Subjective Cognitive Complaints in Cognitively Normal Patients With Parkinson’s Disease: A Systematic Review

Hong, Jin Yong; Lee, Phil Hyu

doi:10.14802/jmd.22059

Cited by 9 publications

(18 citation statements)

References 87 publications

(274 reference statements)

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“…In the present study, SCC were reported by 6 of 16 (37.5%) PSP patients with NC, which was lower than the reported median prevalence of SCC among PD patients with NC (48.8%) (7). Interestingly, there were no significant differences between the clinical and demographic characteristics, including depression (GDS), of the NC + SCC and NC − SCC groups in this study; in contrast, PD patients with NC + SCC reported more affective symptoms, such as depression, anxiety, and apathy, than those without SCC (6,8,26).…”

Section: Discussioncontrasting

confidence: 92%

Subjective cognitive complaints in patients with progressive supranuclear palsy

Lee,

Ahn,

et al. 2023

Front. Neurol.

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IntroductionSubjective cognitive complaints (SCC) refer to self-reported cognitive decline that may or may not be reflected in objective neuropsychological evaluations. Such SCC are prevalent in neurodegenerative diseases, including Parkinson’s disease (PD), but the prevalence and clinical features in patients with progressive supranuclear palsy (PSP) have not been investigated.MethodsWe recruited 83 PSP patients without dementia and investigated their SCC using a semi-structured interview. Comprehensive neuropsychological test results and patient clinical features were compared according to presence of SCC and underlying cognitive state.ResultsAmong the 83 patients, 16 had normal cognition (NC), 67 had mild cognitive impairment (MCI), and 36 (43.4%) reported SCC. Among NC patients, 37.5% (6/16) had SCC, while 44.8% (30/67) of MCI patients reported SCC. There were no differences between the neuropsychological test results or demographic and clinical characteristics of PSP patients with or without SCC in the NC group. The demographic and clinical characteristics of the MCI+SCC (MCI with SCC)and MCI-SCC (MCI without SCC) groups were comparable, but the MCI+SCC group had significantly worse neuropsychological scores than the MCI-SCC group, particularly in tests assessing attention, language, visual memory, and fronto-executive function domains.DiscussionWhile SCC are commonly reported by PSP patients, patients with PSP and MCI+SCC had worse cognitive function than those who did not report SCC. These findings suggest that SCC in PSP patients with MCI could be a worsening sign of cognitive function. Therefore, it is crucial for physicians to assess SCC in PSP patients and to provide timely diagnosis and management of cognitive decline.

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Section: Discussioncontrasting

confidence: 92%

Subjective cognitive complaints in patients with progressive supranuclear palsy

Lee,

Ahn,

et al. 2023

Front. Neurol.

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“…The exclusion criteria for this study were as follows: (1) secondary causes of parkinsonism, as confirmed by laboratory tests and brain structural changes, including territorial cerebral infarction, brain tumors, and normal pressure hydrocephalus, and (2) patients with dementia with Lewy bodies (DLB) based on the clinical distinction of the 1-year rule between the onset of dementia and parkinsonsim. 12 During diagnosis of PD and every follow-up visit at 3-month intervals, cognitive status was screened using the modified question of Unified Parkinson Disease Rating Scale (UPDRS) part I, “Have you had problems remembering things, following conversations, paying attention, thinking clearly, or finding your way around the house or in town?” 13 When the patients or caregivers first complained of cognitive decline, detailed neuropsychological evaluation and NPI questionnaire were administered. Based on the cognitive status assessed by a neuropsychological test, patients were classified as PD-CN, PD-MCI, and PDD.…”

Section: Methodsmentioning

confidence: 99%

“…12 During diagnosis of PD and every follow-up visit at 3-month intervals, cognitive status was screened using the modified question of Unified Parkinson Disease Rating Scale (UPDRS) part I, "Have you had problems remembering things, following conversations, paying attention, thinking clearly, or finding your way around the house or in town?" 13 When the patients or caregivers first complained of cognitive decline, detailed neuropsychological evaluation and NPI questionnaire were administered. Based on the cognitive status assessed by a neuropsychological test, patients were classified as PD-CN, PD-MCI, and PDD.…”

Section: Study Participantsmentioning

confidence: 99%

Association of Neuropsychiatric Symptom Profiles With Cognitive Decline in Patients With Parkinson Disease and Mild Cognitive Impairment

Lee,

Park,

Jeong

et al. 2023

Neurology

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Background and Objectives:Neuropsychiatric symptoms (NPS) are closely associated with cognitive decline in patients with Parkinson’s disease (PD). We investigated which profiles of NPS are associated with the risk of dementia in PD with mild cognitive impairment (PD-MCI).Methods:We retrospectively assessed 338 patients with PD-MCI from a single tertiary hospital, who underwent neuropsychological tests and a neuropsychiatric inventory (NPI) questionnaire. We conducted a factor analysis of the dichotomized presence of 12 NPI symptoms, yielding three NPI factors: factor 1, mood symptoms; factor 2, hyperactivity-related symptoms; and factor 3, psychotic symptoms. Factor analysis of the severity of NPI symptoms also identified similar NPI factors. The neuropsychiatric correlates of NPI factors were evaluated using general linear models for cognitive tests. Subsequently, we evaluated the hazard ratio (HR) of NPI factors on conversion to dementia.Results:A higher prevalence factor 1 score was associated with lower scores in the verbal memory (β = -0.15; 95% confidence interval [CI] = -0.24 – -0.06;p= 0.001) and executive domains (β = -0.16; 95% CI = -0.28 – -0.04;p= 0.007), whereas higher severity factor 2 scores were associated with lower scores in the naming (β = -0.16; 95% CI = -0.28 – -0.03;p= 0.012), visuospatial (β = -0.24; 95% CI = -0.41 – -0.07;p= 0.005), and verbal memory domains (β = -0.15; 95% CI = -0.24 – -0.05;p= 0.005). A higher severity factor 3 score was associated with lower scores in the visuospatial domain (β = -0.25; 95% CI = -0.46 – -0.07;p= 0.007). Cox regression models demonstrated that the risk of dementia was increased in those with higher prevalence factor 1 (HR = 1.48, 95% CI = 1.17 – 1.88,p= 0.001) and factor 2 scores (HR = 1.27, 95% CI = 1.07 – 1.51,p= 0.007) and severity factor 3 score (HR = 1.52, 95% CI = 1.29 – 1.80,p< 0.001) after adjusting for age, sex, education, disease duration, scores for cognition and parkinsonism, and levodopa equivalent dose.Discussion:This study demonstrated that a higher burden of NPS is associated with dementia conversion in patients with PD-MCI.

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“…Since there are no guidelines for PD-SCD, researchers have classified it differently, and some defined it as subjective CI without objective cognitive decline but poor performance in action naming [ 48 ] and an indicator of subsequent CI [ 49 , 50 ]. Its incidence, therefore, varied considerably between 25% and 85% [ 14 , 51 , 52 , 53 , 54 , 55 , 56 ].…”

Section: Epidemiology Of CI In Pdmentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.

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Subjective Cognitive Complaints in Cognitively Normal Patients With Parkinson’s Disease: A Systematic Review

Cited by 9 publications

References 87 publications

Subjective cognitive complaints in patients with progressive supranuclear palsy

Subjective cognitive complaints in patients with progressive supranuclear palsy

Association of Neuropsychiatric Symptom Profiles With Cognitive Decline in Patients With Parkinson Disease and Mild Cognitive Impairment

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

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