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Braun A, Manavis J, Yamanaka A, Ootsuka Y, Blumbergs P, Bobrovskaya L. The role of orexin in Parkinson's disease. J Neurosci Res 2024; 102:e25322. [PMID: 38520160 DOI: 10.1002/jnr.25322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
Emerging evidence has implicated the orexin system in non-motor pathogenesis of Parkinson's disease. It has also been suggested the orexin system is involved in the modulation of motor control, further implicating the orexin system in Parkinson's disease. Parkinson's disease is the second most common neurodegenerative disease with millions of people suffering worldwide with motor and non-motor symptoms, significantly affecting their quality of life. Treatments are based solely on symptomatic management and no cure currently exists. The orexin system has the potential to be a treatment target in Parkinson's disease, particularly in the non-motor stage. In this review, the most current evidence on the orexin system in Parkinson's disease and its potential role in motor and non-motor symptoms of the disease is summarized. This review begins with a brief overview of Parkinson's disease, animal models of the disease, and the orexin system. This leads into discussion of the possible roles of orexin neurons in Parkinson's disease and levels of orexin in the cerebral spinal fluid and plasma in Parkinson's disease and animal models of the disease. The role of orexin is then discussed in relation to symptoms of the disease including motor control, sleep, cognitive impairment, psychological behaviors, and the gastrointestinal system. The neuroprotective effects of orexin are also summarized in preclinical models of the disease.
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Affiliation(s)
- Alisha Braun
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jim Manavis
- Discipline of Anatomy and Pathology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Youichirou Ootsuka
- College of Medicine and Public Health, Flinders Medical and Health Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Peter Blumbergs
- Discipline of Anatomy and Pathology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Larisa Bobrovskaya
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Tiedt HO, Ehlen F, Klostermann F. Dopamine-Related Reduction of Semantic Spreading Activation in Patients With Parkinson's Disease. Front Hum Neurosci 2022; 16:837122. [PMID: 35431839 PMCID: PMC9008217 DOI: 10.3389/fnhum.2022.837122] [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: 12/16/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Impaired performance in verbal fluency (VF) tasks is a frequent observation in Parkinson's disease (PD). As to the nature of the underlying cognitive deficit, it is commonly attributed to a frontal-type dysexecutive syndrome due to nigrostriatal dopamine depletion. Whereas dopaminergic medication typically improves VF performance in PD, e.g., by ameliorating impaired lexical switching, its effect on semantic network activation is unclear. Data from priming studies suggest that dopamine causes a faster decay of semantic activation spread. The aim of the current study was to examine the impact of dopaminergic medication on the dynamic change of word frequency during VF performance as a measure of semantic spreading activation. To this end, we performed a median split analysis of word frequency during phonemic and semantic VF task performance in a PD group tested while receiving dopaminergic medication (ON) as well as after drug withdrawal (i.e., OFF), and in a sample of age-matched healthy volunteers (both groups n = 26). Dopaminergic medication in the PD group significantly affected phonemic VF with improved word production as well as increased error-rates. The expected decrease of word frequency during VF task performance was significantly smaller in the PD group ON medication than in healthy volunteers across semantic and phonemic VF. No significant group-difference emerged between controls and the PD group in the OFF condition. The comparison between both treatment conditions within the PD group did not reach statistical significance. The observed pattern of results indicates a faster decay of semantic network activation during lexical access in PD patients on dopaminergic medication. In view of improved word generation, this finding is consistent with a concept of more focused neural activity by an increased signal-to-noise ratio due to dopaminergic neuromodulation. However, the effect of dopaminergic stimulation on VF output suggests a trade-off between these beneficial effects and increased error-rates.
