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Petkus AJ, Donahue E, Jakowec MW, Bayram E, Van Horn JD, Litvan I, Petzinger GM, Schiehser DM. Data-driven sequence of cognitive decline in people with Parkinson's disease. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-333270. [PMID: 38816189 DOI: 10.1136/jnnp-2023-333270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Understanding the sequential progression of cognitive impairments in Parkinson's disease (PD) is crucial for elucidating neuropathological underpinnings, refining the assessment of PD-related cognitive decline stages and enhancing early identification for targeted interventions. The first aim of this study was to use an innovative event-based modeling (EBM) analytic approach to estimate the sequence of cognitive declines in PD. The second aim was to validate the EBM by examining associations with EBM-derived individual-specific estimates of cognitive decline severity and performance on independent cognitive screening measures. METHODS This cross-sectional observational study included 99 people with PD who completed a neuropsychological battery. Individuals were classified as meeting the criteria for mild cognitive impairment (PD-MCI) or subtle cognitive decline by consensus. An EBM was constructed to compare cognitively healthy individuals with those with PD-MCI or subtle cognitive disturbances. Multivariable linear regression estimated associations between the EBM-derived stage of cognitive decline and performance on two independent cognitive screening tests. RESULTS The EBM estimated that tests assessing executive function and visuospatial ability become abnormal early in the sequence of PD-related cognitive decline. Each higher estimated stage of cognitive decline was associated with approximately 0.24 worse performance on the Dementia Rating Scale (p<0.001) and 0.26 worse performance on the Montreal Cognitive Assessment (p<0.001) adjusting for demographic and clinical variables. CONCLUSION Findings from this study will have important clinical implications for practitioners, on specific cognitive tests to prioritise, when conducting neuropsychological evaluations with people with PD. Results also highlight the importance of frontal-subcortical system disruption impacting executive and visuospatial abilities.
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Affiliation(s)
- Andrew John Petkus
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Erin Donahue
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Michael W Jakowec
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Ece Bayram
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - John Darrell Van Horn
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
- School of Data Science, University of Virginia, Charlottesville, Virginia, USA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Giselle M Petzinger
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Dawn M Schiehser
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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2
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Borghammer P, Okkels N, Weintraub D. Parkinson's Disease and Dementia with Lewy Bodies: One and the Same. JOURNAL OF PARKINSON'S DISEASE 2024; 14:383-397. [PMID: 38640172 DOI: 10.3233/jpd-240002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
The question whether Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) are expressions of the same underlying disease has been vigorously debated for decades. The recently proposed biological definitions of Lewy body disease, which do not assign any particular importance to the dopamine system over other degenerating neurotransmitter systems, has once more brought the discussion about different types of Lewy body disease to the forefront. Here, we briefly compare PDD and DLB in terms of their symptoms, imaging findings, and neuropathology, ultimately finding them to be indistinguishable. We then present a conceptual framework to demonstrate how one can view different clinical syndromes as manifestations of a shared underlying Lewy body disease. Early Parkinson's disease, isolated RBD, pure autonomic failure and other autonomic symptoms, and perhaps even psychiatric symptoms, represent diverse manifestations of the initial clinical stages of Lewy body disease. They are characterized by heterogeneous and comparatively limited neuronal dysfunction and damage. In contrast, Lewy body dementia, an encompassing term for both PDD and DLB, represents a more uniform and advanced stage of the disease. Patients in this category display extensive and severe Lewy pathology, frequently accompanied by co-existing pathologies, as well as multi-system neuronal dysfunction and degeneration. Thus, we propose that Lewy body disease should be viewed as a single encompassing disease entity. Phenotypic variance is caused by the presence of individual risk factors, disease mechanisms, and co-pathologies. Distinct subtypes of Lewy body disease can therefore be defined by subtype-specific disease mechanisms or biomarkers.
