Marti_2007_J.Neurol_254 Suppl 5_41

Dementia is a frequent complication of Parkinson's disease (PD), usually occurring late in the course of the illness. Clinically, dementia in PD often is characterized by an insidious onset and slowly progressive cognitive decline, with predominant dysexecutive syndrome accompanied by a variety of behavioral symptoms. The pathological substrate of dementia in PD is a matter of controversy. The common co-occurrence of alpha-synuclein and Alzheimer disease-type pathology suggests that both may play an important role. Dysfunction of different monoamine transmitters has also been implicated in the cognitive deterioration associated with PD but reduced cholinergic activity in the cortex is thought to account for the predominant mechanism in the development of dementia. Recent studies suggest that cholinesterase inhibitors might be useful in the treatment of dementia of PD.