Demenz bei Parkinson-Syndromen

A. O. Ceballos-Baumann

doi:10.1055/s-0038-1624410

Nervenheilkunde, Table of Contents

Nervenheilkunde 2003; 22(06): 287-294
DOI: 10.1055/s-0038-1624410

Original- und Übersichtsarbeiten/Original and Review Articles

Schattauer GmbH

Demenz bei Parkinson-Syndromen

Klinik und TherapieDementia in parkinsonismClinical and therapeutic aspects

Authors

A. O. Ceballos-Baumann

¹Neurologische Klinik der Technischen Universität München

Abstract

Zusammenfassung

Eine ausgeprägte Demenz früh im Verlauf bei einem Parkinson-Syndrom spricht gegen die Diagnosen Morbus Parkinson (idiopathisches Parkinson-Syndrom) und Multisystematrophie (MSA). Eine Vergesellschaftung von früher Demenz und Parkinson tritt bei der progressiven supranukleären Blickparese (PSP) und der kortikobasalen Degeneration (CBD) auf. Ein Parkinson-Syndrom mit Demenz kommt außerdem bei der diffusen Lewy-Körper-Krankheit (Lewy-Body-Demenz), spät im Verlauf beim Morbus Alzheimer, bei der subkortikalen arteriosklerotischen Enzephalopathie (vaskulärer Parkinsonismus) und beim Normaldruckhydrozephalus vor. Parkinson-Syndrom plus Demenz stellt ein therapeutisches Problem dar. Diese Patienten reagieren besonders schnell mit Verwirrtheit und exogenen Psychosen auf Antiparkinsonika. Neuroleptika sind bei bestehendem Parkinson-Syndrom kontraindiziert. Hier kommt den Cholinesterase-Hemmer eine neue Rolle zu, da sie nach jüngeren Studien die nicht-kognitiven Demenz-Symptome bessern, ohne das Parkinson-Syndrom zu verschlechtern.

Summary

Dementia early in the course of parkinsonism represents an exclusion criteria for the diagnosis Parkinson’s disease and multiple system atrophy. Dementia with parkinsonism develops in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Parkinsonism together with dementia also occurs in a varierty of other conditions such as in diffuse Lewy-disease, late in the course of Alzheimer’s disease, in vascular parkinsonism and normal pressure hydrocephalus. Parkinsonism plus dementia is a therapeutic challenge. Antiparkinsonian drugs commonly cause delirium and psychosis. Neuroleptics are contraindicated as they worsen parkinsonism. Cholinesterase inhibitors may play here a new role as recent studies show that these compounds are effective for the behavioural signs of dementia without worsening parkinsonism.

