Associations between cognitive impairment and motor dysfunction in Parkinson's disease

Wang, Yixuan; Zhao, Jue; Li, Dake; Peng, Fang; Wang, Ying; Yang, Ke; Liu, Zhenyang; Liu, Feng‐Tao; Wu, Jianjun; Wang, Jian

doi:10.1002/brb3.719

Cited by 36 publications

(27 citation statements)

References 41 publications

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“…Prevalence was significantly moderated by disease stage evaluated by H&Y only, suggesting that PD‐MCI often develops during the disease course when the neurodegenerative process affects several cortical and subcortical areas, as highlighted in previous studies . This relationship is also supported by the findings of a significant difference between patients with and without PD‐MCI on the severity of motor symptoms, LEDD, and disease duration.…”

Section: Discussionsupporting

confidence: 77%

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

et al. 2019

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Mild cognitive impairment associated with Parkinson's disease (PD) is a risk factor for the development of dementia. Despite the importance of early identification of mild cognitive impairment in PD, its prevalence and clinical correlates are still debated. The present meta‐analysis provides a robust estimate of prevalence rate of mild cognitive impairment in PD according to the Movement Disorder Society clinical criteria and to explore the differences between PD patients with and without mild cognitive impairment in demographic, clinical, and neuropsychiatric features. A systematic literature search was performed up to April 2019 using PsycInfo (PROQUEST), PubMed, and Scopus. From 4706 titles and abstracts, 41 studies were selected (n = 7053 patients). Pooled mild cognitive impairment prevalence was 40% on a total sample of 7053 PD patients (95% confidence interval = 36–44; Q = 490.14, P < 0.0001; I2 = 91.84%) with a higher frequency for the multiple domain subtype (31%; 95% confidence interval = 23–41, Q = 93.24; P < 0.0001; I2 = 92.49%). Meta‐regression analysis revealed that stage of PD moderate prevalence estimates of mild cognitive impairment (β = 2.80; P = 0.008). Mild cognitive impairment in PD was associated with older age, lower education, longer disease duration, higher levodopa equivalent daily dose, more severe motor symptoms, and postural instability/gait difficulty motor subtype, poorer quality of life, higher levels of apathy, and depression. The present meta‐analysis indicated that mild cognitive impairment in PD is a frequent cognitive status deserving to be early detected by means of standardized cognitive assessments in clinical practice. © 2019 International Parkinson and Movement Disorder Society

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Section: Discussionsupporting

confidence: 77%

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

et al. 2019

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“…In our previous study, we reported a significant correlation between subdomains of cognitive impairment and motor dysfunction, suggesting shared neurochemical pathways (Wang et al, 2017). In a previous study, PD-D patients exhibit greater dopamine depletion than nondemented patients (Emre, 2003).…”

Section: Cognitive Profile In Pd Patients and Healthy Controlsmentioning

confidence: 84%

Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in ¹⁸F‐FDG PET imaging

Liu

et al. 2018

Human Brain Mapping

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This study aimed to characterize the clinical features and the related cerebral glucose metabolism pattern of cognitive impairments in Parkinson's disease (PD) with positron emission tomography (PET) imaging. We recruited 168 PD patients and 100 age-matched healthy controls of similar education and gender distribution. All of those enrolled underwent clinical assessment including the unified Parkinson's disease rating scale motor score, Hoehn and Yahr scale, and comprehensive neuropsychological tests including domains of executive function, attention, memory, visuospatial function, and language. Demographics and the results of cognitive measures were compared between patients and healthy controls. Cognition status was classified as PD patients with dementia (PD-D), PD patients with mild cognitive impairment (PD-MCI), or PD patients with normal cognition (PD-NC). In 53 PD patients who underwent F-fluorodeoxyglucose ( F-FDG) PET imaging, correlations between Z-score values of the different cognitive domains and cerebral F-FDG uptake were assessed using statistical parametric mapping (SPM8) corrected for age and motor severity. A total of 23.2% of PD patients were PD-MCI and 8.9% were PD-D. In the group of PD-MCI, 96.3% showed multiple-domain deficits, with executive function and attention impairment most predominantly involved. All the cognitive domain scores with the exception of language correlated with F-FDG metabolisms, primarily in posterior temporo-parieto-occipital association cortical areas. This study found that cognitive impairment in PD particularly encompasses frontal/executive deficits. Posterior cortical areas, containing multiple neurotransmitters and neural circuits, may play an important role in the pathogenesis of cognitive impairment in PD.