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Affiliation(s)
- Hannes Ole Tiedt
- Department of Neurology, Motor and Cognition Group, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universitätzu Berlin, Berlin, Germany
| | - Felicitas Ehlen
- Department of Neurology, Motor and Cognition Group, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universitätzu Berlin, Berlin, Germany
- Department of Psychiatry, Jüdisches Krankenhaus Berlin, Berlin, Germany
| | - Fabian Klostermann
- Department of Neurology, Motor and Cognition Group, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universitätzu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Han LL, Wang L, Xu ZH, Liang XN, Zhang MW, Fan Y, Sun YM, Liu FT, Yu WB, Tang YL. Disease progression in Parkinson's disease patients with subjective cognitive complaint. Ann Clin Transl Neurol 2021; 8:2096-2104. [PMID: 34595848 PMCID: PMC8528458 DOI: 10.1002/acn3.51461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/03/2021] [Accepted: 09/09/2021] [Indexed: 12/05/2022] Open
Abstract
Objective Little is known about the disease progression of Parkinson's disease patients with subjective cognitive complaint (PD‐SCC). This longitudinal cohort study aims to compare the progression of clinical features and quality of life (QoL) in PD patients with normal cognition (NC), SCC, and mild cognitive impairment (MCI). Methods A total of 383 PD patients were enrolled, including 189 PD‐NC patients, 59 PD‐SCC patients, and 135 PD‐MCI patients, with 1–7 years of follow‐up. Linear mixed models were applied to evaluate longitudinal changes in motor symptoms, nonmotor features (cognitive impairment, depression, and excessive daytime sleepiness), and QoL in PD. Results At baseline, PD‐SCC patients had lower Beck Depression Inventory (BDI) scores and Parkinson's Disease Questionnaire‐39 (PDQ‐39) scores than PD‐NC patients (all p < 0.05). Longitudinal analyses revealed that the PD‐SCC group exhibited faster progression in terms of BDI scores (p = 0.042) and PDQ‐39 scores (p = 0.035) than the PD‐NC group. The PD‐MCI group exhibited faster progression rates in the Epworth Sleepiness Scale scores (p = 0.001) and PDQ‐39 scores (p = 0.005) than the PD‐NC group. In addition, the PD‐SCC group exhibited a greater reduction in attention (Trail Making Test Part A, p = 0.047) and executive function (Stroop Color‐Word Test, p = 0.037) than the PD‐NC group. Interpretation PD‐SCC patients exhibited faster deterioration of depression and QoL than PD‐NC patients, and SCC may be an indicator of initial attention and executive function decline in PD. Our findings provided a more accurate prognosis in PD‐SCC patients.
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Affiliation(s)
- Lin-Lin Han
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Lan Wang
- Department of Neurology, Drum Tower Hospital, Nanjing, 210008, China
| | - Zhi-Heng Xu
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiao-Niu Liang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Meng-Wei Zhang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yun Fan
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yi-Min Sun
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Feng-Tao Liu
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Wen-Bo Yu
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yi-Lin Tang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
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Hamada T, Higashiyama Y, Saito A, Morihara K, Landin-Romero R, Okamoto M, Kimura K, Miyaji Y, Joki H, Kishida H, Doi H, Ueda N, Takeuchi H, Tanaka F. Qualitative Deficits in Verbal Fluency in Parkinson's Disease with Mild Cognitive Impairment: A Clinical and Neuroimaging Study. JOURNAL OF PARKINSONS DISEASE 2021; 11:2005-2016. [PMID: 34366367 DOI: 10.3233/jpd-202473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) in Parkinson's disease (PD) is considered a risk factor for PD with dementia (PDD). Verbal fluency tasks are widely used to assess executive function in PDD. However, in cases of PD with MCI (PD-MCI), the relative diagnostic accuracy of different qualitative verbal fluency measures and their related neural mechanisms remain unknown. OBJECTIVE This study aimed to investigate the relative diagnostic accuracy of qualitative (clustering and switching) verbal fluency strategies and their correlates with functional imaging in PD-MCI. METHODS Forty-five patients with PD (26 with MCI and 19 without MCI) and 25 healthy controls underwent comprehensive neurocognitive testing and resting-state functional magnetic resonance imaging. MCI in patients with PD was diagnosed according to established clinical criteria. The diagnostic accuracy of verbal fluency measures was determined via receiver operating characteristic analysis. Changes in brain functional connectivity between groups and across clinical measures were assessed using seed-to-voxel analyses. RESULTS Patients with PD-MCI generated fewer words and switched less frequently in semantic and phonemic fluency tasks compared to other groups. Switching in semantic fluency showed high diagnostic accuracy for PD-MCI and was associated with reduced functional connectivity in the salience network. CONCLUSION Our results indicate that reduced switching in semantic fluency tasks is a sensitive and specific marker for PD-MCI. Qualitative verbal fluency deficits and salience network dysfunction represent early clinical changes observed in PD-MCI.