Schlüsselwörter

Parkinson-Syndrom - Demenz - Cholinesterase-Hemmer - Dopaminergika

Keywords

Parkinson’s disease - dementia - cholinesterase inhibitors - dopaminergics

Full Text

References

Literatur
1 Aarsland D, Laake K, Larsen JP, Janvin C. Donepezil for cognitive impairment in Parkinson’s disease: a randomised controlled study. J Neurol Neurosurg Psychiatry 2002; 72 (06) 708-12.
2 Albert ML, Feldmann RG, Willis AL. The subcortical dementia of progressive supranuclear plasy. J Neurol Neurosurg Psychiat 1974; 37: 121-30.
3 Baezner H, Oster M, Henning O, Cohen S, Hennerici MG. Amantadine increases gait steadiness in frontal gait disorder due to subcortical vascular encephalopathy: a doubleblind randomized placebo-controlled trial based on quantitative gait analysis. Cerebrovasc Dis 2001; 11 (03) 235-44.
4 Ballard C, O’Brien J, Swann A, Neill D, Lantos P, Holmes C. et al. One year follow-up of parkinsonism in dementia with Lewy bodies. Dement Geriatr Cogn Disord 2000; 11 (04) 219-22.
5 Barclay CL, Lang AE. Dystonia in progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 1997; 62 (04) 352-6.
6 Bergman J, Lerner V. Successful use of donepezil for the treatment of psychotic symptoms in patients with Parkinson’s disease. Clin Neuropharmacol 2002; 25 (02) 107-10.
7 Biggins CA, Boyd JL, Harrop FM, Madeley P, Mindham R, Randall JI. et al. A controlled, longitudinal study of dementia in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1992; 55 (07) 566-71.
8 Black SE. Focal cortical atrophy syndromes. Brain Cogn 1996; 31 (02) 188-229.
9 Boeve BF, Maraganore DM, Parisi JE, Ahlskog JE, Graff-Radford N, Caselli RJ. et al. Pathologic heterogeneity in clinically diagnosed corticobasal degeneration. Neurology 1999; 53 (04) 795-800.
10 Bower JH, Maraganore DM, McDonnell SK, Rocca WA. Incidence of progressive supranuclear palsy and multiple system atrophy in Olmsted County, Minnesota, 1976 to 1990. Neurology 1997; 49 (05) 1284-8.
11 Brandstadter D, Oertel WH. Treatment of drug-induced psychosis with quetiapine and clozapine in Parkinson’s disease. Neurology 2002; 58 (01) 160-1.
12 Burke WJ, Pfeiffer RF, McComb RD. Neuroleptic sensitivity to clozapine in dementia with Lewy bodies. J Neuropsychiatry Clin Neurosci 1998; 10 (02) 227-9.
13 Ceballos-Baumann AO. Idiopathisches Parkinson-Syndrom. In: Berlit P. (ed). Facharztbuch: Klinische Neurologie. Heidelberg: Springer; 1999: 863-86.
14 Ceballos-Baumann AO. Weitere Erkrankungen mit akinetisch-rigidem Syndrom: Progressive supranukleäre Blickparese, kortikobasale Degeneration, Lewy-Body-Demenz und weitere Parkinson-Plus-Syndrome. In: Berlit P. (ed). Facharztbuch: Klinische Neurologie. Heidelberg: Springer; 1999: 886-91.
15 Cooper JA, Sagar HJ, Tidswell P, Jordan N. Slowed central processing in simple and go/no-go reaction time tasks in Parkinson’s disease. Brain 1994; 117: 517-29.
16 De Deyn PP, Rabheru K, Rasmussen A, Bocksberger JP, Dautzenberg PL, Eriksson S. et al. A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia. Neurology 1999; 53 (05) 946-55.
17 Engel PA. Treatment of progressive supranuclear palsy with amitriptyline: therapeutic and toxic effects. J Am Geriatr Soc 1996; 44 (09) 1072-4.
18 Fernandez HH, Friedman JH, Jacques C, Rosenfeld M. Quetiapine for the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord 1999; 14 (03) 484-7.
19 Fernandez HH, Trieschmann ME, Burke MA, Friedman JH. Quetiapine for psychosis in Parkinson’s disease versus dementia with Lewy bodies. J Clin Psychiatry 2002; 63 (06) 513-5.
20 FitzGerald PM, Jankovic J. Lower body parkinsonism: evidence for vascular etiology. Mov Disord 1989; 04 (03) 249-60.
21 Friedman JH, Factor SA. Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord 2000; 15 (02) 201-11.
22 Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol 1999; 56 (01) 33-9.
23 Geroldi C, Frisoni GB, Bianchetti A, Trabucchi M. Drug treatment in Lewy body dementia. Dement Geriatr Cogn Disord 1997; 08 (03) 188-97.
