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Rudd KD, Lawler K, Callisaya ML, Alty J. Investigating the associations between upper limb motor function and cognitive impairment: a scoping review. GeroScience 2023; 45:3449-3473. [PMID: 37337026 PMCID: PMC10643613 DOI: 10.1007/s11357-023-00844-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/26/2023] [Indexed: 06/21/2023] Open
Abstract
Upper limb motor function is a potential new biomarker of cognitive impairment and may aid discrimination from healthy ageing. However, it remains unclear which assessments to use. This study aimed to explore what methods have been used and to describe associations between upper limb function and cognitive impairment. A scoping review was conducted using PubMed, CINAHL and Web of Science. A systematic search was undertaken, including synonyms for key concepts 'upper limb', 'motor function' and 'cognitive impairment'. Selection criteria included tests of upper limb motor function and impaired cognition in adults. Analysis was by narrative synthesis. Sixty papers published between 1998 and 2022, comprising 41,800 participants, were included. The most common assessment tasks were finger tapping, Purdue Pegboard Test and functional tasks such as writing. Protocols were diverse in terms of equipment used and recording duration. Most participants were recruited from clinical settings. Alzheimer's Disease was the most common cause of cognitive impairment. Results were mixed but, generally, slower speed, more errors, and greater variability in upper limb movement variables was associated with cognitive impairment. This review maps the upper limb motor function assessments used and summarises the available evidence on how these associate with cognitive impairment. It identifies research gaps and may help guide protocols for future research. There is potential for upper limb motor function to be used in assessments of cognitive impairment.
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Affiliation(s)
- Kaylee D Rudd
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
| | - Katherine Lawler
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Michele L Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia.
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
- Neurology Department, Royal Hobart Hospital, Hobart, Tasmania, Australia.
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:73-87. [DOI: 10.1590/1980-5764-dn-2022-s105pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/13/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
RESUMO A demência da doença de Parkinson (DDP) e a demência com corpos de Lewy (DCL) representam a segunda causa mais comum de demência neurodegenerativa em pessoas com mais de 65 anos, ocasionando progressivo declínio cognitivo e comprometimento da qualidade de vida. O presente estudo tem como objetivo prover um consenso de especialistas sobre a DDP e DCL, baseado em revisão sistemática da literatura brasileira e revisão não-sistemática de literatura internacional. Ademais, tal estudo visa promover informação e conceder recomendações sobre abordagem diagnóstica, com foco nos níveis de atenção primária e secundária em saúde. Com base nos dados disponíveis, recomendamos que os profissionais realizem pelo menos um breve instrumento cognitivo global, como o Mini-Exame do Estado Mental, contudo de preferência optem pela Avaliação Cognitiva de Montreal e o Exame Cognitivo de Addenbrooke-Revisado. Observa-se uma carência de instrumentos validados para a avaliação precisa das habilidades funcionais em pacientes brasileiros com DDP e DCL. Além disso, mais estudos focando em biomarcadores com coortes brasileiras também são necessários.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnosis and management of Parkinson’s disease dementia and dementia with Lewy bodies: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s105en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) represent the second most common type of degenerative dementia in patients aged 65 years and older, leading to progressive cognitive dysfunction and impaired quality of life. This study aims to provide a consensus based on a systematic Brazilian literature review and a comprehensive international review concerning PDD and DLB. Moreover, we sought to report on and give recommendations about the best diagnostic approaches focusing on primary and secondary care. Based on the available data, we recommend clinicians to apply at least one brief global cognitive instrument to assess PDD, such as the Mini-Mental State Examination and preferably the Montreal Cognitive Assessment and the Addenbrooke’s Cognitive Examination-Revised. Validated instruments to accurately assess functional abilities in Brazilian PD patients are still incipient. Further studies should focus on biomarkers with Brazilian cohorts.