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Affiliation(s)
- Tomoya Hamada
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.,Department of Speech-Language-Hearing Therapy, Japan Welfare Education College, Shinjuku-ku, Tokyo, Japan
| | - Yuichi Higashiyama
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Asami Saito
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Keisuke Morihara
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ramon Landin-Romero
- The University of Sydney, School of Psychology, Sydney, NSW, Australia.,The University of Sydney, Brain & Mind Centre, Sydney, NSW, Australia.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Mitsuo Okamoto
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center Hospital, Yokohama, Kanagawa, Japan
| | - Yousuke Miyaji
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hitaru Kishida
- Department of Neurology, Yokohama City University Medical Center Hospital, Yokohama, Kanagawa, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Naohisa Ueda
- Department of Neurology, Yokohama City University Medical Center Hospital, Yokohama, Kanagawa, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Combs HL, Wyman-Chick KA, Erickson LO, York MK. Development of standardized regression-based formulas to assess meaningful cognitive change in early Parkinson's disease. Arch Clin Neuropsychol 2021; 36:734-745. [PMID: 33103727 DOI: 10.1093/arclin/acaa104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Longitudinal assessment of cognitive and emotional functioning in patients with Parkinson's disease (PD) is helpful in tracking progression of the disease, developing treatment plans, evaluating outcomes, and educating patients and families. Determining whether change over time is meaningful in neurodegenerative conditions, such as PD, can be difficult as repeat assessment of neuropsychological functioning is impacted by factors outside of cognitive change. Regression-based prediction formulas are one method by which clinicians and researchers can determine whether an observed change is meaningful. The purpose of the current study was to develop and validate regression-based prediction models of cognitive and emotional test scores for participants with early-stage idiopathic PD and healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). METHODS Participants with de novo PD and HC were identified retrospectively from the PPMI archival database. Data from baseline testing and 12-month follow-up were utilized in this study. In total, 688 total participants were included in the present study (NPD = 508; NHC = 185). Subjects from both groups were randomly divided into development (70%) and validation (30%) subsets. RESULTS Early-stage idiopathic PD patients and healthy controls were similar at baseline. Regression-based models were developed for all cognitive and self-report mood measures within both populations. Within the validation subset, the predicted and observed cognitive test scores did not significantly differ, except for semantic fluency. CONCLUSIONS The prediction models can serve as useful tools for researchers and clinicians to study clinically meaningful cognitive and mood change over time in PD.
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D'Iorio A, Guida P, Maggi G, Redgrave P, Santangelo G, Obeso I. Neuropsychological spectrum in early PD: Insights from controlled and automatic behavioural regulation. Neurosci Biobehav Rev 2021; 126:465-480. [PMID: 33836213 DOI: 10.1016/j.neubiorev.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/05/2021] [Accepted: 04/02/2021] [Indexed: 11/15/2022]
Abstract
Initial changes in Parkinson's disease (PD) are marked by loss of automatic movements and decline of some cognitive functions. Yet, the exact profile and extent of cognitive impairments in early stages of PD as well as their mechanisms related to automatic motor dysfunction remain unclear. Our objective was to examine the neuropsychological changes in early PD and their association to automatic and controlled modes of behavioural control. Significant relationships between early PD and cognitive dysfunction in set-shifting, abstraction ability/concept formation, processing speed, visuospatial/constructional abilities and verbal-visual memory was found. We also noted that tests with a strong effortful and controlled component were similarly affected as automatic tests by early PD, particularly those testing verbal memory, processing speed and visuospatial/constructional functions. Our findings indicate that initial stages of PD sets constraints over most of the cognitive domains normally assessed and are not easily explained in terms of either automatic or controlled mechanisms, as both appear similarly altered in early PD.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pasqualina Guida
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Peter Redgrave
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ignacio Obeso
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain.
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Informant-Reported Cognitive Decline is Associated with Objective Cognitive Performance in Parkinson's Disease. J Int Neuropsychol Soc 2021; 27:439-449. [PMID: 33292885 DOI: 10.1017/s1355617720001137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The utility of informant-based measures of cognitive decline to accurately describe objective cognitive performance in Parkinson's disease (PD) without dementia is uncertain. Due to the clinical relevance of this information, the purpose of this study was to examine the relationship between informant-based reports of patient cognitive decline via the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE) and objective cognition in non-demented PD controlling for cognitive status (i.e., mild cognitive impairment; PD-MCI and normal cognition; PD-NC). METHOD One-hundred and thirty-nine non-demented PD participants (PD-MCI n = 38; PD-NC n = 101) were administered measures of language, executive function, attention, learning, delayed recall, visuospatial function, mood, and motor function. Each participant identified an informant to complete the IQCODE and a mood questionnaire. RESULTS Greater levels of informant-based responses of patient cognitive decline on the IQCODE were significantly associated with worse objective performance on measures of global cognition, attention, learning, delayed recall, and executive function in the overall sample, above and beyond covariates and cognitive status. However, the IQCODE was not significantly associated with language or visuospatial function. CONCLUSIONS Results indicate that informant responses, as measured by the IQCODE, may provide adequate information on a wide range of cognitive abilities in non-demented PD, including those with MCI and normal cognition. Findings have important clinical implications for the utility of the IQCODE in the identification of PD patients in need of further evaluation, monitoring, and treatment.