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Affiliation(s)
- Per Borghammer
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Okkels
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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3
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Borgnis F, Borghesi F, Rossetto F, Pedroli E, Meloni M, Riva G, Baglio F, Cipresso P. Psychometric validation for a brand-new tool for the assessment of executive functions using 360° technology. Sci Rep 2023; 13:8613. [PMID: 37244936 DOI: 10.1038/s41598-023-35530-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/19/2023] [Indexed: 05/29/2023] Open
Abstract
EXecutive-functions Innovative Tool 360° (EXIT 360°) is an original 360° instrument for an ecologically valid and multicomponent evaluation of executive functioning. This work aimed to test the diagnostic efficacy of EXIT 360° in distinguishing executive functioning between healthy controls (HC) and patients with Parkinson's Disease (PwPD), a neurodegenerative disease in which executive dysfunction is the best-defined cognitive impairment in the early stage. 36 PwPD and 44 HC underwent a one-session evaluation that involved (1) neuropsychological evaluation of executive functionality using traditional paper-and-pencil tests, (2) EXIT 360° session and (3) usability assessment. Our findings revealed that PwPD made significantly more errors in completing EXIT 360° and took longer to conclude the test. A significant correlation appeared between neuropsychological tests and EXIT 360° scores, supporting a good convergent validity. Classification analysis indicated the potential of the EXIT 360° for distinguishing between PwPD and HC in terms of executive functioning. Moreover, indices from EXIT 360° showed higher diagnostic accuracy in predicting PD group membership compared to traditional neuropsychological tests. Interestingly, EXIT 360° performance was not affected by technological usability issues. Overall, this study offers evidence that EXIT 360° can be considered an ecological tool highly sensitive to detect subtle executive deficits in PwPD since the initial phases of the disease.
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Affiliation(s)
- Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, Milan, Italy
| | | | - Federica Rossetto
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, Milan, Italy
| | - Elisa Pedroli
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Mario Meloni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, Milan, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, Milan, Italy.
| | - Pietro Cipresso
- Department of Psychology, University of Turin, Turin, Italy
- IRCCS Istituto Auxologico Italiano, Milan, Italy
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4
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Borgnis F, Baglio F, Pedroli E, Rossetto F, Uccellatore L, Oliveira JAG, Riva G, Cipresso P. Available Virtual Reality-Based Tools for Executive Functions: A Systematic Review. Front Psychol 2022; 13:833136. [PMID: 35478738 PMCID: PMC9036486 DOI: 10.3389/fpsyg.2022.833136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/17/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Executive dysfunctions constitute a significant public health problem: their high impact on everyday life makes it a priority to identify early strategies for evaluating and rehabilitating these disorders in a real-life context. The ecological limitation of traditional neuropsychological tests and several difficulties in administering tests or training in real-life scenarios have paved the way to use Virtual Reality-based tools to evaluate and rehabilitate Executive Functions (EFs) in real-life. Objective This work aims to conduct a systematic review to provide a detailed description of the VR-based tools currently developed for the evaluation and rehabilitation of EFs. Methods We systematically searched for original manuscripts regarding VR tools and EFs by looking for titles and abstracts in the PubMed, Scopus, PsycInfo, and Web of Science databases up to November 2021 that contained the following keywords “Virtual Reality” AND “Executive function*.” Results and Conclusion We analyzed 301 articles, of which 100 were included. Our work shows that available VR-based tools appear promising solutions for an ecological assessment and treatment of EFs in healthy subjects and several clinical populations.
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Affiliation(s)
- Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | | | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Faculty of Psychology, eCampus University, Milan, Italy
| | | | - Lidia Uccellatore
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | | | - Giuseppe Riva
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Pietro Cipresso
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5
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Salari N, Kazeminia M, Sagha H, Daneshkhah A, Ahmadi A, Mohammadi M. The performance of various machine learning methods for Parkinson’s disease recognition: a systematic review. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02949-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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6
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Borgnis F, Baglio F, Pedroli E, Rossetto F, Meloni M, Riva G, Cipresso P. A Psychometric Tool for Evaluating Executive Functions in Parkinson's Disease. J Clin Med 2022; 11:jcm11051153. [PMID: 35268244 PMCID: PMC8911216 DOI: 10.3390/jcm11051153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022] Open
Abstract
Recently, there has been an increasing interest in using 360° virtual-reality video for an ecologically valid assessment of executive functioning in the neurologic population. In this framework, we have developed the EXecutive-functions Innovative Tool (EXIT 360°), an original 360°-based instrument for a multicomponent, ecologically valid evaluation of executive functioning in Parkinson’s Disease (PD). This work aimed to test the usability and user experience of EXIT 360° in patients with PD (PwPD). Twenty-seven PwPD and twenty-seven healthy controls underwent an evaluation that involved: (1) usability assessment by the System Usability Scale and (2) evaluation of user experience using the ICT—Sense of Presence and User Experience Questionnaire. Results showed a satisfactory level of usability for patients (mean = 76.94 ± 9.18) and controls (mean = 80 ± 11.22), with good scores for usability and learnability. Regarding user experience, patients provided a positive overall impression of the tool, evaluating it as attractive, enjoyable, activating, and funny. Moreover, EXIT 360° showed good pragmatic (e.g., efficient, fast, clear) and hedonic quality (e.g., exciting, interesting, and creative). Finally, PwPD considered EXIT 360° as an original tool with high ecological validity (mean = 4.29 ± 0.61), spatial presence (mean = 3.11 ± 0.83) and engagement (mean = 3.43 ± 0.54) without relevant adverse effects. Technological expertise had no impact on performance. Overall, EXIT 360° appeared to be a usable, easy-to-learn, engaging, and innovative instrument for PD. Further studies will be conducted to deepen its efficacy in distinguishing between healthy subjects and patients with executive dysfunctions.