24 Ghika J, Bogousslavsky J. Presymptomatic hypertension is a major feature in the diagnosis of progressive supranuclear palsy. Arch Neurol 1997; 54 (09) 1104-8.
25 Goetz CG, Blasucci LM, Leurgans S, Pappert EJ. Olanzapine and clozapine: comparative effects on motor function in hallucinating PD patients. Neurology 2000; 55 (06) 789-94.
26 Grimes DA, Lang AE, Bergeron CB. Dementia as the most common presentation of corticalbasal ganglionic degeneration. Neurology 1999; 53 (09) 1969-74.
27 Group TPS. Low-dose clozapine for the treatment of drug-induced psychosis in Parkinson’s disease. N Engl J Med 1999; 340 (10) 757-63.
28 Haussermann P, Ceballos-Baumann A, Reinbold H, Goecker D, Schroder S. Applications of cholinesterase inhibitors. Lancet 2001; 357 9261 1039.
29 Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55 (03) 181-4.
30 Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC. et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996; 47 (01) 1-9.
31 Mark MH, Sage JI, Walters AS, Duvoisin RC, Miller DC. Binswanger’s disease presenting as levodopa-responsive parkinsonism: clinicopathologic study of three cases. Mov Disord 1995; 10 (04) 450-4.
32 McGaffigan S, Bliwise DL. The treatment of sundowning. A selective review of pharmacological and nonpharmacological studies. Drugs Aging 1997; 10 (01) 10-7.
33 McKeith I, Del Ser T, Spano P, Emre M, Wesnes K, Anand R. et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet 2000; 356 9247 2031-6.
34 McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA. et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996; 47 (05) 1113-24.
35 McKeith IG, Perry EK, Perry RH. Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consortium on Dementia with Lewy Bodies. Neurology 1999; 53 (05) 902-5.
36 McKeith IG, Ballard CG, Perry RH, Ince PG, O’Brien JT, Neill D. et al. Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology 2000; 54 (05) 1050-8.
37 Meehan KM, Wang H, David SR, Nisivoccia JR, Jones B, Beasley Jr CM. et al. Comparison of rapidly acting intramuscular olanzapine, lorazepam, and placebo: a double-blind, randomized study in acutely agitated patients with dementia. Neuropsychopharmacology 2002; 26 (04) 494-504.
38 Naville F. Études sur les complications et les séquelles mentales de l’encéphalitide épidémique. La bradyphrénie. Encéphale 1922; 17: 369-75.
39 Olin JT, Fox LS, Pawluczyk S, Taggart NA, Schneider LS. A pilot randomized trial of carbamazepine for behavioral symptoms in treatment-resistant outpatients with Alzheimer disease. Am J Geriatr Psychiatry 2001; 09 (04) 400-5.
40 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 (06) 1171-4.
41 Rebeiz J, Kolodny EH, Richardson EP. Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol 1968; 18: 20-33.
42 Shea C, MacKnight C, Rockwood K. Donepezil for treatment of dementia with Lewy bodies: a case series of nine patients. Int Psychogeriatr 1998; 10 (03) 229-38.
43 Steele JC, Richardson JC, Olszewski J. Progressive supranuclear palsy. A heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. Arch Neurol 1964; 10: 333-58.
44 Tariot P, Gaile SE, Castelli NA, Porsteinsson AP. Treatment of agitation in dementia. New Dir Ment Health Serv. 1997 76. 109-23.
45 Tariot PN, Erb R, Podgorski CA, Cox C, Patel S, Jakimovich L. et al. Efficacy and tolerability of carbamazepine for agitation and aggression in dementia. Am J Psychiatry 1998; 155 (01) 54-61.
46 Taylor TD, Litt M, Kramer P, Pandolfo M, Angelini L, Nardocci N. et al. Homozygosity mapping of Hallervorden-Spatz syndrome to chromosome 20p12.3-p13 [published erratum appears in Nat Genet 1997 May; 16(1): 109]. Nat Genet 1996; 14 (04) 479-81.
47 Werber EA, Rabey JM. The beneficial effect of cholinesterase inhibitors on patients suffering from Parkinson’s disease and dementia. J Neural Transm 2001; 108 (11) 1319-25.