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Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression. Neuropsychol Rev 2021; 32:149-160. [PMID: 33860906 DOI: 10.1007/s11065-021-09502-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 03/24/2021] [Indexed: 12/19/2022]
Abstract
Mild cognitive changes, including executive dysfunction, are seen in Parkinson's Disease (PD). Approximately 30% of individuals with PD develop Parkinson's disease dementia (PDD). Mild cognitive impairment (MCI) has been identified as a transitional state between normal cognition and dementia. Although PD-MCI and its cognitive correlates have been increasingly studied as a risk indicator for development of PDD, investigations into the PD-MCI construct have yielded heterogeneous findings. Thus, a typical PD-MCI cognitive profile remains undefined. The present meta-analysis examined published cross-sectional studies of PD-MCI and cognitively normal PD (PD-CN) groups to provide aggregated effect sizes of group test performance by cognitive domain. Subsequently, longitudinal studies examining PD-MCI to PDD progression were meta-analyzed. Ninety-two cross-sectional articles of PD-MCI vs. PD-CN were included; 5 longitudinal studies of PD-MCI conversion to PDD were included. Random effects meta-analytic models were constructed resulting in effect sizes (Hedges' g) for cognitive domains. Overall performance across all measures produced a large effect size (g = 0.83, 95% CI [0.79, 0.86], t2 = 0.18) in cross-sectional analyses, with cognitive screeners producing the largest effect (g = 1.09, 95% CI [1.00, 1.17], t2 = 0.19). Longitudinally, overall measures produced a moderate effect (g = 0.47, 95% CI [0.40, 0.53], t2 = 0.01), with measures of executive functioning exhibiting the largest effect (g = 0.70, 95% CI [0.51, 0.89], t2 = 0.01). Longitudinal effects were made more robust by low heterogeneity. This report provides the first comprehensive meta-analysis of PD-MCI cognitive outcomes and predictors in PD-MCI conversion to PDD. Limitations include heterogeneity of cross-sectional effect sizes and the potential impact of small-study effects. Areas for continued research include visuospatial skills and visual memory in PD-MCI and longitudinal examination of executive dysfunction in PD-MCI.
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A Comprehensive Meta-analysis on Short-term and Working Memory Dysfunction in Parkinson's Disease. Neuropsychol Rev 2021; 31:288-311. [PMID: 33523408 DOI: 10.1007/s11065-021-09480-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/05/2021] [Indexed: 12/29/2022]
Abstract
A previous meta-analysis demonstrated short-term memory (STM) and working memory (WM) dysfunction in patients with Parkinson's disease (PD). However, considerable research on the topic that calls into question the extent of such impairments in PD has since been published. The aim of the present quantitative review was to provide the largest statistical overview on STM and WM dysfunction in Parkinson's disease (PD), while simultaneously providing novel insights on moderating factors of effect size heterogeneity in PD. The systematic literature search in PubMed, PsycINFO, PsycArticles, Scopus and Web of Science databases allowed us to estimate 350 effect sizes from 145 empirical studies that reported STM and WM scores for patients with PD against healthy controls. The outcomes indicated general dysfunction in the visuospatial domain and poor verbal WM in PD. Subgroup analyses suggested that mild cognitive impairment is associated with STM and WM difficulties in PD. Furthermore, meta-regression analyses revealed that disease duration accounted for more than 80% of the visuospatial STM effect size variance (β = 0.136, p < .001, R2 = .8272), larger daily levodopa equivalent dose was associated with WM dysfunction (verbal: β = -0.001, p = .016, R2 = .1812; visuospatial: β = 0.003, p = .069, R2 = .2340), and years of education partially explained the verbal STM effect size variance (β = -0.027, p = .040, R2 = .1171). Collectively, these findings advance our understanding of underlying factors that influence STM and WM functioning in PD, while at the same time providing novel directions for future research.
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Kjeldsen PL, Damholdt MF. Subjective cognitive complaints in patients with Parkinson's disease. Acta Neurol Scand 2019; 140:375-389. [PMID: 31433855 DOI: 10.1111/ane.13158] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/18/2019] [Accepted: 08/18/2019] [Indexed: 01/05/2023]
Abstract
Mild cognitive impairment (MCI) is common in Parkinson's disease (PD), affecting almost all patients with PD at some time. It has been shown that patients with PD, who express subjective cognitive complaints, are at a higher risk of eventually developing PD-MCI. This is corroborated by the Movement Disorders Society's (MDS) diagnostic criteria from 2012 for PD-MCI, from which it follows that a subjective cognitive complaint must be present in addition to objective cognitive impairment for a patient with PD to receive a diagnosis of PD-MCI. Nevertheless, there is currently no standardized measurement available for assessing subjective cognitive complaints. Therefore, this review aims to generate an overview of how subjective cognitive complaints are commonly operationalized in the empirical literature as well as whether they are found to be associated with the level of cognitive impairment. The findings revealed that a broad range of measures has been used to obtain subjective cognitive complaints and that there is little consistency between different studies with regard to how they have obtained these complaints, from whom they had obtained them, how many they have obtained, which types of complaints they have obtained and whether they were associated with cognitive impairment. Given the fact that the presence of subjective cognitive complaints is a requirement for setting a diagnosis, there is a need for more methodological consensus with regard to the measurement hereof.
