Dementia in Parkinson’s disease

Ravina B, Putt M, Siderowf A, et al Donepezil for dementia in Parkinson s disease a randomised, double blind, placebo controlled, crossover study. J Neurol Neurosurg Psychiatry 76 934-939, 2005... 

Levy G, Schupf N, Tang MX, Cote LJ, Louis ED, Mejia H, Stem Y, Marder K. Combined effect of age and severity on the risk of dementia in Parkinson s disease. Ann Neurol 2002 51 722-729. 

Aarsland D, Perry R, Brown A, Larsen JP, Ballard C (2005) Neuropathology of dementia in Parkinson s disease a prospective community based study. Ann Neurol 58 773-776... 

El Ftikhri G, Kijewski ME, Johnson KA, Sytldn G, KUliany RJ, Becker JA, Zimmerman RE, Albert MS (2003) MRI-guided SPECT perfusion measures and volumetric MRI in prodromal Alzheimer disease. Arch Neurol 6(K8) 1066-1072 Emre M (2004, Aug) Dementia in Parkinson s disease cause and treatment. Curr Opin Neurol... 

Eppelbaum, J., Ruberg, M., Moyse, M., Javoy-Agid, F., Dubois, E. and Agid, Y. (1983) Somatostatin and dementia in Parkinson s disease. Brain Res. 278 376-379. 

Mayeux, R. (1982) Depression and dementia in Parkinson s disease. In C.D. Marsden and S. Fahn (Eds.), Movement Disorders, Butterworths, London, pp. 75-95. 

Consider rarer dementias if unusual (particularly neurological) symptoms frontotemporal, dementia in Parkinson s disease, Huntingdon s disease (family histoiy, chorea), Creutzfeldt Jakob Disease, AIDs-related encephalopathy, neurosyphilis, progressive supranuclear palsy. 

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

On the one hand, the biochemical study of the neuro-pathological lesions led to the identification of their main molecular components. On the other hand, the study of rare, familial forms of Alzheimer s disease, frontotemporal dementia and Parkinson s disease led to the identification of gene defects that cause inherited variants of the different diseases. Remarkably, in these cases, the defective genes have been found to encode or increase the expression of the main components of the neuropathological lesions. It has therefore been established that the basis of the familial forms of these diseases is a toxic property conferred by mutations in the proteins that make up the filamentous lesions. A corollary of this insight is that a similar toxic property may also underlie the much more common, sporadic forms of the diseases. 

Junn, E., Ronchetti, R. D., Quezado, M. M., Kim, S. Y., and Mouradian, M. M. (2003). Tissue transglutaminase-induced aggregation of alpha-synuclein Implications for Lewy body formation in Parkinson s disease and dementia with Lewy bodies. Proc. Natl. Acad. Sci. USA 100, 2047-2052. 

Chan-Palay V, Asan E Alterations in catecholamine neurons of the locus coeruleus in senile dementia of the Alzheimer type and in Parkinson s disease with and without dementia and depression. J Comp Neurol 287 373-392, 1989... 

Whitehouse PJ, Price DL, Clark AW, et al Alzheimer disease evidence for selective loss of cholinergic neurons in the nucleus basahs. Ann Neurol 10 122-126, 1981 Whitehouse PJ, Price DL, Struble RG, et al Alzheimer s disease and senile dementia—loss of neurons in the basal forebrain. Science 215 1237-1239, 1982 Whitehouse PJ, Hedreen JC, White CL, et al Basal forebrain neurons in dementia of Parkinson s disease. Ann Neurol 13 243-248, 1983 Whitehouse P, Martino A, Antuono P, et al Nicotinic acetylcholine binding sites in Alzheimer s disease. Brain Res 371 146-151, 1986 Whitehouse PJ, Martino AM, Marcus KA, et al Reductions in acetylcholine and nicotine binding in several degenerative diseases. Arch Neurol 45 722-724, 1988 Whitton PS, Sama GS, O Connell MT The effect of the novel antidepressant tianeptine on the concentration of 5-hydroxytryptamine in rat hippocampal diasylates in vivo. Neuropharmacology 39 1-4, 1991 Whitworth P, Kendall DA Lithium selectively inhibits muscarinic receptor-stimulated inositol tetrakisphosphate accumulation in mouse cerebral cortex slices. J Neurochem 51 258-265, 1988... 

Ketamine also shares a close chemical kinship to prescription drugs Tiletamine and Memantine. Tileta-mine is used in combination with zolazepam as a veterinary anesthetic under the brand names Zoletic and Tela-zol. Memantine is derived from the anti-influenza drug amantadine, and also works to block NDMA receptors. Memantine has been approved for use in Parkinson s disease and dementia in the elderly. It is also being used experimentally with AIDS patients for the treatment of HIV encephalopathy. 

Foy, C.J., Passmore, A.P., Vahidassr, M.D., Young, ES., and Lawson, J.T. 1999. Plasma chainbreaking antioxidants in Alzheimer s disease, vascular dementia and Parkinson s disease. OJM... 

Blood plasma TAC was not altered in patients with Alzheimer s disease, vascular dementia, Parkinson s disease and dementia, or Parkinson s disease (F6, F10). However, another study found decreased blood plasma TAC in Alzheimer patients (by 24%) (R12). TAC was decreased in blood plasma of children with Down syndrome (by 26%) (C18). Epileptic patients receiving phenytoin showed decreased TAC of blood sera, apparently due to the oxidative stress induced by the drug (M3). 

Leplow B, Dierks C, Herrmann P, Pieper N, Annecke R, Ulm G (1997) Remote memory in Parkinson s disease and senile dementia. Neuropsychologia 35 547-555 Lesne S, Koh MT, Kotilinek L, Kayed R, Glabe CG, Yang A, Gallagher M, Ashe KH (2006) A specific amyloid-beta protein assembly in the brain impairs memory. Nature 440(7082) 352-357... 

Use only with caution If at all In Parkinson s disease or Lewy Body dementia, especially at high doses... 

Behavioral disturbances in Parkinson s disease and Lewy Body dementia... 

Bohnen, N.I., Kaufer, D.I., Hendrickson, R., Constantine, G.M., Mathis, C.A., Moore, R.Y. (2007). Cortical cholinergic denervation is associated with depressive symptoms in Parkinson s disease and parkinsonian dementia. J. Neurol. Neu-... 

Cytokines, such as tumor necrosis alfa and oxygen radicals, may be produced by HIV-infected macrophages or microglia. These substances cause apoptosis in the cerebral cortex and basal ganglia. Selegiline, also called deprenyl, and thioctic acid are monoamine oxidase-B inhibitors that have antioxidative effects and have been evaluated in tv o clinical hdals. Deprenyl has been previously studied in patients with Alzheimer s dementia and Parkinson s disease, showing improvement of memory in these conditions. 

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