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Affiliation(s)
- Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (F.B.); (F.B.); (F.R.); (M.M.)
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
| | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (F.B.); (F.B.); (F.R.); (M.M.)
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, 20149 Milan, Italy;
- Faculty of Psychology, eCampus University, 22060 Novedrate, Italy
| | - Federica Rossetto
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (F.B.); (F.B.); (F.R.); (M.M.)
| | - Mario Meloni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (F.B.); (F.B.); (F.R.); (M.M.)
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, 20149 Milan, Italy;
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, 20149 Milan, Italy;
- Department of Psychology, Università degli Studi di Torino, 10124 Turin, Italy
- Correspondence:
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El-Tallawy HN, Saleem TH, Farghaly WM, Eldien HMS, Khodaery A, Sayed SA, Helaly AA, Elnady HM. Study of cognitive impairment and genetic polymorphism of SLC41A1 (rs11240569 allele) in Parkinson’s disease in Upper Egypt: case-control study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00341-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Parkinson’s disease is one of the neurodegenerative disorders that is caused by genetic and environmental factors or interaction between them. Solute carrier family 41 member 1 within the PARK16 locus has been reported to be associated with Parkinson’s disease. Cognitive impairment is one of the non-motor symptoms that is considered a challenge in Parkinson’s disease patients. This study aimed to investigate the association of rs11240569 polymorphism; a synonymous coding variant in SLC41A1 in Parkinson’s disease patients in addition to the assessment of cognitive impairment in those patients.
Results
In a case -control study, rs11240569 single nucleotide polymorphisms in SLC41A1, genes were genotyped in 48 Parkinson’s disease patients and 48 controls. Motor and non-motor performance in Parkinson's disease patients were assessed by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The genotype and allele frequencies were compared between the two groups and revealed no significant differences between case and control groups for rs11240569 in SLC41A1 gene with P value .523 and .54, respectively. Cognition was evaluated and showed the mean ± standard deviation (SD) of WAIS score of PD patients 80.4 ± 9.13 and the range was from 61 to 105, in addition to MMSE that showed mean ± SD 21.96 ± 3.8.
Conclusion
Genetic testing of the present study showed that rs11240569 polymorphism of SLC41A1 gene has no significant differences in distributions of alleles and genotypes between cases and control group, in addition to cognitive impairment that is present in a large proportion of PD patients and in addition to the strong correlation between cognitive impairment and motor and non-motor symptoms progression.
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8
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Borgnis F, Baglio F, Pedroli E, Rossetto F, Riva G, Cipresso P. A Simple and Effective Way to Study Executive Functions by Using 360° Videos. Front Neurosci 2021; 15:622095. [PMID: 33912001 PMCID: PMC8072005 DOI: 10.3389/fnins.2021.622095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
Executive dysfunctions constitute a significant public health problem due to their high impact on everyday life and personal independence. Therefore, the identification of early strategies to assess and rehabilitate these impairments appears to be a priority. The ecological limitations of traditional neuropsychological tests and the numerous difficulties in administering tests in real-life scenarios have led to the increasing use of virtual reality (VR) and 360° environment-based tools for assessing executive functions (EFs) in real life. This perspective aims at proposing the development and implementation of Executive-functions Innovative Tool 360° (EXIT 360°), an innovative, enjoyable, and ecologically valid tool for a multidimensional and multicomponent evaluation of executive dysfunctions. EXIT 360° allows a complete and integrated executive functioning assessment through an original task for EFs delivered via a mobile-powered VR headset combined with eye tracker (ET) and electroencephalograms (EEG). Our tool is born as a 360°-based instrument, easily accessible and clinically usable, that will radically transform clinicians’ and patient’s assessment experience. In EXIT 360°, patients are engaged in a “game for health,” where they must perform everyday subtasks in 360° daily life environments. In this way, the clinicians can obtain quickly more ecologically valid information about several aspects of EFs (e.g., planning, problem-solving). Moreover, the multimodal approach allows completing the assessment of EFs by integrating verbal responses, reaction times, and physiological data (eye movements and brain activation). Overall, EXIT 360° will allow obtaining simultaneously and in real time more information about executive dysfunction and its impact in real life, allowing clinicians to tailor the rehabilitation to the subject’s needs.