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Affiliation(s)
- Pernille Louise Kjeldsen
- Department of Clinical Medicine Aarhus University Aarhus Denmark
- Department of Nuclear Medicine and PET Aarhus University Hospital Aarhus Denmark
| | - Malene Flensborg Damholdt
- Department of Clinical Medicine Aarhus University Aarhus Denmark
- Department of Psychology Aarhus University Aarhus Denmark
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Baiano C, Barone P, Trojano L, Santangelo G. Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis. Mov Disord 2019; 35:45-54. [DOI: 10.1002/mds.27902] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 01/16/2023] Open
Affiliation(s)
- Chiara Baiano
- Department of Psychology University of Campania Luigi Vanvitelli Caserta Italy
| | - Paolo Barone
- Centre for Neurodegenerative Disease‐CEMAND University of Salerno Salerno Italy
| | - Luigi Trojano
- Department of Psychology University of Campania Luigi Vanvitelli Caserta Italy
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Cammisuli DM, Cammisuli SM, Fusi J, Franzoni F, Pruneti C. Parkinson's Disease-Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge. Front Aging Neurosci 2019; 11:303. [PMID: 31780918 PMCID: PMC6856711 DOI: 10.3389/fnagi.2019.00303] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
Mild cognitive impairment (MCI) is a common feature in Parkinson's Disease (PD), even at the time of diagnosis. Some levels of heterogeneity in nature and severity of cognitive impairment and risk of conversion to Parkinson's Disease Dementia (PDD) exist. This brief overview summarized the current understanding of MCI in PD, by considering the following major points: historical development of the clinical entity, evaluation, epidemiology, predictors and outcomes, neuroimaging findings, pathophysiology, treatment, and pharmacological and non-pharmacological intervention. MCI in PD represents a concept in evolution and plays a pivotal role in advancing our understanding of the disease mechanisms, with the ultimate goal of building effective strategies to prevent conversion into PDD. Challenges for future research are also discussed.
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Affiliation(s)
- Davide Maria Cammisuli
- Laboratories of Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Jonathan Fusi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo Pruneti
- Laboratories of Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
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Menéndez-González M, Álvarez-Avellón T, Salas-Pacheco JM, de Celis-Alonso B, Wyman-Chick KA, Arias-Carrión O. Frontotemporal Lobe Degeneration as Origin of Scans Without Evidence of Dopaminergic Deficit. Front Neurol 2018; 9:335. [PMID: 29881367 PMCID: PMC5976748 DOI: 10.3389/fneur.2018.00335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/26/2018] [Indexed: 12/30/2022] Open
Abstract
The term scans without evidence of dopaminergic deficit (SWEDD) can be associated with any patient diagnosed at first with Parkinson's disease but with a negative dopamine transporter-single photon emission computed tomography (DaTSPECT), which does not confirm the presynaptic dopaminergic deficiency. Therefore, an alternative diagnosis should be sought to support parkinsonism as a clinical diagnosis. Parkinsonism is a well-known manifestation of frontotemporal lobar degeneration (FTLD), particularly frequent in those with positive DaTSPECT. Here, we reinforce previous observations that parkinsonism can be present in FTLD patients with negative DaTSPECT and therefore, FTLD may account for a percentage of patients with SWEDD. We gather the clinical observations supporting this hypothesis and describe a case report illustrating this idea. Studies suggest the result of DaTSPECT in FTLD may depend on the neuropathology and clinical subtype. However, most studies do not provide a clinical description of the clinical subtype or pathological features making the association between subtypes of FTLD and DaTSPECT results impossible at the moment. Further studies correlating clinical, neuropsychological, neuroimaging, genetic, and pathology findings are needed to better understand parkinsonism in FTLD.
