Analyzing the subcortical dementia syndrome of Parkinson’s disease using the RBANS

Abstract

On mental status examinations, groups of equally impaired patients with subcortical (Huntington's disease, HD; Parkinson's disease, PD) or cortical (Alzheimer's disease, AD) dementias exhibit different patterns of neuropsychological deficits. Using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), classification accuracies of 90% or greater have been reported for individual patients with AD or HD. To test the generality of the RBANS classification algorithm, we studied patients with dementia (AD and PDD) and without dementia (PDND). Classification accuracies were AD: 87%, PDD: 78%, and PDND: 39%. Comparisons of performance on subtests of the RBANS showed that all groups performed more poorly on tests that require motor skill or rapid information processing and that memory performance by the PD groups was not improved by procedures that enhance encoding and facilitate retrieval. The RBANS is useful for discriminating patterns of cognitive impairment in PD and AD, but only if the diagnosis of dementia is established independent of the RBANS test results. Cognitive slowing is not specific to subcortical dementia and current concepts of memory dysfunction in PD may require re-examination.

Brain structural MRI correlates of cognitive dysfunctions in Parkinson's disease

“…Memory problems associated with PD have traditionally been reported to be secondary to retrieval deficits and therefore also reflect fronto-striatal dysfunction [6]. However, there is increasing evidence of a learning and recognition memory deficit in both demented and non-demented PD patients, which is inconsistent with this retrieval deficit hypothesis [7,8]. MRI studies suggest that medial temporal lobe atrophy may be responsible for memory dysfunction in PD.…”

Dysfunctions of cerebral networks precede recognition memory deficits in early Parkinson's disease

“…Memory problems associated with PD have traditionally been reported to be secondary to retrieval deficits, suggesting that free recall is impaired but that recognition and cued recall are intact. However, there is increasing evidence of a recognition memory deficit in both demented and non-demented PD patients, which is inconsistent with this retrieval deficit hypothesis (Beatty et al, 2003;Higginson et al, 2005). The degree to which recognition memory is affected seems to depend on disease severity and the level of difficulty of the recognition memory tasks (Whittington et al, 2000(Whittington et al, , 2006.…”

The Validity of the Repeatable Battery of Neuropsychological Status in Acute Stroke

“…Additional evidence comes from clinical studies that support the usefulness of the RBANS in differentiating among dementia subtypes (Beatty, 2004;Beatty et al, 2003;Randolph, Tierney, Mohr, & Chase, 1998). For example, Randolph et al compared the RBANS performances of mildly demented Alzheimer's disease (AD) and Huntington's disease patients.…”