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Affiliation(s)
- Francesca Borgnis
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | | | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | | | - Giuseppe Riva
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Pietro Cipresso
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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9
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John KD, Wylie SA, Dawant BM, Rodriguez WJ, Phibbs FT, Bradley EB, Neimat JS, van Wouwe NC. Deep brain stimulation effects on verbal fluency dissociated by target and active contact location. Ann Clin Transl Neurol 2021; 8:613-622. [PMID: 33596331 PMCID: PMC7951101 DOI: 10.1002/acn3.51304] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Deep brain stimulation (DBS) improves motor symptoms in Parkinson's disease (PD), but it can also disrupt verbal fluency with significant costs to quality of life. The current study investigated how variability of bilateral active electrode coordinates along the superior/inferior, anterior/posterior, and lateral/medial axes in the subthalamic nucleus (STN) or the globus pallidus interna (GPi) contribute to changes in verbal fluency. We predicted that electrode location in the left hemisphere would be linked to changes in fluency, especially in the STN. METHODS Forty PD participants treated with bilateral DBS targeting STN (n = 23) or GPi (n = 17) completed verbal fluency testing in their optimally treated state before and after DBS therapy. Normalized atlas coordinates from left and right active electrode positions along superior/inferior, anterior/posterior, and lateral/medial axes were used to predict changes in fluency postoperatively, separately for patients with STN and GPi targets. RESULTS Consistent with prior studies, fluency significantly declined pre- to postsurgery (in both DBS targets). In STN-DBS patients, electrode position along the inferior to superior axis in the left STN was a significant predictor of fluency changes; relatively more superior left active electrode was associated with the largest fluency declines in STN. Electrode coordinates in right STN or GPi (left or right) did not predict fluency changes. INTERPRETATION We discuss these findings in light of putative mechanisms and potential clinical impact.
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Affiliation(s)
- Kevin D. John
- Department of Neurological SurgeryUniversity of LouisvilleLouisvilleKYUSA
| | - Scott A. Wylie
- Department of Neurological SurgeryUniversity of LouisvilleLouisvilleKYUSA
| | - Benoit M. Dawant
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTNUSA
| | - William J. Rodriguez
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTNUSA
| | - Fenna T. Phibbs
- Department of NeurologyVanderbilt University Medical CenterNashvilleTNUSA
| | - Elise B. Bradley
- Department of NeurologyVanderbilt University Medical CenterNashvilleTNUSA
| | - Joseph S. Neimat
- Department of Neurological SurgeryUniversity of LouisvilleLouisvilleKYUSA
| | - Nelleke C. van Wouwe
- Department of Neurological SurgeryUniversity of LouisvilleLouisvilleKYUSA
- Department of NeurologyVanderbilt University Medical CenterNashvilleTNUSA
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10
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Foran AM, Mathias JL, Bowden SC. Effectiveness of sorting tests for detecting cognitive decline in older adults with dementia and other common neurodegenerative disorders: A meta-analysis. Neurosci Biobehav Rev 2020; 120:442-454. [PMID: 33091417 DOI: 10.1016/j.neubiorev.2020.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/13/2022]
Abstract
The demand for simple, accurate and time-efficient screens to detect cognitive decline at point-of-care is increasing. Sorting tests are often used to detect the 'executive' deficits that are commonly associated with behavioural-variant frontotemporal dementia (bvFTD), but their potential for use as a cognitive screen with older adults is unclear. A comprehensive search of four databases identified 142 studies that compared the sorting test performance (e.g. WCST, DKEFS-ST) of adults with a common neurodegenerative disorder (e.g. Alzheimer's disease, vascular dementia, bvFTD, Parkinson's disease) and cognitively-healthy controls. Hedges' g effect sizes were used to compare the groups on five common test scores (Category, Total, Perseveration, Error, Description). The neurodegenerative disorders (combined) showed large deficits on all scores (g -1.0 to -1.3), with dementia (combined subtypes) performing more poorly (g -1.2 to -2.1), although bvFTD was not disproportionately worse than the other dementias. Overall, sorting tests detected the cognitive impairments caused by common neurodegenerative disorders, especially dementia, highlighting their potential suitability as a cognitive screen for older adults.
