Dement Geriatr Cogn Disord 2007;23:251–267
(DOI:10.1159/000101337)

Treatment of Dementia in Parkinsonian Syndromes with Cholinesterase Inhibitors

Liepelt I.a · Maetzler W.a · Blaicher H.-P.b · Gasser T.a · Berg D.a
aHertie Institute for Clinical Brain Research and bDepartment of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
email Corresponding Author


 goto top of outline Key Words

  • Dementia
  • Parkinsonian syndromes
  • Cholinesterase inhibitor

 goto top of outline Abstract

In Parkinsonian syndromes behavioural symptoms and dementia can be even more debilitating than motor symptoms and are an important predictor for nursing home placement and mortality. Neuropathologically, dementia seems to be primarily related to cortical changes rather than to subcortical alterations. Concerning neurotransmitter systems, the cholinergic system has been proposed to play a key role in cognitive disturbances. Based on studies with patients with Alzheimer disease, the application of cholinesterase inhibitors is vividly discussed also for dementia associated with parkinsonian syndromes. This review focuses on the specific symptoms of dementia in different parkinsonian syndromes and critically questions the effect of cholinergic treatment on cognitive functions in patients with extrapyramidal syndromes and dementia. There is evidence that medication with some cholinesterase inhibitors can enhance cognition as well as activities of daily living in dementia with Parkinson’s disease and seems to reduce behavioural disturbances in both dementia with Parkinson’s disease and dementia with Lewy bodies. The effect of treatment with cholinesterase inhibitors in progressive supranuclear palsy and corticobasal degeneration warrants carefully designed studies including a sufficient number of patients and symptom-adopted dementia scales.

Copyright © 2007 S. Karger AG, Basel


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 goto top of outline Author Contacts

Inga Liepelt, Hertie Institute for Clinical Brain Research
Department of Neurodegenerative Diseases
Hoppe-Seyler Strasse 3, DE–72076 Tübingen (Germany)
Tel. +49 7071, ext. 2980 424, Fax +49 7071 2948
E-Mail info-hih@med.uni-tuebingen.de


 goto top of outline Article Information

Accepted: November 25, 2006
Published online: March 26, 2007
Number of Print Pages : 17
Number of Figures : 0, Number of Tables : 5, Number of References : 176


 goto top of outline Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 23, No. 6, Year 2007 (Cover Date: May 2007)

Journal Editor: Chan-Palay, V. (New York, N.Y.)
ISSN: 1420–8008 (print), 1421–9824 (Online)

For additional information: http://www.karger.com/DEM


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