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“…These findings are consistent with past observations showing that motor dysfunction is associated with cognitive decline, autonomic dysfunction, and RBD. 28,48 PD with RBD is also associated with faster motor progression and a higher risk of cognitive decline. 28 In line with these studies, we found that patients with biotype 1 had much worse RBD symptomatology and more cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Association of specific biotypes in patients with Parkinson disease and disease progression

et al. 2020

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Objective:To identify biotypes in newly diagnosed Parkinson’s disease patients and test whether these biotypes could explain inter-individual differences in longitudinal progression.Methods:In this longitudinal analysis, we use a data-driven approach clustering PD patients from the Parkinson’s Progression Markers Initiative (PPMI) (n = 314, age = 61.0 ± 9.5, 34.1% female, 5 years follow-up). Voxel-level neuroanatomical features were estimated using deformation-based morphometry (DBM) of T1-weighted MRI. Voxels whose deformation values were significantly correlated (P < 0.01) with clinical scores (MDS-UPDRS-Parts I-III, MDS-UPDRS-total, tremor score, and postural instability and gait difficulty score) at baseline were selected. Then, these neuroanatomical features were subjected to hierarchical cluster analysis. Changes in the longitudinal progression and neuroanatomical pattern were compared between different biotypes.Results:Two neuroanatomical biotypes were identified: (i) biotype 1 (n = 114) with subcortical brain volumes smaller than heathy controls; (ii) biotype 2 (n = 200) with subcortical brain volumes larger than heathy controls. Biotype 1 had more severe motor impairment, autonomic dysfunction, and very much worse REM sleep behavior disorder than biotype 2 at baseline. Although disease duration at initial visit and follow-up were similar between biotypes, PD patients with smaller subcortical brain volume had poorer prognosis, with more rapid decline in several clinical domains and in dopamine functional neuroimaging over an average of five years.Conclusion:Robust neuroanatomical biotypes exist in PD with distinct clinical and neuroanatomical pattern. These biotypes can be detected at diagnosis, and predict the course of longitudinal progression, which should benefit trial design and evaluation.Glossary:ADL = activities of daily living; ESS = Epworth Sleepiness Scale; GDS = Geriatric Depression Scale; HVLT = Hopkins Verbal Learning Test; MDS-UPDRS = Movement Disorder Society–sponsored revision of the Unified Parkinson’s Disease Rating Scale; MoCA = Montreal Cognitive Assessment; QUIP = Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease; RBD = REM sleep behavior disorder; RBDSQ = REM Sleep Behavior Disorder Screening Questionnaire; SCOPA-AUT = Scales for Outcomes in Parkinson’s Disease–Autonomic; STAI = State-Trait Anxiety Inventory; UPSIT = University of Pennsylvania Smell Identification Test.

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Associations between cognitive impairment and motor dysfunction in Parkinson's disease

Cited by 36 publications

References 41 publications

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in ¹⁸F‐FDG PET imaging

Association of specific biotypes in patients with Parkinson disease and disease progression

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Associations between cognitive impairment and motor dysfunction in Parkinson's disease

Cited by 36 publications

References 41 publications

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in 18F‐FDG PET imaging

Association of specific biotypes in patients with Parkinson disease and disease progression

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Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in ¹⁸F‐FDG PET imaging