PMC:6723065 / 33567-35398 JSONTXT

{"project":"2_test","denotations":[{"id":"31434341-28592453-7278321","span":{"begin":168,"end":171},"obj":"28592453"},{"id":"31434341-21661055-7278322","span":{"begin":436,"end":439},"obj":"21661055"},{"id":"31434341-12473757-7278323","span":{"begin":567,"end":570},"obj":"12473757"},{"id":"31434341-22419314-7278324","span":{"begin":738,"end":741},"obj":"22419314"},{"id":"31434341-22998158-7278325","span":{"begin":844,"end":846},"obj":"22998158"},{"id":"31434341-25914281-7278326","span":{"begin":847,"end":850},"obj":"25914281"},{"id":"31434341-25224676-7278327","span":{"begin":1125,"end":1128},"obj":"25224676"},{"id":"31434341-21193343-7278328","span":{"begin":1485,"end":1488},"obj":"21193343"},{"id":"31434341-20729148-7278329","span":{"begin":1489,"end":1492},"obj":"20729148"},{"id":"31434341-27030249-7278330","span":{"begin":1696,"end":1699},"obj":"27030249"},{"id":"31434341-21500280-7278331","span":{"begin":1822,"end":1825},"obj":"21500280"},{"id":"31434341-27829318-7278332","span":{"begin":1826,"end":1829},"obj":"27829318"}],"text":"3.2.1. Cognitive Deficits\nCognitive deficits, by definition, should not appear within a year from MS onset (1-year rule), otherwise DLB diagnosis should be considered [115]. Over years, about 26% of PD patients will present mild cognitive impairment (MCI) features. PD-MCI is mainly associated with “subcortical” deficits (i.e., executive and attentional), but also visuospatial, praxis, language, and memory impairment can be present [116]. Dementia also appears in PD in up to 80% of cases, typically in advanced stages, and is associated with increased mortality [117].\nAchEI (donepezil 5–10 mg daily, galantamine 4–8 mg twice a day, rivastigmine 1.5 mg twice a day up to 6 mg bid) can improve cognition in PD-MCI and in PDD patients [118]. Rivastigmine efficacy seems higher, especially in PDD patients, as compared to the other two drugs [60,119]. However, although AchEI does not seem to significantly increase the rate of falls in these patients, a worsening of tremor may appear. Donepezil seems to show less adverse effects, as compared to Rivastigmine, and could be employed in patients with more prominent tremor [120].\nMemantine, a N methyl D aspartate (NMDA) glutamate receptor used in Alzheimer’s Disease (AD), was also investigated as a possible therapy in PD patients. Nevertheless, Memantine treated patients did not show any significant clinical improvement as compared to controls, in cognition as well as in other NMS (fatigue, apathy, mood, and quality of sleep) [121,122], so its administration is not supported by evidence. Some previous studies also assessed the effects of Rasagiline (1 mg daily) on cognitively impaired PD patients. Conflicting results have been found [123]. Nonetheless, some benefits, particularly in the executive and attentional functions, were observed in treated patients [124,125]."}