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Cognitive and neuropsychiatric disorders in extrapyramidal diseases

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The affliction of basal ganglia and their associations, which underlies extrapyramidal diseases, leads not only to diverse movements, but also to a broad spectrum of neuropsychological disorders, including cognitive, emotional-personality, and psychotic ones. The basis for these disorders are most commonly dysfunction of one or a few parallel frontostriatal circuits combining the basal ganglia with the thalamus, limbic structures, frontal and other cortical regions into the uniform functional system. The pattern of neuropsychological disorders has both specific and common features, the discussion of which is the subject matter of this paper. Analysis of the specific features of neuropsychological and behavioral disorders allows one to specify the localization of a pathological process and its extent, which may be of important differential diagnostic value. Cognitive and emotional-personality impairments sometimes develop earlier than motor disorders and their detection may be of significance for the early diagnosis of Parkinson’s disease or Huntington’s disease in persons who are predisposed to these diseases. Moreover, to establish the nature of mental disorders and the degree of their disadapting effect and to identify the affected and preserved components in the psychic processes are important for the choice of adequate pharmacotherapy and the elaboration of neuropsychological rehabilitation programs.

About the Authors

O. S. Levin
Department of Neurology, Russian Medical Academy of Postgraduate Education, Center of Extrapyramidal Diseases, Moscow
Russian Federation

M. A. Anikin
Department of Neurology, Russian Medical Academy of Postgraduate Education, Center of Extrapyramidal Diseases, Moscow
Russian Federation

E. E. Vasenina
Department of Neurology, Russian Medical Academy of Postgraduate Education, Center of Extrapyramidal Diseases, Moscow
Russian Federation


1. <div><p>Глозман Ж.М., Левин О.С. Психические расстройства при экстрапирамидных заболеваниях. Экстрапирамидные расстройства. Рук-во по диагностике и лечению. Под ред. В.Н. Штока и др. М.: Медпресс-информ, 2002;56–73.</p><p>Aarsland D., Marsh L., Schrag А. Neuropsychiatric Symptoms in Parkinson’s Disease. Mov Dis 2009;24:2175–86.</p><p>Melamed E. Neurobehavioral abnormalities in Parkinson's disease. In: R.L. Watts, W.C. Koller (eds). Movement disorders. New York McGraw-Hill, 1997;257–62.</p><p>Шток В.Н., Левин О.С., Федорова Н.В. Экстрапирамидные расстройства. М, 1998;128 с.</p><p>Cummings J.L., Litvan I. Neuropsychiatric aspects of corticobasal degeneration. In: I. Litvan, C.G. Goetz, A.E. Lang (eds). Corticobasal degeneration and related disorders. Adv Neurol 2000;82:147–52.</p><p>Pillon B., Dubois B., Agid Y. Testing cognition may contribute to the diagnosis of movement disorders. Neurology 1996;46:329–33.</p><p>Rickards Н., Souza J. Analysis of behavioral symptoms in Huntington’s disease. J Neurol Neurosurg Psychiatry 2010;82:411–2.</p><p>Лурия А.Р. Основы нейропсихология. М.: МГУ, 1973;378 с.</p><p>Сummings J.L. Frontal-subcortical circuits and human behavior. Arch Neurol 1993;50:873–80.</p><p>Kertesz A., McMonagle P. Behavior and cognition in corticobasal degeneration and progressive supranuclear palsy. J Neurol Sci 2009;289:138–43.</p><p>Laplane D., Levasseur M., Pillon B. et al. Obsessive-compulsive and other behavioral changes with bilateral basal ganglia lesions. Brain 1989;112:699–725.</p><p>Левин О.С., Наймушина Т.В., Смоленцева И.Г. Психотические расстройства при болезни Паркинсона: клинико-нейропсихологическое исследование. Неврол журн 2002;5:21–6.</p><p>Albert M.S., Feldman R.G., Willis A.L. The subcortical dementia of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 1974;37:121–30.</p><p>Verny M., Duyckaerts C., Agid Y. et al. The significance of cortical pathology in progressive supranuclear palsy. Brain 1996;119:1123–36.</p><p>Onofrj M., Bonanni L., Manzoli L. et al. Cohort study on somatoform disorders in Parkinson disease and dementia with Lewy bodies. Neurology 2010;74:1598–606.</p><p>Brown R.G., Lacomblez L., Bernard G. Cognitive impairment in patients with multiple system atrophy and progressive supranuclear palsy. Brain 2010;133(23):2382–93.</p><p>Kulisevsky J., Berthier M.L., Pujol L. Hemiballismus and secondary mania following a right thalamic infarction. Neurology 1993;43:1422–4.</p><p>Savage C.R. Neuropsychology of subcortical dementias. In: Miguel E.C., Rauch S.L., Leckman J.F. (eds). Neuropsychiatry of the basal ganglia. The Psychiatric clinics of North America 1997;20:911–32.</p><p>Litvan I. Parkinsonism-Dementia syndromes. In: J.Jankovic, E.Tolosa (eds). Parkinson's disease and movement disorders. 3nd ed. Baltimore: Williams&amp;Wilkins, 1998;245–62.</p><p>Robbins T.W., James M., Owen A.M. et al. Cognitive deficits in progressive supranuclear palsy, Parkinson's disease and multiple system atrophy in tests sensitive to frontal lobe dysfunction. J Neurol Neurosurg Psychiatry 1994;57:79–88.</p><p>Левин О.С., Батукаева Л.А., Смоленцева И.Г. Диагностика и лечение деменции при болезни Паркинсона. Журн неврол и психиатр 2008;6:85–91.</p><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(прил. 1):4–12.</p><p>Perry E.K., Fairbrain A.F., Perry R. et al. Evidence of a monoaminergic-cholinergic imbalance related to visual hallucinations in Lewy body dementia. J Neurochim 1990;55:1454–6.</p><p>Alexander G.E., DeLong M.R., Strick P.L. Parallel organization of functionally segrated circuits linking basal ganglia and cortex. Ann Rev Neurosci 1986;9:357–81.</p></div><br />


For citations:

Levin O.S., Anikin M.A., Vasenina E.E. Cognitive and neuropsychiatric disorders in extrapyramidal diseases. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2S):22-30. (In Russ.)

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