Cognitive impairment in incident, untreated Parkinson disease

Aarsland, Dag; Brønnick, Kolbjørn; Larsen, Jan Petter; Tysnes, Ole‐Bjørn; Alves, Guido

doi:10.1212/01.wnl.0000338632.00552.cb

Cited by 574 publications

(479 citation statements)

References 25 publications

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“…Each patient underwent a neuropsychological examination as follows: neuropsychological tests evaluating multiple cognitive domains were used for analysis following the approach previously reported for cognitive impairment in PD (Aarsland et al, 2009). These tests included measures of verbal and nonverbal memory: California Verbal Learning Test (Delis et al, 2000) and Benton Visual Retention Test (Benton, 1974); executive/reasoning functions: WAIS III Picture Arrangement test (Wechsler, 1997), and Stroop Color Word Interference test together with a switching version of the Stroop 3 test in which subjects name the ink, unless the word is surrounded by a box, in which case they read the word itself (Stroop 4).…”

Section: Subjects and Clinical Test Batterymentioning

confidence: 99%

Heterogeneity of Cholinergic Denervation in Parkinson's Disease without Dementia

Bohnen

Müller

Kotagal

et al. 2012

J Cereb Blood Flow Metab

155

171

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Parkinson's disease (PD) is a multisystem neurodegenerative disorder. Heterogeneous clinical features may reflect heterogeneous changes in different brain regions. In contrast to the pronounced nigrostriatal denervation characteristic of PD, cholinergic changes are less marked. We investigated cholinergic innervation activity in PD subjects relative to normal subjects. Nondemented PD subjects (n = 101, age 65.3±7.2 years) and normal subjects (n = 29, age 66.8 ± 10.9 years) underwent clinical assessment and [ 11 C]methyl-4-piperidinyl propionate acetylcholinesterase and [ 11 C]dihydrotetrabenazine monoaminergic positron emission tomography (PET) imaging. Cholinergic projection changes were heterogeneous for 65 out of 101 PD subjects who had neocortical and thalamic acetylcholinesterase activity within the normal range. The remainder had combined neocortical and thalamic (13/101), isolated neocortical (18/101), or isolated thalamic (5/101) acetylcholinesterase activity below the normal range. The low neocortical acetylcholinesterase activity subgroup had significantly lower global cognitive performance compared with the normal range subgroup (F = 7.64, P = 0.0069) with an independent effect for nigrostriatal denervation (F = 7.60, P = 0.0074). The low thalamic acetylcholinesterase activity subgroup did not differ from the normal thalamic acetylcholinesterase activity subgroup in cognitive performance or motor impairments except for a history of falls (P = 0.0023). Cholinergic denervation is heterogeneous with reduced neocortical and/or thalamic acetylcholinesterase activity in 36% of nondemented PD subjects with corresponding clinical phenotypic variation. Results also show independent cognitive effects for both cholinergic and dopaminergic system changes in nondemented PD subjects.

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Section: Subjects and Clinical Test Batterymentioning

confidence: 99%

Heterogeneity of Cholinergic Denervation in Parkinson's Disease without Dementia

Bohnen

Müller

Kotagal

et al. 2012

J Cereb Blood Flow Metab

155

171

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“…Moreover, already in the early stages of PD some 20% of patients have mild cognitive impairment [1]. Because of the underlying neurodegenerative nature of PD, cognitive impairments are overall related to increased motor severity [2].…”

Section: Introductionmentioning

confidence: 99%

Involvement of specific executive functions in mobility in Parkinson's disease

Smulders

Nimwegen

Munneke

et al. 2013

Parkinsonism & Related Disorders

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a b s t r a c tPostural instability and gait disorders (PIGD) in Parkinson's disease (PD) seem to be associated with executive dysfunction. We investigated which specific executive functions are associated with functional mobility in mildly affected PD patients. Functional mobility (Timed Up&Go Test, TUG), PIGD score, (spatial) working memory, set shifting, response inhibition and response generation were assessed in a large cohort of 232 non-demented PD patients. Both performance on the TUG and PIGD score were weakly associated with working memory and response generation (semantic and phonemic fluency). TUG also correlated with semantic fluency when corrected for disease severity and age. These results indicate that response generation and working memory are associated with (and possibly also causally related to) gait and balance deficits. In order to fully interpret gait and postural stability of PD patients in everyday situations, the role of impairments in working memory and response generation should be taken into account.

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“…Levene and Kolmogorov-Smirnov tests were used to determine homogeneity and normal eventually develop dementia in the advanced stages [4]. Cognitive decline progresses with disease course, and cognitive impairment is no longer considered just a late-stage problem [5][6][7]. Cognitive impairment is associated with decreased quality of life and increased functional impairment, caregiver burden and likelihood of placement in nursing homes [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Function in Early and Advanced Parkinson’s disease

Chen¹,

Wang²

2018

Neuropsychiatry

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Objective: To investigate the occurrence of mild cognitive impairment (MCI) in early and advanced Parkinson's disease (PD) and identify the risk factors for PD-MCI.Methods: A total of 138 PD patients were recruited between April 2015 and December 2017. We evaluated demographic and clinical data, including sex, age, age of onset, disease duration, Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale (UPDRS) part Ⅲ, 39-item Parkinson's Disease Questionnaire (PDQ-39), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI) and Mini-Mental State Examination (MMSE) scores. Participants were divided into early and advanced PD groups according to Hoehn and Yahr stage. Group comparisons were performed using Student's t-tests or chi-square tests. Binary logistic regression was conducted to identify risk factors for PD-MCI. Results:There was no significant difference in MMSE scores between the early and advanced groups. According to PD-MCI Level 1 criteria, 27 individuals (30.0%) in the early group and 16 individuals (33.3%) in the advanced group were classified as having PD-MCI. The proportion of PD-MCI was not significantly different between the two groups (chi-square = 0.162, p = 0.687). No demographic or clinical factors were significantly associated with the development of PD-MCI. Conclusions:Cognitive impairment is stable in PD patients with short disease duration when the MMSE is used as a global cognitive test. The occurrence of PD-MCI is high, even in newly diagnosed PD patients.

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Cognitive impairment in incident, untreated Parkinson disease

Cited by 574 publications

References 25 publications

Heterogeneity of Cholinergic Denervation in Parkinson's Disease without Dementia

Heterogeneity of Cholinergic Denervation in Parkinson's Disease without Dementia

Involvement of specific executive functions in mobility in Parkinson's disease

Cognitive Function in Early and Advanced Parkinson’s disease

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