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Parkinsons Dis. 2012;2012:561046. doi: 10.1155/2012/561046. Epub 2011 Dec 6.

Frontostriatal cognitive staging in Parkinson's disease.

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  • 1Section of Neurology, Hospital A. Marcide, 15405 Ferrol, Spain.

Abstract

Cognitive impairment and behavioural disorders are often encountered in subjects with Parkinson's disease (PD). A simple PD-related frontostriatal cognitive dysfunction (PDFCD) staging is proposed. Executive dysfunction and mental fatigue (stage I), depression/anxiety (stage IIa), apathy/pain (stage IIb), and dementia (stage III) reflect a sequential process of dopamine depletion occurring in different regions of the striatum (stages I and II) and the frontal cortex (stage III). In addition to these nonmotor manifestations present in the unmedicated (OFF) state, the PDFCD model also predicts a number of complications related to dopaminergic treatment (ON state), from impulse control disorders (stages I and IIa) to hallucinations (stage IIb) and psychosis (stage III). Although the model admittedly needs further refinements, it provides a framework for hypothesis testing and may help clinicians optimize therapeutic strategies.

PMID:
22191070
PMCID:
PMC3236592
DOI:
10.1155/2012/561046
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