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Schmidt N, Strohmaier T, Witt K. A modified version of the interlocking finger test as a bedside screening test for visuospatial deficits and dementia in Parkinson's disease. Brain Behav 2022; 12:e2516. [PMID: 35257517 PMCID: PMC9015001 DOI: 10.1002/brb3.2516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/11/2021] [Accepted: 01/22/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Objective of this study was to examine if the Interlocking Finger Test (ILFT) is a suitable bedside screening test for visuospatial functions and/or dementia in Parkinson's disease (PD) patients aiming to facilitate the diagnosis of a dementia syndrome associated with posterior cortical and temporal lobe dysfunction according to the dual syndrome hypothesis (frontostriatal vs. posterior cortical cognitive impairment). METHODS Forty-seven PD patients were assessed with the ILFT and an extensive cognitive test battery. The ILFT was carried out in the original version as well as in three modified versions of the test including a fifth figure and/or a more complex rating system, leading to four different ILFT scores (named after the maximum achievable scoring result: ILFT 4, ILFT 5, ILFT 12, and ILFT 15). We conducted a correlation analysis to reveal associations between the ILFT scores and cognitive as well as motor impairments. Receiver operating curve (ROC) analyses were calculated to evaluate the ability of the ILFT scores to predict visuospatial impairments and dementia. RESULTS ILFT scores correlated significantly with global cognition, visuospatial functions, memory, attention, and age (p < .0125) but not with executive functions, language, education, depression, and motor impairment. The ROC analyses revealed ILFT 15 as best predictor for visuospatial deficits and dementia with an area under the curve of .82 and .88, respectively. CONCLUSION The ILFT is suitable for detecting symptoms of the posterior cortical degeneration syndrome according to the dual syndrome hypothesis. We recommend the use of the modified test version ILFT 15.
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Affiliation(s)
- Nele Schmidt
- Department of Neurology, University Oldenburg, Oldenburg, Germany
| | | | - Karsten Witt
- Department of Neurology, University Oldenburg, Oldenburg, Germany.,Research Center of Neurosensory Sciences, University Oldenburg, Oldenburg, Germany
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Nagahama Y, Okina T, Suzuki N. Neuropsychological basis of impaired gesture imitations in patients with Alzheimer's disease and dementia with Lewy bodies. Int J Geriatr Psychiatry 2022; 37. [PMID: 34505307 DOI: 10.1002/gps.5622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/06/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The aim of this study was to examine the neuropsychological factors that may be related to the impaired gesture imitations in patients with dementia. METHODS The imitation of unilateral finger and bimanual gestures was evaluated in 162 patients with Alzheimer's disease (AD) and 103 patients with dementia with Lewy bodies (DLB). The relationships of gesture imitation performance to global cognition, semantic fluency, phonemic fluency, figure copying, clock drawing, and trail-making test part A (TMT-A) scores were examined. RESULTS Mean scores for unilateral finger imitation were significantly lower in DLB patients than in AD patients, and significantly more DLB patients showed impaired performance in unilateral finger imitation than AD patients. In contrast, the percentage of patients with impaired bimanual gesture imitation was not significantly different between AD and DLB patients. Unilateral finger imitation performance was predicted by pentagon copying in the AD patients, and was predicted by cube copying in the DLB patients. Bimanual gesture imitation performance was predicted by TMT-A scores and phonemic fluency in the AD patients but was predicted by TMT-A scores, cube copying, and parkinsonism severity in the DLB patients. DISCUSSION Our study suggested that bimanual gesture imitation is a complex task that is supported by a wide range of neuropsychological processes, such as visuospatial attention, executive function, and visuomotor control, and therefore, it was easily impaired in early dementia. Unilateral finger imitation was more similar to constructional tasks, such as figure drawing, and was impaired more often in DLB patients than in AD patients.