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Affiliation(s)
- A M Foran
- School of Psychology, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - J L Mathias
- School of Psychology, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - S C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
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11
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van de Weijer SCF, Duits AA, Bloem BR, de Vries NM, Kessels RPC, Köhler S, Tissingh G, Kuijf ML. Feasibility of a Cognitive Training Game in Parkinson's Disease: The Randomized Parkin'Play Study. Eur Neurol 2020; 83:426-432. [PMID: 32756067 DOI: 10.1159/000509685] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 06/13/2020] [Indexed: 12/24/2022]
Abstract
Cognitive training (CT) shows modest positive effects on cognitive function in patients with Parkinson's disease (PD). Gamification may enhance adherence to traditional CT, but this has not been studied yet. Here, we investigated the feasibility of a gamified CT. We performed a randomized controlled trial including PD patients with mild cognitive impairment. Participants were randomly allocated to a 12-week home-based gamified CT intervention or waiting-list control group. Assessments were performed at baseline and at weeks 12 and 24. Forty-one patients were included (21 intervention and 20 waiting-list controls). Sixty-three percent of the intervention group trained >50% of the recommended sessions, while 81% voluntarily continued training after 12 weeks. After 24 weeks, 87.5% graded the game to be satisfactory. Global cognition scores improved after 24 weeks. Home-based gamified CT shows acceptable feasibility in patients with PD, and we observed preliminary indications for efficacy. Larger trials are needed to establish this efficacy.
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Affiliation(s)
| | - Annelien A Duits
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Nienke M de Vries
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gerrit Tissingh
- Department of Neurology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Mark L Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
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12
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Rau YA, Wang SM, Tournier JD, Lin SH, Lu CS, Weng YH, Chen YL, Ng SH, Yu SW, Wu YM, Tsai CC, Wang JJ. A longitudinal fixel-based analysis of white matter alterations in patients with Parkinson's disease. Neuroimage Clin 2019; 24:102098. [PMID: 31795054 PMCID: PMC6889638 DOI: 10.1016/j.nicl.2019.102098] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/01/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Disruption to white matter pathways is an important contributor to the pathogenesis of Parkinson's disease. Fixel-based analysis has recently emerged as a useful fiber-specific tool for examining white matter structure. In this longitudinal study, we used Fixel-based analysis to investigate white matter changes occurring over time in patients with Parkinson's disease. METHODS Fifty patients with idiopathic Parkinson's disease (27 men and 23 women; mean age: 61.8 ± 6.1 years), were enrolled. Diffusion-weighted imaging and clinical examinations were performed at three different time points (baseline, first follow-up [after a mean of 24±2 months], and second follow-up [after a mean of 40 ± 3 months]). Additional 76 healthy control subjects (38 men and 38 women; mean age: 62.3 ± 5.5 years) were examined at baseline. The following fixel-based metrics were obtained: fiber density (FD), fiber bundle cross-section (FC), and a combined measure of both (FDC). Paired comparisons of metrics between three different time points were performed in patients. Linear regression was implemented between longitudinal changes of fixel-based metrics and the corresponding modifications in clinical parameters. A family-wise error corrected p < 0.05 was considered statistically significant. RESULTS AND DISCUSSIONS Early degeneration in the splenium of corpus callosum was identified as a typical alteration of Parkinson's disease over time. At follow-up, we observed significant FDC reductions compared with baseline in white matter, noticeably in corpus callosum; tapetum; cingulum, posterior thalamic radiation, corona radiata, and sagittal stratum. We also identified significant FC decreases that reflected damage to white matter structures involved in Parkinson's disease -related pathways. Fixel-based metrics were found to relate with a deterioration of 39-item Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale and activity of daily living. A Parkinson's disease -facilitated aging effect was observed in terms of white matter disruption. CONCLUSION This study provides a thorough fixel-based profile of longitudinal white matter alterations occurring in patients with Parkinson's disease and new evidence of FC as an important role in white matter degeneration in this setting.
