Epidemiological and clinical studies of synucleinopathy: DLB, PDD, PD, MSA

Kenji Wada-Isoe, Keiko Imamura, Michio Kitayama, Yutaka Suto, Kenji Nakashima

Department of Neurology, Institute of Neurological Science,
Faculty of Medicine, Tottori University

Parkinson's disease (PD) is the most common neurodegenerative disorder.　Recent improvement of longevity has shown us that PD is a movement disorder as well as a neuropsychiatric disorder.　In Tottori University cohort, 32.4% of PD patients have dementia.　Onset age of PD is not different between PD patients without dementia and PD patients with dementia (PDD).　The average age of occurrence of dementia in PD patients is 71.4 years old and it takes 8.4 years on average from the onset of PD until the occurrence of dementia.　Visual hallucination is more common in PDD patients than in PD patients without dementia.　Dementia with Lewy bodies (DLB) is the second most common senile degenerative dementia after AlzheimerAlzheimer'srsquo;s disease (AD).　The presentation of overlapping symptoms between these two disorders leads to difficulties in the clinical differentiation of the entities.　We examined the diagnostic value of cerebrospinal fluid (CSF) marker of p-tau and Aβ42 and ¹²³-I MIBG cardiac scintigraphy.　ROC analysis revealed that the diagnostic value of ¹²³-I MIBG cardiac scintigraphy was superior to that of CSF markers.　Dementia is included in the exclusion criteria of consensus statement on the diagnosis of multiple system atrophy (MSA).　It has been reported that frontal and executive function, attention and language function were disturbed in some MSA patients.　We reviewed MSA patients with dementia in Tottori University Cohort.　Of 53 MSA patients, four MSA patients had dementia, they showed sympathetic dysfunction in ¹²³I-MIBG cardiac scintigraphy.　Studies of cognitive dysfunction in MSA are further needed.

Address correspondence to Dr. Kenji Wada-Isoe, Department of Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University (36-1, Nishi-cho, Yonago 683-8504, Japan)