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Affiliation(s)
- Manuel Menéndez-González
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Departamento de Morfología y Biología Funcional, Universidad de Oviedo, Oviedo, Spain
| | | | - José M Salas-Pacheco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Durango, México
| | - Benito de Celis-Alonso
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | | | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño/Centro de Innovación Médica Aplicada, Hospital General Dr. Manuel Gea González, Ciudad de México, México
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14
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Stojkovic T, Stefanova E, Soldatovic I, Markovic V, Stankovic I, Petrovic I, Agosta F, Galantucci S, Filippi M, Kostic V. Exploring the relationship between motor impairment, vascular burden and cognition in Parkinson's disease. J Neurol 2018; 265:1320-1327. [PMID: 29572571 DOI: 10.1007/s00415-018-8838-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine frequency and type of cognitive disorders in cross-sectional analysis of a Parkinson's disease (PD) cohort, and explore its relations to motor symptoms, modifiable vascular risk factors and white matter lesions (WML) volume. METHODS In a group of 133 PD patients, mild cognitive impairment (PD-MCI) and dementia (PDD) were diagnosed according to Movement Disorders Society Task Force criteria (level 2 for PD-MCI). Detailed motor measurements were applied, including rigidity, axial, bradykinesia, tremor and postural instability gait disorders (PIGD) scores. Vascular risk was estimated by the Framingham General Cardiovascular Disease risk scoring algorithm and WML volume was measured for whole brain and frontal lobe. RESULTS Sixty-one (46.9%) patients fulfilled criteria for PD-MCI, and 23 (17.7%) for PDD. Non-amnestic multiple domain MCI was most frequent (52% of PD-MCI patients). Motor scores were significantly higher in cognitively impaired patients, but only axial score discriminated between MCI and dementia. High vascular risk was related to impaired cognition, bradykinesia, axial, PIGD and freezing of gait (FOG) score, while whole brain WML volume was associated with PDD, FOG and attention deficits. Furthermore, high vascular risk was identified as a potential predictor of both MCI and dementia in PD. Additionally, age and bradykinesia score were independently associated with PD-MCI and age, axial score and whole brain WML volume with PDD. CONCLUSION Cognitive disorders in PD are associated with more severe, predominantly axial motor deficits and increased, but partly modifiable vascular burden, thus opening a possibility for development of preventive strategies in PD.
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Affiliation(s)
- Tanja Stojkovic
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
- School of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Elka Stefanova
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute of Medical Statistics, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladana Markovic
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Iva Stankovic
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Igor Petrovic
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Sebastiano Galantucci
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Vladimir Kostic
- Neurology Clinic, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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15
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Goldman JG, Holden SK, Litvan I, McKeith I, Stebbins GT, Taylor JP. Evolution of diagnostic criteria and assessments for Parkinson's disease mild cognitive impairment. Mov Disord 2018; 33:503-510. [DOI: 10.1002/mds.27323] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/01/2018] [Accepted: 01/04/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jennifer G. Goldman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders; Rush University Medical Center; Chicago Illinois USA
| | - Samantha K. Holden
- Department of Neurology; University of Colorado, Department of Neurology; Aurora Colorado USA
| | - Irene Litvan
- Department of Neurosciences; University of California San Diego, Department of Neurosciences; San Diego California USA
| | - Ian McKeith
- Institute of Neuroscience; Newcastle University; Newcastle upon Tyne United Kingdom
| | - Glenn T. Stebbins
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders; Rush University Medical Center; Chicago Illinois USA
| | - John-Paul Taylor
- Institute of Neuroscience; Newcastle University; Newcastle upon Tyne United Kingdom
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16
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Seubert-Ravelo AN, Yáñez-Téllez MG, Salgado-Ceballos H, Escartín-Pérez RE, Neri-Nani GA, Velázquez-Osuna S. Mild Cognitive Impairment in Patients with Early-Onset Parkinson's Disease. Dement Geriatr Cogn Disord 2018; 42:17-30. [PMID: 27467581 DOI: 10.1159/000447533] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Few studies have described mild cognitive impairment (MCI) and cognitive characteristics in early-onset Parkinson's disease (EOPD). This study describes attention/working memory, language, memory, visuospatial abilities, executive function, and frequency of MCI and dementia in EOPD. METHODS Eighty-one EOPD patients were administered neuropsychological tests and the Beck Depression Inventory. Scores were compared with age/education-appropriate norms and were correlated to years of disease progression and severity of motor symptoms. The frequency of MCI and dementia was determined by the Movement Disorder Society criteria. RESULTS Thirty-one percent of patients met the MCI criteria, but none had dementia. Commonly affected domains were memory, visuospatial, and executive function. Cognitive dysfunction was not explained by depression or severity of motor symptoms. CONCLUSION One third of EOPD patients presented with MCI, which was not associated with the same risk factors as reported in late-onset Parkinson's disease. MCI could have a different prognostic value in EOPD.
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Affiliation(s)
- Ana Natalia Seubert-Ravelo
- Interdisciplinary Investigation Unit in Health and Education Sciences, Master in Psychology, Clinical Neuropsychology Residency Program, FES Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
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17
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Dahdal P, Meyer A, Chaturvedi M, Nowak K, Roesch AD, Fuhr P, Gschwandtner U. Fine Motor Function Skills in Patients with Parkinson Disease with and without Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2018; 42:127-134. [PMID: 27643700 DOI: 10.1159/000448751] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. METHODS Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. RESULTS PD MCI patients performed significantly worse in precision (p < 0.05), dexterity (p < 0.05), and velocity (arm-hand movements; p < 0.05) compared to PD non-MCI patients. The fine motor function skills were confounded by age. CONCLUSIONS Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research.