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Affiliation(s)
- Yi-Ai Rau
- Division of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shi-Ming Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Jacques-Donald Tournier
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Sung-Han Lin
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Song Lu
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsin Weng
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Liang Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shao-Wen Yu
- Division of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Chih-Chien Tsai
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Erro R, Santangelo G, Barone P, Picillo M, Amboni M, Longo K, Giordano F, Moccia M, Allocca R, Pellecchia MT, Vitale C. Do subjective memory complaints herald the onset of mild cognitive impairment in Parkinson disease? J Geriatr Psychiatry Neurol 2014; 27:276-81. [PMID: 24789732 DOI: 10.1177/0891988714532015] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Longitudinal studies on healthy participants have shown that subjective memory impairment (defined as subjective cognitive complaints with normal cognitive objective performance) might be a strong predictor of mild cognitive impairment (MCI). Parkinson disease (PD) also manifests cognitive disturbances, but whether subjective memory complaints may predict the development of MCI in PD has not yet been explored. METHODS We prospectively screened newly diagnosed, untreated patients with PD in order to evaluate whether subjective memory complaints may predict development of MCI over a 2-year follow-up evaluation. RESULTS We enrolled 76 de novo untreated patients with PD. Of the 76 patients, 23 (30.3%) complained memory issues. Among the patients cognitively unimpaired at baseline, those with subjective complaints were more likely to develop MCI at follow-up. The regression model confirmed that presence of subjective memory complaints at baseline was an independent predictor of development of MCI at follow-up. DISCUSSION This is the first prospective study to explore the relationship between subjective and objective cognitive deficits in newly diagnosed, untreated patients. Our results provide preliminary evidence that subjective memory complaints might predict future development of MCI.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London (UCL), London, United Kingdom
| | - Gabriella Santangelo
- Department of Psychology, Neuropsychology Laboratory, Second University of Naples, Caserta, Italy IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases-CEMAND, University of Salerno, Salerno, Italy
| | - Marina Picillo
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | | | | | - Flavio Giordano
- Center for Neurodegenerative Diseases-CEMAND, University of Salerno, Salerno, Italy
| | - Marcello Moccia
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | - Roberto Allocca
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | | | - Carmine Vitale
- IDC Hermitage-Capodimonte, Naples, Italy Department of Motor Sciences, University of Naples "Parthenope", Naples, Italy
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Calamia M, Markon K, Tranel D. The robust reliability of neuropsychological measures: meta-analyses of test-retest correlations. Clin Neuropsychol 2013; 27:1077-105. [PMID: 24016131 DOI: 10.1080/13854046.2013.809795] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Test-retest reliability is an important psychometric property relevant to assessment instruments typically used in neuropsychological assessment. This review presents a quantitative summary of test-retest reliability coefficients for a variety of widely used neuropsychological measures. In general, the meta-analytic test-retest reliabilities of the test scores ranged from adequate to high (i.e., r=.7 and higher). Furthermore, the reliability values were largely robust across factors such as age, clinical diagnosis, and the use of alternate forms. The values for some of the memory and executive functioning scores were lower (i.e., less than r=.7). Some of the possible reasons for these lower values include ceiling effects, practice effects, and across time variability in cognitive abilities measured by those tests. In general, neuropsychologists who use these measures in their assessments can be encouraged by the magnitude of the majority of the meta-analytic test-retest correlations obtained.
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Affiliation(s)
- Matthew Calamia
- a Department of Psychology , University of Iowa , Iowa City , IA , USA
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15
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Pereira JB, Junqué C, Bartrés-Faz D, Martí MJ, Sala-Llonch R, Compta Y, Falcón C, Vendrell P, Pascual-Leone Á, Valls-Solé J, Tolosa E. Modulation of verbal fluency networks by transcranial direct current stimulation (tDCS) in Parkinson’s disease. Brain Stimul 2013; 6:16-24. [DOI: 10.1016/j.brs.2012.01.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 12/26/2011] [Accepted: 01/17/2012] [Indexed: 10/28/2022] Open
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16
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Miller N, Andrew S, Noble E, Walshe M. Changing perceptions of self as a communicator in Parkinson's disease: a longitudinal follow-up study. Disabil Rehabil 2011; 33:204-10. [DOI: 10.3109/09638288.2010.508099] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Poletti M, Emre M, Bonuccelli U. Mild cognitive impairment and cognitive reserve in Parkinson’s disease. Parkinsonism Relat Disord 2011; 17:579-86. [DOI: 10.1016/j.parkreldis.2011.03.013] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 03/09/2011] [Accepted: 03/19/2011] [Indexed: 11/30/2022]
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18
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Maetzler W, Liepelt I, Berg D. Progression of Parkinson's disease in the clinical phase: potential markers. Lancet Neurol 2009; 8:1158-71. [PMID: 19909914 DOI: 10.1016/s1474-4422(09)70291-1] [Citation(s) in RCA: 204] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Neuromodulatory or even neuroprotective therapy could soon be available for Parkinson's disease (PD), raising the question of how we should define and measure disease progression. Reported evidence suggests that several symptoms worsen with disease duration. Bradykinesia, rigidity, and activities of daily living deteriorate faster at the beginning of the disease, and this deterioration is paralleled by a decline in functional presynaptic dopaminergic activity, as shown by imaging techniques. Cognitive, speech, sleep, and gait difficulties might progress linearly in proportion to disease duration. Reduced variability in heart rate, orthostatic dysfunction, and visual hallucinations start to develop at mid-stage disease and are more common in late stages than earlier stages. In this Review, we summarise our current understanding of the progression of PD-associated symptoms and markers and conclude that an effective measurement of progression of PD must adapt to the different stages of the disease. In addition to routine clinical rating scales, new quantitative assessments of motor and non-motor symptoms, which should be more broadly available, reasonably priced, and easy-to-use, are needed.