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Affiliation(s)
- Yasuhiro Nagahama
- Department of Psychiatry and Neurology, Kawasaki Memorial Hospital, Kawasaki, Kanagawa, Japan
| | - Tomoko Okina
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Norio Suzuki
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
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Koros C, Stefanis L, Scarmeas N. Parkinsonism and dementia. J Neurol Sci 2021; 433:120015. [PMID: 34642023 DOI: 10.1016/j.jns.2021.120015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 12/13/2022]
Abstract
The aim of the present review is to summarize literature data on dementia in parkinsonian disorders. Cognitive decline and the gradual development of dementia are considered to be key features in the majority of parkinsonian conditions. The burden of dementia in everyday life of parkinsonian patients and their caregivers is vast and can be even more challenging to handle than the motor component of the disease. Common pathogenetic mechanisms involve the aggregation and spreading of abnormal proteins like alpha-synuclein, tau or amyloid in cortical and subcortical regions with subsequent dysregulation of multiple neurotransmitter systems. The degree of cognitive deterioration in these disorders is variable and ranges from mild cognitive impairment to severe cognitive dysfunction. There is also variation in the number and type of affected cognitive domains which can involve either a single domain like executive or visuospatial function or multiple ones. Novel genetic, biological fluid or imaging biomarkers appear promising in facilitating the diagnosis and staging of dementia in parkinsonian conditions. A significant part of current research in Parkinson's disease and other parkinsonian syndromes is targeted towards the cognitive aspects of these disorders. Stabilization or amelioration of cognitive outcomes represents a primary endpoint in many ongoing clinical trials for novel disease modifying treatments in this field. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer's, Disease and the Aging Brain, Columbia University, New York, USA.
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Lan BL, Yeo JHW. Comparison of computer-key-hold-time and alternating-finger-tapping tests for early-stage Parkinson's disease. PLoS One 2019; 14:e0219114. [PMID: 31247037 PMCID: PMC6597101 DOI: 10.1371/journal.pone.0219114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 06/14/2019] [Indexed: 11/19/2022] Open
Abstract
Giancardo et al. recently introduced the neuroQWERTY index (nQi), which is a novel motor index derived from computer-key-hold-time data using an ensemble regression algorithm, to detect early-stage Parkinson's disease. Here, we derive a much simpler motor index from their hold-time data, which is the standard deviation (SD) of the hold-time fluctuations, where fluctuation is defined as the difference between successive natural-log of hold time. Our results show the performance of the SD and nQi tests in discriminating early-stage subjects from controls do not differ, although the SD index is much simpler. There is also no difference in performance between the SD and alternating-finger-tapping tests.
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Affiliation(s)
- Boon Leong Lan
- Electrical and Computer Systems Engineering & Advanced Engineering Platform, School of Engineering, Monash University, Bandar Sunway, Malaysia
- * E-mail:
| | - Jacob Hsiao Wen Yeo
- Electrical and Computer Systems Engineering & Advanced Engineering Platform, School of Engineering, Monash University, Bandar Sunway, Malaysia
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Cognitive profile of non-demented Parkinson's disease: Meta-analysis of domain and sex-specific deficits. Parkinsonism Relat Disord 2018; 60:32-42. [PMID: 30361136 DOI: 10.1016/j.parkreldis.2018.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 09/24/2018] [Accepted: 10/12/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Better awareness of the cognitive domains affected in non-demented Parkinson's Disease (PD) should improve understanding of cognitive disease mechanisms. A complete understanding of the cognitive areas impaired in non-demented PD is hindered because most studies use small clinical samples without comparison to healthy controls. This meta-analysis examined cumulative evidence across studies to determine if there were impairments in non-demented PD in the three cognitive domains thought to be most widely affected in PD: frontal executive, visuospatial, and verbal memory. Because there are well-documented sex differences in PD, a second objective was to explore sex differences in these findings. METHODS MEDLINE, EMBASE and PsycINFO databases were searched (1988-March 2017). Random effects models were used to compute and compare effect sizes of differences between PD patients and controls within cognitive domains. Sex differences in effect sizes were also examined in these comparisons. Moderating factors including age, disease duration, motor symptom severity, levodopa dosage, and depression were examined through meta-regression. RESULTS PD patients showed deficits of moderate effect sizes in all three cognitive domains relative to controls. Significant sex differences were observed only for frontal executive abilities, with male PD patients showing greater deficits than female PD patients relative to controls. No moderators of effect sizes were identified in the domain specific overall or sex-segregated meta-analyses. CONCLUSIONS Results indicate that non-demented PD patients have deficits of moderate magnitude in frontal executive, verbal memory, and visuospatial abilities. Our findings of greater frontal executive deficits in males warrant further confirmation.
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