Executive Functioning in Daily Life in Parkinson's Disease: Initiative, Planning and Multi-Task Performance

Koerts, Janneke; Beilen, Marije van; Tucha, Oliver; Leenders, Klaus L.; Brouwer, Wiebo

doi:10.1371/journal.pone.0029254

Cited by 49 publications

(39 citation statements)

References 42 publications

(44 reference statements)

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“…7 However, deficits across executive functions are present, even in cases without significant motor slowing, and are attributed to an alteration of connectivity between prefrontal and striatal regions, where dopaminergic and cholinergic projections are abundant. [8][9][10][11][12] An updated model of cognitive decline in PD is now appropriately characterized as a disconnection syndrome. 13 We hypothesized that cognition is transiently impaired during OH in PD and that persons with PD and OH would have cognitive deficits that are more severe than those with PD without OH.…”

Section: Discussionmentioning

confidence: 99%

Effects of orthostatic hypotension on cognition in Parkinson disease

et al. 2017

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Objective: To investigate the relation between orthostatic hypotension (OH) and posturemediated cognitive impairment in Parkinson disease (PD) using a cross-sectional and withingroup design.Methods: Individuals without dementia with idiopathic PD included 18 with OH (PDOH) and 19 without OH; 18 control participants were also included. Neuropsychological tests were conducted in supine and upright-tilted positions. Blood pressure was assessed in each posture. Results:The PD groups performed similarly while supine, demonstrating executive dysfunction in sustained attention and response inhibition, and reduced semantic fluency and verbal memory (encoding and retention). Upright posture exacerbated and broadened these deficits in the PDOH group to include phonemic fluency, psychomotor speed, and auditory working memory. When group-specific supine scores were used as baseline anchors, both PD groups showed cognitive changes following tilt, with the PDOH group exhibiting a wider range of deficits in executive function and memory as well as significant changes in visuospatial function. Conclusions:Cognitive deficits in PD have been widely reported with assessments performed in the supine position, as seen in both our PD groups. Here we demonstrated that those with PDOH had transient, posture-mediated changes in excess of those found in PD without OH. These observed changes suggest an acute, reversible effect. Understanding the effects of OH due to autonomic failure on cognition is desirable, particularly as neuroimaging and clinical assessments collect data only in the supine or seated positions. Identification of a distinct neuropsychological profile in PD with OH has quality of life implications, and OH presents itself as a possible target for intervention in cognitive disturbance. Orthostatic hypotension (OH) is among the most commonly reported nonmotor manifestations in persons with Parkinson disease (PD), with prevalence as high as 53%.1 Symptoms include lightheadedness, fatigue, neck pain, presyncope, and syncope.2,3 The causes can include both CNS and peripheral nervous system degeneration.4 Dopamine replacement therapies have been implicated as well. 5OH is associated with cognitive impairment. Even when controlling for systolic blood pressure (SBP), both elderly and younger individuals with OH show relative deficits in verbal memory and sustained attention, both of which are predictors of subsequent cognitive decline that is greater than would be expected in the context of normal aging. 6Idiopathic PD is itself associated with cognitive deficits. Historically, these were thought to be limited to psychomotor/information processing speeds and caused by disease-specific subcortical pathologies.7 However, deficits across executive functions are present, even in cases without

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Section: Discussionmentioning

confidence: 99%

Effects of orthostatic hypotension on cognition in Parkinson disease

et al. 2017

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“…Limitations might be more apparent in complex daily activities like eating, dressing, shopping and gardening because the attention load and mental flexibility required for these activities can further constrain motor performance [30]. Non-motor impairments also affect daily activities, such as visual deficits (i.e.…”

Section: Limitations In Activitiesmentioning

confidence: 99%

Physical therapy and occupational therapy in Parkinson's disease

Radder

Sturkenboom

Nimwegen

et al. 2017

International Journal of Neuroscience

134

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Current medical management is only partially effective in controlling the symptoms of Parkinson's disease. As part of comprehensive multidisciplinary care, physical therapy and occupational therapy aim to support people with Parkinson's disease in dealing with the consequences of their disease in daily activities. In this narrative review, we address the limitations that people with Parkinson's disease may encounter despite optimal medical management, and we clarify both the unique and shared approaches that physical therapists and occupational therapists can apply in treating these limitations.

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“…Lack of abilities in making plans, goal formulation, process evaluation are the basic feature of function execution related cognitive abnormalities [45,48]. In the study by Koerts et al difficulties in execution of function has been evaluated through 'Cognitive Effort Test' and explored the vulnerability of the PD patient in performing daily-life works [49].…”

Section: Difficulties In Execution Of Functionmentioning

confidence: 99%

Cognitive and Psychological Anomalies in Parkinsons Disease: An Insight into Non-Motor Characteristic Features

Choudhury¹,

Rao²,

R³

et al. 2017

Neuropsychiatry

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While most of the clinical concerns for Parkinson's disease (PD) are limited to the cardinal motor abnormalities, non-motor features like cognitive and psychological anomalies are also acquired ample of importance in last few decades. Progressive research has showcased several obvious incidences of cognitive and psychological anomalies in the pathophysiology of PD. It has been reported that, almost 30% PD sufferers show different degree of cognitive impairment but lack of awareness or negligence makes it difficult to diagnose it, at the initial stage of the disease. As a result, cognitive and psychological impairments continue to increases progressively and deteriorate the quality of life of the patient. It is presumable that, early detection of PD can be achieved by the identification of specific set of cognitive and psychological anomalies and the similar scope might open up new avenue in the non-invasive diagnosis of PD. In the present review, we have accumulated all the timely documentation on cognitive and psychological anomalies in PD and highlighted most of the non-motor features with rational justification for the relevance of their study in the early diagnosis of PD.

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Executive Functioning in Daily Life in Parkinson's Disease: Initiative, Planning and Multi-Task Performance

Cited by 49 publications

References 42 publications

Effects of orthostatic hypotension on cognition in Parkinson disease

Effects of orthostatic hypotension on cognition in Parkinson disease

Physical therapy and occupational therapy in Parkinson's disease

Cognitive and Psychological Anomalies in Parkinsons Disease: An Insight into Non-Motor Characteristic Features

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