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Affiliation(s)
- Walter Maetzler
- Center of Neurology, Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
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19
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Abstract
Verbal fluency tests are often used to assess cognitive dysfunction in Parkinson's disease. These tests have been found to be impaired even in initial stages of this illness. We applied voxel-based morphometry to investigate the neuroanatomic substrates of semantic and phonemic fluency impairment. Correlations between gray matter density and semantic as well as phonemic fluency performance were performed in 32 nondemented Parkinson's disease patients. We found that gray matter of temporal, frontal and cerebellar areas correlated with semantic fluency scores. In contrast, no gray matter correlations were found for phonemic fluency or for general cognitive functions. These results suggest that semantic fluency impairment is reflecting structural gray matter changes in regions involved in language networks.
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20
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Nazem S, Siderowf AD, Duda JE, Have TT, Colcher A, Horn SS, Moberg PJ, Wilkinson JR, Hurtig HI, Stern MB, Weintraub D. Montreal cognitive assessment performance in patients with Parkinson's disease with "normal" global cognition according to mini-mental state examination score. J Am Geriatr Soc 2008; 57:304-8. [PMID: 19170786 DOI: 10.1111/j.1532-5415.2008.02096.x] [Citation(s) in RCA: 228] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine Montreal Cognitive Assessment (MoCA) performance in patients with Parkinson's disease (PD) with "normal" global cognition according to Mini-Mental State Examination (MMSE) score. DESIGN A cross-sectional comparison of the MoCA and the MMSE. SETTING Two movement disorders centers at the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center. PARTICIPANTS A convenience sample of 131 patients with idiopathic PD who were screened for cognitive and psychiatric complications. MEASUREMENTS Subjects were administered the MoCA and MMSE, and only subjects defined as having a normal age- and education-adjusted MMSE score were included in the analyses (N=100). As previously recommended in patients without PD, a MoCA score less than 26 was used to indicate the presence of at least mild cognitive impairment (MCI). RESULTS Mean MMSE and MoCA scores+/-standard deviation were 28.8+/-1.1 and 24.9+/-3.1, respectively. More than half (52.0%) of subjects with normal MMSE scores had cognitive impairment according to their MoCA score. Impairments were seen in numerous cognitive domains, including memory, visuospatial and executive abilities, attention, and language. Predictors of cognitive impairment on the MoCA using univariate analyses were male sex, older age, lower educational level, and greater disease severity; older age was the only predictor in a multivariate model. CONCLUSION Approximately half of patients with PD with a normal MMSE score have cognitive impairment based on the recommended MoCA cutoff score. These results suggest that MCI is common in PD and that the MoCA is a more sensitive instrument than the MMSE for its detection.
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Affiliation(s)
- Sarra Nazem
- Department of Psychiatry, University of Pennsyvania, Philadelphia, USA
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21
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Mamikonyan E, Moberg PJ, Siderowf A, Duda JE, Have TT, Hurtig HI, Stern MB, Weintraub D. Mild cognitive impairment is common in Parkinson's disease patients with normal Mini-Mental State Examination (MMSE) scores. Parkinsonism Relat Disord 2008; 15:226-31. [PMID: 18595765 DOI: 10.1016/j.parkreldis.2008.05.006] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2008] [Revised: 05/09/2008] [Accepted: 05/12/2008] [Indexed: 11/15/2022]
Abstract
PURPOSE Cognitive impairment occurs in the majority of Parkinson's disease (PD) patients, but little is known about detection of mild cognitive impairment (MCI) in this population. We report on the frequency and characteristics of cognitive deficits in PD patients with intact global cognition based on Mini-Mental State Examination (MMSE) performance. METHODS One hundred and six PD patients with normal age- and education-adjusted MMSE scores (mean [SD] score=29.1 [1.1]) were administered standardized neuropsychological tests assessing memory, executive function, and attention. Impairment on a cognitive domain was a low score (i.e., >or=1.5 SD below the published normative mean) on at least two measures or tests (for memory and executive abilities) or a single measure (for attention). RESULTS Mild cognitive impairment was found in 29.2% of PD patients, with 17.9% demonstrating single domain and 11.3% multiple domain impairment. Memory and attention impairment were most common (15.1% and 17.0%, respectively), followed by executive impairment (8.5%). Depending on the measure of disease severity chosen, increasing age and disease severity, anti-anxiety medication use, and a suggestion for increasing severity of daytime sleepiness were independent predictors of cognitive impairment. CONCLUSIONS Cognitive deficits are common in PD patients with "normal" cognition based on MMSE performance, suggesting that MCI is under-recognized in clinical practice due to routine use of insensitive screening instruments. In contrast with some previous reports, early memory impairment may be as common as either executive or attentional deficits in PD. In addition, psychiatric medication use and daytime sleepiness may be reversible or treatable contributors to cognitive impairment.
