La valutazione neuropsicologica è diventata parte integrante della valutazione clinica dei pazienti con malattia di Parkinson
(MP). Numerosi studi clinici e sperimentali hanno infatti dimostrato l’importanza della valutazione neuropsicologica nel percorso
diagnostico delle sindromi extrapiramidali, sia per un corretto inquadramento nosografico e prognostico, sia perché i disturbi
cognitivi, una volta considerati accessori nel quadro clinico, hanno un peso notevole nella ridotta qualità di vita dei pazienti
(Padovani et al., 2006).
[Show abstract][Hide abstract] ABSTRACT: A new, short, neuropsychologically oriented test for dementia assessment--the Milan Overall Dementia Assessment (MODA)--is described. Age and education adjusted norms based on 217 healthy controls are given. A validation study on 312 outpatients suspected of dementia (121 with probable Alzheimer's disease) showed that the MODA differentiated patients with cognitive impairment from normal subjects more effectively than did the DSM III-R. The correlation between the MODA and the mini mental state examination was 0.63 in controls and 0.84 in patients with Alzheimer's dementia. The MODA test-retest reliability was 0.83. The test proved to be well suited to longitudinal studies.
[Show abstract][Hide abstract] ABSTRACT: An information-processing model is outlined that predicts that performance on non-routine tasks can be impaired independently of performance on routine tasks. The model is related to views on frontal lobe functions, particularly those of Luria. Two methods of obtaining more rigorous tests of the model are discussed. One makes use of ideas from artificial intelligence to derive a task heavily loaded on planning abilities. A group of patients with left anterior lesions has a specific deficit on the task. Subsidiary investigations support the inference that this is a planning impairment.
Philosophical Transactions of The Royal Society B Biological Sciences 07/1982; 298(1089):199-209. DOI:10.1098/rstb.1982.0082 · 7.06 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Parkinson's disease is classically characterised as a motor neurodegenerative disorder. Motor symptoms in the disorder are secondary to an altered dopamine-acetylcholine balance due to reduced striatal dopaminergic tone and subsequent cholinergic overactivity. In the past, anticholinergic drugs were given to improve motor aspects of the disease. There is now an increasing interest in the cognitive and non-motor symptoms of Parkinson's disease and in cholinesterase-inhibitor therapy for dementia associated with Parkinson's disease. In this Personal View, we reconsider the dopamine-acetylcholine balance theory and look at recent clinical findings and the possible cooperative role of dopamine and acetylcholine in the induction and maintenance of the long-lasting changes of striatal and cortical synaptic plasticity. We also discuss a convergent versus parallel model to explain cognitive dysfunctions in Parkinson's disease according to dopamine-acetylcholine dependent alterations in synaptic plasticity.
The Lancet Neurology 12/2006; 5(11):974-83. DOI:10.1016/S1474-4422(06)70600-7 · 21.90 Impact Factor
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