Journal of Alzheimers & Neurodegenerative Diseases Category: Clinical Type: Letter to the Editor

Parkinsonism Variant of Alzheimer’s Disease

Naoki Kasahata1*
1 National Institute Of Advanced Industrial Science And Technology, Japan

*Corresponding Author(s):
Naoki Kasahata
National Institute Of Advanced Industrial Science And Technology, Japan
Email:naoki.kasahata@gmail.com

Received Date: Sep 17, 2021
Accepted Date: Oct 08, 2021
Published Date: Oct 15, 2021

Introduction

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 [7]. 

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 [8].

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 [8]. Neuropathological examination of an autopsied patient demonstrated pure Alzheimer’s disease pathology [9].

We propose this clinico-pathological entity as “parkinsonism variant of Alzheimer’s disease”.

References

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  2. Mitchell SL, Rockwood K (2000) The association between Parkinsonism, Alzheimer’ disease and mortality: A comprehensive approach. J Am Geriatr Soc 48: 422-425.
  3. Attems J, Quass M, Jellinger KA (2007) Tau and alpha-synuclein brainstem pathology in Alzheimer disease: Relation with extrapyramidal signs. Acta Neuropathol 113: 53-62.
  4. Toru S, Uchihara T, Takahashi M, Ichihara K, Endo T, et al. (2010) Depletion or preservation of cardiac sympathetic nerve-an autopsy- verified contrast in two cases of Alzheimer’s disease with or without Lewy bodies. Eur Neurol 64: 129-133.
  5. King AE, Mintz J, Royall DR (2011) Meta-analysis of (123)I-MIBG cardiac scintigraphy for the diagnosis of Lewy body-related disorders. Mov Disord 26: 1218-1224.
  6. Daniel SE, Lees AJ (1991) Neuropathological features of AD in non-demented parkinsonian patients. J Neurol Neurosurg Psychiatry 54: 972-975.
  7. Hughes AJ, Daniel SE, Kliford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinic-pathological study of 100 case. J Neurol Neurosurg Psychiatry 55: 181-184.
  8. Kasahata N, Tamamoto F, Kato H (2016) 123I-metaiodobenzylguanidine myocardial scintigraphy-normal Parkinsonism with radiological features of Alzheimer’s disease-Parkinsonism variant of Alzheimer’s disease or Alzheimer’s disease with brainstem involvement? Medical Science (Discovery publication) 20: 132-141.
  9. Kasahata N, Hagiwara M, Kato H, Nakamura A, Uchihara T (2014) An 85-year old male with levodopa-responsive parkinsonism followed by dementia and supranuclear ophthalmoplegia caused by Alzheimer type pathology without Lewy bodies. J Alzheimer Dis 39: 471-476.

Citation: Kasahata N (2021) Parkinsonism Variant of Alzheimer’s Disease. J Alzheimers Neurodegener Dis 7: 057.

Copyright: © 2021  Naoki Kasahata, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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