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Affiliation(s)
- Eugenia Mamikonyan
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
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22
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Sabbagh MN, Lahti T, Connor DJ, Caviness JN, Shill H, Vedders L, Mahant P, Samanta J, Burns RS, Evidente VGH, Driver-Dunckley E, Reisberg B, Bircea S, Adler CH. Functional ability correlates with cognitive impairment in Parkinson's disease and Alzheimer's disease. Dement Geriatr Cogn Disord 2008; 24:327-34. [PMID: 17851237 DOI: 10.1159/000108340] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Previously we have shown that functional declines in Parkinson's disease (PD) and Alzheimer's disease (AD) correlate to global measures of cognitive decline. We now determine if the correlation between cognitive impairment and functional ability in PD is similar to that in AD using individual cognitive measures. METHODS 93 PD subjects and 124 AD/MCI subjects underwent the Functional Assessment Staging (FAST), the Global Deterioration Scale (GDS), and a neuropsychological battery. RESULTS In PD subjects, the FAST and GDS correlated significantly with Rey Auditory Verbal Learning Test (AVLT), Controlled Oral Word Association (COWA), Animal Fluency, and Stroop but not with Clock Draw or Judgment Line Orientation (JLO). In AD/MCI subjects, FAST and GDS correlated with all neuropsychological components except Stroop. In the AD/MCI group, the UPDRS significantly correlated with the FAST, GDS, MMSE, and all neuropsychological parameters except the Stroop. In the PD group, the motor UPDRS significantly correlated significantly with FAST, GDS, MMSE and all neuropsychological parameters except Digit Span, Stroop, Clock Draw and JLO. CONCLUSIONS Similar to AD, functional decline in PD correlates with multiple measures of cognitive impairment. Some differences between PD and AD may be explained by the influence of motor disability and declines in visuospatial function in PD.
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Affiliation(s)
- M N Sabbagh
- The Cleo Roberts Center for Clinical Research, Sun Health Research Institute, Sun City, AZ 85351, USA.
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Course of cognitive decline in Parkinson's disease: a meta-analysis. J Int Neuropsychol Soc 2007; 13:920-32. [PMID: 17942010 DOI: 10.1017/s1355617707071160] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Revised: 04/03/2007] [Accepted: 04/17/2007] [Indexed: 11/07/2022]
Abstract
A meta-analysis was conducted on 25 longitudinal studies involving 901 initially non-demented Parkinson's disease (PD) patients to examine the magnitude of decline across multiple cognitive domains associated with disease progression. Pooled effect sizes reflecting the standardized difference between baseline and follow-up neuropsychological performance were calculated for 8 cognitive domains using a random-effects model. Relatively small effect sizes were found across all cognitive domains (d = .00 - .40). During a mean follow-up interval of 29 months, significant declines were detected in global cognitive ability (d = .40), visuoconstructive skills (d = .32), and memory (d = .29). Age showed a significant relation with decline in global cognitive ability and memory. Lower educational level was associated with greater decline in all cognitive domains. Studies with longer follow-up intervals yielded larger effect sizes for global cognitive ability. In non-demented PD patients, changes in cognitive functions over time appear to be modest. Educational level, age, and length of the follow-up interval are likely to affect the magnitude of decline in several domains. Methodological flaws, such as selection bias and uncontrolled practice effects, may have caused underestimation of the true extent of decline.
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Angwin AJ, Copland DA, Chenery HJ, Murdoch BE, Silburn PA. The influence of dopamine on semantic activation in Parkinson's disease: Evidence from a multipriming task. Neuropsychology 2006; 20:299-306. [PMID: 16719623 DOI: 10.1037/0894-4105.20.3.299] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Research has suggested that semantic processing deficits in Parkinson's disease (PD) are related to striatal dopamine deficiency. As an investigation of the influence of dopamine on semantic activation in PD, 7 participants with PD performed a lexical-decision task when on and off levodopa medication. Seven healthy controls matched to the participants with PD in terms of sex, age, and education also participated in the study. By use of a multipriming paradigm, whereby 2 prime words were presented prior to the target word, semantic priming effects were measured across stimulus onset asynchronies (SOAs) of 250 ms and 1,200 ms. The results revealed a similar pattern of priming across SOAs for the control group and the PD participants on medication. In contrast, within-group comparisons revealed that automatic semantic activation was compromised in PD participants when off medication. The implications of these results for the neuromodulatory influence of dopamine on semantic processing in PD are discussed.
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Affiliation(s)
- Anthony J Angwin
- Centre for Research in Language Processing and Linguistics, University of Queensland, and Department of Neurosciences, Princess Alexandra Hospital, Brisbane, QLD, Australia.
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