Introduction The Parkinson's disease questionnaire-39 (PDQ-39) is a common measure of health related quality of life (HRQoL) that is widely used with Parkinson disease (PD) patients. Previous evidence suggests that the PDQ-39 reflects at least 8 dimensions (i.e., Emotion, Cognitions, Mobility, etc). To date, little research has examined the external/convergent validity of the Cognitions and Emotional Well-being domains of the PDQ-39. Methods A convenience sample of 303 PD patients underwent a comprehensive multi-domain neuropsychological evaluation, including tests of execution function, episodic verbal memory, processing speed, language and working memory, as well as completing measures of depression, apathy, state and trait anxiety and HRQoL (PDQ-39). Hierarchical regressions were conducted in order to examine the relationship between scores on neuropsychological tests and the Cognitions index, as well as mood measures and the Emotional Well-being index of the PDQ-39. Results Neuropsychological test performance did not account for a significant amount of variance in the PDQ-39 Cognitions index scores. Instead, it was depression that significantly contributed to the Cognitions index, above and beyond neuropsychological performance. The PDQ-39 Emotional Well-being index was also related to mood measures, primarily depression and trait anxiety. Conclusions The PDQ-39 Cognition index may be more related to mood functioning, as opposed to cognitive functioning, and should not be considered a “proxy” for cognitive functioning. Future studies are needed to better explain the construct of this index.

Due to controversy regarding the influence of apathy on quality of life (QoL), the authors examined the independent influence of apathy, depression, and trait anxiety in a nondemented sample of patients with Parkinson disease (PD). Participants (N=107) completed standard self-report measures of QoL and mood/motivation. Analyses investigated the contribution of these measures and empirically derived factor scores on QoL. QoL was predicted by trait anxiety, dysphoria, and decreased interest, with no independent contribution of apathy. Different patterns emerged with respect to domain-specific QoL, with trait anxiety being the strongest predictor across most domains. Anxiety was most widely related to QoL in PD, with minimal contribution of apathy. Future studies should examine different roles of PD mood/motivation symptoms on caregiver QoL.

Objective Studies with healthy elderly adults suggest apathy, depression and anxiety are more common among individuals with mild cognitive impairment (MCI). We examined differences in mood/amotivational symptoms among Parkinson’s patients with and without MCI. Methods Parkinson patients (N=214) underwent neurocognitive evaluations including assessment of apathy (Apathy Scale; AS), depression (Beck Depression Inventory-II; BDI-II) and trait anxiety (State-Trait Anxiety Inventory-Trait scale; STAI-T). Results Trait anxiety and depression were more severe in PDs with MCI. Delineation of MCI into amnestic vs non-amnestic subtypes revealed greater depression, apathy and anxiety among amnestic MCI relative to cognitively-intact PD patients. Conclusion Parkinson patients with MCI report greater mood symptoms compared to Parkinson patients who are cognitively intact.

Objective: Many patients require repeat neuropsychological evaluations to determine change over time. Repeat evaluations lead to practice effects, which can impact the validity of the assessment. The current study assessed, in older adults, the validity of an alternative set of verbal memory stories created by Newcomer and colleagues (1994).Method: A total 154 of nondemented adults, ages 60 to 92, completed the WMS-III Logical Memory (LM) stories and two Newcomer stories (Carson-Jones) as part of a larger battery of neurocognitive tests. The Carson-Jones stories were scored for: 1) verbatim (traditional) and 2) thematic (developed for this study) accuracy. Story memory variables were compared to each other and additional neurocognitive measures using bivariate correlations. A subset of participants (n=133) completed magnetic resonance imaging (MRI) and various structural regions (e.g., thickness and volume of medial temporal lobe structures) were used to assess external validity of Carson-Jones stories with hierarchical multiple regression analyses.Results: There was a strong positive correlation between WMS-III LM and Carson-Jones stories for both verbatim and thematic scoring. Both scoring types showed convergent validity with other verbal memory measures (e.g., WMS-III LM and HVLT-R Delay/Learning) and divergent validity with Stroop Word Reading and JOLO. Regarding neuroimaging correlates, Carson-Jones verbatim scoring was significantly associated with left subiculum and left whole hippocampal volume whereas thematic scoring was significantly associated only with left subiculum.Conclusions: Newcomer stories appear to be a valid alternative to WMS-III LM stories in terms of assessing verbal memory in healthy older adults.

Neuroanatomically, it remains unclear whether diminished startle modulation in essential tremor is secondary to aberrant cerebellar input to the amygdala, which is involved in priming the startle response in emotional contexts, or due to more direct disruption between the cerebellum and brainstem startle circuitry. If the former is correct, these findings may be the first to reveal dysregulation of emotional networks in essential tremor.