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Affiliation(s)
- Philippe Dahdal
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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18
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Siciliano M, De Micco R, Trojano L, De Stefano M, Baiano C, Passaniti C, De Mase A, Russo A, Tedeschi G, Tessitore A. Cognitive impairment is associated with Hoehn and Yahr stages in early, de novo Parkinson disease patients. Parkinsonism Relat Disord 2017; 41:86-91. [DOI: 10.1016/j.parkreldis.2017.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/03/2017] [Accepted: 05/23/2017] [Indexed: 12/16/2022]
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19
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Mild Cognitive Impairment in Parkinson's Disease: Clustering and Switching Analyses in Verbal Fluency Test. J Int Neuropsychol Soc 2017; 23:511-520. [PMID: 28494819 DOI: 10.1017/s1355617717000297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Mild cognitive impairment is common in non-demented Parkinson disease patients (PD-MCI) and is considered as a risk factor for dementia. Executive dysfunction has been widely described in PD and the Verbal Fluency Tests (VFT) are often used for executive function assessment in this pathology. The Movement Disorder Society (MDS) published guidelines for PD-MCI diagnosis in 2012. However, no investigation has focused on the qualitative analysis of VFT in PD-MCI. The aim of this work was to study the clustering and switching strategies in VFT in PD-MCI patients. Moreover, these variables are considered as predictors for PD-MCI diagnosis. METHODS Forty-three PD patients and twenty normal controls were evaluated with a neuropsychological protocol and the MDS criteria for PD-MCI were applied. Clustering and switching analysis were conducted for VFT. RESULTS The percentage of patients diagnosed with PD-MCI was 37.2%. The Mann-Whitney U test analysis showed that PD-MCI performed poorly in different cognitive measures (digit span, Wisconsin Card Sorting Test, judgment of line orientation, and comprehension test), compared to PD patients without mild cognitive impairment (PD-nMCI). Phonemic fluency analyses showed that PD-MCI patients produced fewer words and switched significantly less, compared to controls and PD-nMCI. Concerning semantic fluency, the PD-MCI group differed significantly, compared to controls and PD-nMCI, in switches. Discriminant function analyses and logistic regression analyses revealed that switches predicted PD-MCI. CONCLUSIONS PD-MCI patients showed poor performance in VFT related to the deficient use of production strategies. The number of switches is a useful predictor for incident PD-MCI. (JINS, 2017, 23, 511-520).
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20
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Wyman-Chick KA, Martin PK, Barrett MJ, Manning CA, Sperling SA. Diagnostic Accuracy and Confidence in the Clinical Detection of Cognitive Impairment in Early-Stage Parkinson Disease. J Geriatr Psychiatry Neurol 2017; 30:178-183. [PMID: 28351200 DOI: 10.1177/0891988717701001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND/AIMS Mild cognitive impairment (MCI) is present in up to 34% of patients with early-stage Parkinson disease (PD); however, it is difficult to detect subtle impairment without objective cognitive testing. METHODS Data were obtained from the Parkinson Progression Marker Initiative. All 341 participants were administered the Montreal Cognitive Assessment (MoCA) and a brief neuropsychological battery. Participants were classified as PD-MCI if MoCA was <26 or if they scored ≥1 standard deviation below the normative mean in 2 or more domains, based upon established criteria. The sensitivity/specificity for the clinical detection of PD-MCI was determined. RESULTS Overall accuracy for clinical detection of PD-MCI was 67.4%. Although clinical determination was highly specific (96.3%; 95% confidence interval [CI]: 0.92-0.98), sensitivity was poor (32.0%; 95% CI: 0.25-0.40). CONCLUSION Identifying MCI in early-stage PD based on clinical interview alone appears to be insufficient. The inclusion of objective cognitive tests allowing for normative sample comparisons is needed to increase the detection of cognitive impairment in this population.
