Clinical and positron emission tomographic studies in the 'extrapyramidal syndrome' of dementia of the Alzheimer type
P. J. Tyrrell, G. V. Sawle, V. Ibanez, P. M. Bloomfield, K. L. Leenders, R. S. Frackowiak and M. N. Rossor
Medical Research Council Cyclotron Unit, Hammersmith Hospital, London, England.
Extrapyramidal signs, particularly rigidity and tremor, have been reported
in a proportion of patients with dementia of the Alzheimer type. To test
the hypothesis that these extrapyramidal signs are similar clinically and
neurochemically to the extrapyramidal signs of Parkinson's disease, a group
of 20 patients satisfying clinical criteria for probable Alzheimer's
disease were studied and assessed clinically for the presence of rigidity,
tremor, and bradykinesia. In those patients with extrapyramidal signs,
qualitative differences were observed between the signs in these patients
and in subjects with Parkinson's disease. Fifteen of 20 patients underwent
fluoro-18-dopa scans, which showed no significant difference in
fluoro-18-dopa uptake into the caudate and putamen between normal subjects
and the rigid and nonrigid patients with Alzheimer's disease, in contrast
to the marked reduction in fluoro-18-dopa uptake into the putamen that is
observed in Parkinson's disease. This provides clinical and in vivo
neurochemical support for the hypothesis that extranigral factors may be
involved in the pathogenesis of rigidity in Alzheimer's disease.
Functional pharmacology in human brain.
Raiteri
Pharmacol. Rev. 2006;58:162-193.
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Scarmeas et al.
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Knesper
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