Comparison Trail Making Test between individuals with Parkinson’s disease and health controls: Suggestions of cutoff point.

Abstract

Some of the most common losses in Parkinson’s disease (PD) are the changes in executive functions. The Trail Making Test is an important test to evaluate the executive functions. The objective of this study was to verify the cutoff point of the Trail Making Test for individuals with PD compared to healthy controls. This was a cross-sectional case-control study. The inclusion criteria for the case group were a diagnosis of PD and having taken PD medicine before the evaluation. Individuals with other neurological disorders and atypical or secondary parkinsonism were excluded. The inclusion criterion for the control group was absence of neurological impairment, and participants were paired by age and level of education with patients with PD. The following protocols were applied to individuals from the two groups: Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) A and B and verbal TMT (vTMT) A and B. The sample was composed of 78 individuals, with 39 persons in both groups. In the Mann-Whitney test, a significant difference was verified in TMT A and B and vTMT B between the groups, and the case group presented worse results. We suggest a cutoff point for TMT A of 103 seconds, TMT B of 297.5 seconds, and vTMT B of 77.5 seconds. In conclusion, the TMT B verbal and written test can differentiate patients with PD from healthy controls. It can be used as a fast application test for executive function screening.

Changes in Metabolic Activity and Gait Function by Dual-Task Cognitive Game-Based Treadmill System in Parkinson’s Disease: Protocol of a Randomized Controlled Trial

“…Disruption of frontostriatal circuits in Parkinson's disease (PD) have been shown to be associated with gait impairments (Rochester et al, 2004;Rosenberg-Katz et al, 2015) and deficits in executive cognitive functions (Kudlicka et al, 2011;Olchik et al, 2017). It is now well established that gait and cognition are closely linked (Plotnik et al, 2011;Kelly et al, 2012;Callisaya et al, 2016).…”

Imaging Cerebral Glucose Metabolism during Dual‐Task Walking in Patients with Parkinson's disease

“…Disruption of frontostriatal circuits in PD has been shown to be associated with increased fall risk 1,2 and deficits in executive cognitive function. 3,4 One model of executive cognitive function focused on the supervisory attentional system, which distinguishes between processing of non-routine, attentional demanding cognitive and motor tasks versus routine, automated tasks. 5 The role of frontostriatal circuits has been equated with that of routine tasks concerned with automation of cognitive and motor actions.…”

“…Recent studies using resting fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging have identified altered metabolic patterns of prefrontal and motor planning regions in PD that are associated with various gait abnormalities 13 and executive cognitive dysfunction. 4 A few studies have examined FDG PET in which the FDG uptake period involves either treadmill walking or over ground walking, giving insight on gait-induced changes in brain metabolism. [14][15][16][17] However brain metabolic signatures of DT walking in PD have not been investigated.…”

“…The concept of automatic versus controlled processing has important implications in understanding the pathophysiology of Parkinson's disease (PD)‐related mobility/gait limitations. Disruption of frontostriatal circuits in PD has been shown to be associated with increased fall risk 1,2 and deficits in executive cognitive function 3,4 . One model of executive cognitive function focused on the supervisory attentional system, which distinguishes between processing of non‐routine, attentional demanding cognitive and motor tasks versus routine, automated tasks 5 .…”

“…Individuals with PD have greater frontal lobe activation during simple walking but reduced activation during cognitively distracting conditions compared to age and gender matched healthy controls. Recent studies using resting fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging have identified altered metabolic patterns of prefrontal and motor planning regions in PD that are associated with various gait abnormalities 13 and executive cognitive dysfunction 4 …”