It has been previously well known that Alzheimer’s disease may present with parkinsonism [1-5]. However, it has been scarcely described that parkinsonism is an initial and predominant manifestastions of Alzheimer’s disease. 2 cases of neuropathological features of Alzheimer’s disease in non-demented patients have been reported in 100 autopsy cases of clinically diagnosed Parkinson’s disease [6,7]. 3 of 100 clinical diagnosis of idiopathic Parkinson’s disease had AD pathology without Lewy bodies, and 3 had Alzheimer-type pathology without Lewy bodies .
Sixty-one patients with parkinsonism underwent MIBG myocardial scintigraphy, of which 22 showed normal MIBG. Of these patients, 5 demonstrated both MRI and SPECT findings consistent with Alzheimer’s disease .
Characteristics of these patients included as following: >80 years of age, predominantly male, exhibiting Parkinsonism with rigidity and gait disturbance. Three patients exhibited tremor. Two patients had supranuclear ophthalmoparesis of vertical gaze. Two patients showed dementia . Neuropathological examination of an autopsied patient demonstrated pure Alzheimer’s disease pathology .
We propose this clinico-pathological entity as “parkinsonism variant of Alzheimer’s disease”.