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Comparison of Extrapyramidal Signs in Dementia With Lewy Bodies and Parkinson's Disease

Received July 10, 2000; revised October 9, 2000; accepted October 26, 2000. From the Section of Geriatric Psychiatry, Rogaland Psychiatric Hospital, and Department of Neurology, Rogaland Central Hospital, Stavanger, Norway; and the MRC Neurochemical Pathology Unit and Department of Neuropathology, Newcastle General Hospital, and Department of Old Age Psychiatry, Wolfson Research Centre, Newcastle Upon Tyne, UK. Correspondence to Dr. Aarsland, Geriatric Psychiatry, Rogaland Psychiatric Hospital, P.O. Box 1163 Hillevåg, N-4095 Stavanger, Norway. E-mail: aarsland{at}netpower.no

Extrapyramidal signs (EPS) were compared in 98 dementia with Lewy bodies (DLB) and 130 medication-responsive Parkinson's disease (PD) patients. DLB patients were older at assessment and at disease onset, were cognitively more impaired, and had a shorter duration of disease than PD patients. Sixty-seven DLB patients (68%) showed EPS. The 58 DLB patients with complete data had more severe action tremor, body bradykinesia, difficulty arising from a chair, and facial expression, gait, and rigidity symptoms than PD patients (all P<0.001). Abnormal posture and tremor at rest did not differ. Severity of EPS correlated with age, duration of disease, and cognitive impairment in PD patients but not in DLB patients. Studies of the clinical significance and management of EPS in DLB patients are needed.

Key Words: Dementia • Lewy Bodies • Parkinson's Disease

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