, Lyketsos CG, Grill S, Thompson R, et al. Randomized placebo controlled trial of donepezil in cognitive impairment in Parkinson's disease. Int J Geriatr Psychiatry 2004;19:1-8.

27. Giladi N, Shabtai H, Gurevich T, Benbunan B, Anca M, Korczyn AD. Rivastigmine for dementia in patients with Parkinson's disease. Acta Neurol Scand 2003;108:368-73.

28. Reading PJ, Luce AK, Mckeith IG. Rivastigmine in the treatment of Parkinsonian psychosis and cognitive impairment: preliminary findings from an open trial. Mov Disord 2001;16:1171-4.

29. Bullock R, Cameron A. Rivastigmine for the treatment of dementia and visual hallucinations associated with Parkinson's disease: a case series. Curr Med Res Opin 2002;18:258-64.

30. Bergman J, Lerner V. Successful use of donepezil for the treatment of psychotic symptoms in patients with Parkinson's disease. Clin Neuropharmacol 2002;25:107-10.

31. Aarsland D, Hutchnson M, Larsen JP. Cognitive, psychiatric and motor response to galantamine in Parkinson's disease with dementia. Int J Geriatr Psychiatry 2003;18: 937-41.

32. Hutchinson M, Fazzini E. Cholinesterase inhibition in Parkinson's disease. J Neurol Neurosurg Psychiatry 1996;61:324-5.

33. Werber EA, Rabey JM. The beneficial effect of cholinesterase inhibitors on patients suffering from Parkinson's disease and dementia. J Neurotrans 2001;108:1319-25.