Screening for Mild Cognitive Impairment in Parkinson’s Disease: Comparison of the Italian Versions of Three Neuropsychological Tests

Abstract

Mild cognitive impairment (MCI) is frequent in Parkinson's disease (PD). Recently proposed criteria for MCI in PD (PD-MCI) indicate level I diagnosis based on abbreviated assessment and level II based on comprehensive neuropsychological evaluation. The study explored the sensitivity and specificity of the Italian versions of three neuropsychological tests for level I diagnosis of PD-MCI. We recruited 100 consecutive PD patients. After screening for inclusion criteria, 43 patients were included. The sensitivity and specificity of the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Addenbrooke's Cognitive Examination Revised (ACE-R) in comparison to level II diagnosis of PD-MCI were examined. PD-MCI was diagnosed (level II) in 51% of patients. Disease duration was significantly longer and PD motor scales were more severely impaired in MCI group. The receiver-operator characteristics curve documented nonsignificant difference in the performance of the three tests, with slight advantage of MMSE (corrected data). The time of administration favored MMSE. In Italian-speaking PD patients, MMSE might represent a good screening tool for PD-MCI, because of the shorter time of administration and the performance comparable to those of MoCA and ACE-R. Further studies are needed to validate the new PD-MCI criteria across different languages and cultures.

Mutation inADORA1identified as likely cause of early-onset parkinsonism and cognitive dysfunction

“…Although identification of a mutation in ADORA1 in a second family would have provided very strong confirmation, the gene was screened in only 100 PD cases. They were all early‐onset cases (age at onset < 45 years), but none were documented to have cognitive dysfunctions . PD is sometimes accompanied by cognitive impairment, and we are attempting to identify patients whose phenotypes more closely resemble those of the patients of PD‐102.…”

“…They were all early-onset cases (age at onset < 45 years), but none were documented to have cognitive dysfunctions. 12,13 PD is sometimes accompanied by cognitive impairment, and we are attempting to identify patients whose phenotypes more closely resemble those of the patients of PD-102. But it is not uncommon that mutations in potentially causative genes are identified in isolated pedigrees.…”

Pathophysiology of Motor Dysfunction in Parkinson’s Disease as the Rationale for Drug Treatment and Rehabilitation

“…Among motor symptoms and signs, the cardinal ones (bradykinesia, rest tremor, and rigidity) are mainly ascribed to the loss of dopaminergic neurons [ 4 ], but those involving posture, balance, and gait are largely secondary to degeneration of nondopaminergic pathways and significantly contribute to impairment and disability in advanced PD patients [ 5 ]. Nonmotor features result from multiple neurotransmitter deficiencies in the central and peripheral nervous system [ 6 ] and include psychiatric (depression, apathy, hallucinations, and delusions) and autonomic (constipation, orthostatic hypotension, and urinary and genital disturbances) features, cognitive impairment (involvement of executive functions, memory, and visuospatial functions up to dementia) [ 7 , 8 ], sleep disorders, olfactory dysfunction, and pain [ 9 ] that together contribute to worsening the quality of life (QoL) and patient's disability [ 6 ].…”

Regression-based normative data and equivalent scores for Trail Making Test (TMT): an updated Italian normative study

“…The MoCA is thought to show higher sensitivity and specificity in identifying cognitive impairment with respect to Mini-Mental State Examination (MMSE) [8][9][10] This superiority is probably due to the structure of the MoCA, as it includes several tasks with visuospatial material along with tasks and procedures specifically assessing frontal/executive functions and attention [11]. The MoCA is characterized by good concurrent validity with respect to validated neuropsychological tests [12,13] and can detect cognitive impairment in different neurological disorders [13][14][15].…”