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Affiliation(s)
| | - Phillip K Martin
- 2 Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Matthew J Barrett
- 1 Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Carol A Manning
- 1 Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Scott A Sperling
- 1 Department of Neurology, University of Virginia, Charlottesville, VA, USA
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21
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Bezdicek O, Sulc Z, Nikolai T, Stepankova H, Kopecek M, Jech R, Růžička E. A parsimonious scoring and normative calculator for the Parkinson’s disease mild cognitive impairment battery. Clin Neuropsychol 2017; 31:1231-1247. [DOI: 10.1080/13854046.2017.1293161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
| | - Zdenek Sulc
- National Institute of Mental Health, Klecany, Czech Republic
| | - Tomas Nikolai
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Hana Stepankova
- National Institute of Mental Health, Klecany, Czech Republic
| | | | - Robert Jech
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
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22
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Cognition in Patients With a Clinical Diagnosis of Parkinson Disease and Scans Without Evidence of Dopaminergic Deficit (SWEDD): 2-Year Follow-Up. Cogn Behav Neurol 2017; 29:190-196. [PMID: 27984256 DOI: 10.1097/wnn.0000000000000107] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE AND BACKGROUND More than 10% of patients clinically diagnosed with Parkinson disease demonstrate normal dopamine uptake on dopamine transporter single-photon emission computed tomography (DaTscan), but little is known about how cognitive function differs between patients with dopamine deficiency on DaTscan and patients with scans without evidence of dopaminergic deficit (SWEDD). We compared the cognitive function of these two groups of patients over 2 years. METHODS We retrospectively analyzed data obtained from the Parkinson's Progression Markers Initiative on 309 participants clinically diagnosed with idiopathic Parkinson disease who had scored in the normal range on the Montreal Cognitive Assessment at baseline and had completed 1- and 2-year follow-up visits. We compared the Montreal Cognitive Assessment scores at 1 and 2 years between the 42 participants with SWEDD and the 267 with dopamine deficiency. RESULTS Mean cognitive scores did not differ significantly between groups at 1 year, but at 2 years the participants with SWEDD performed more poorly. At 2 years, 31% of the participants with SWEDD versus 15% of those with dopamine deficiency had statistically reliable cognitive impairment. CONCLUSIONS This study provides evidence that some individuals clinically diagnosed with idiopathic Parkinson disease but with SWEDD demonstrate early cognitive decline. The results also suggest that recently diagnosed patients with SWEDD may be at even greater risk for cognitive decline than patients with DaTscan-confirmed early-stage Parkinson disease. While patients with SWEDD likely represent a heterogeneous group of etiologies, our results highlight the need to monitor these patients' cognitive function over time.
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23
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Dementia in Parkinson's disease. J Neurol Sci 2017; 374:26-31. [PMID: 28088312 DOI: 10.1016/j.jns.2017.01.012] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 01/01/2017] [Accepted: 01/04/2017] [Indexed: 11/20/2022]
Abstract
Dementia can occur in a substantial number of patients with Parkinson's disease with a point prevalence close to 30%. The cognitive profile is characterized by predominant deficits in executive, visuospatial functions, attention and memory. Behavioral symptoms are frequent such as apathy, visual hallucinations and delusions. The most prominent associated pathology is Lewy body-type and biochemical deficit is cholinergic. Placebo-controlled randomized trials with cholinesterase inhibitors demonstrated modest but significant benefits in cognition, behavioral symptoms and global functions.
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24
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Nonmotor Fluctuations in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:947-971. [DOI: 10.1016/bs.irn.2017.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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25
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Bezdicek O, Nikolai T, Michalec J, Růžička F, Havránková P, Roth J, Jech R, Růžička E. The Diagnostic Accuracy of Parkinson's Disease Mild Cognitive Impairment Battery Using the Movement Disorder Society Task Force Criteria. Mov Disord Clin Pract 2016; 4:237-244. [PMID: 30363396 DOI: 10.1002/mdc3.12391] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 04/27/2016] [Accepted: 05/10/2016] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to provide empirical evidence regarding the classification accuracy of the International Parkinson and Movement Disorder Society (MDS) neuropsychological battery (NB) in the determination of Parkinson's disease mild cognitive impairment (PD-MCI). Methods The present cross-sectional study included 106 PD patients subjected to PD-MCI classification at Level I and 120 healthy controls (HCs). All HC and PD subjects were then assessed with MDS-NB at Level II and matched according to age and education using different thresholds (1.5 and 2.0 standard deviations [SDs] below average). Results We found that Level I and II resulted in different classifications of PD-MCI status. Detection thresholds of -1.5 SD and -2.0 SDs at Level II had also a significant impact on the discriminative validity of all measures in the MDS neuropsychological battery, based on area under the curve analyses. Overall, semantic fluency showed the highest potential in all comparisons not only between PD-MCI and HC, but also between PD-MCI and PD with no deficit (PD-ND). Conclusions Our results show that the battery at Level II is applicable and that some measures, such as semantic fluency, have high discriminative validity in the detection of PD-MCI versus PD-ND and HCs.
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Affiliation(s)
- Ondrej Bezdicek
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Tomas Nikolai
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Jiri Michalec
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Psychiatry Prague Czech Republic
| | - Filip Růžička
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Petra Havránková
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Jan Roth
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Robert Jech
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Evžen Růžička
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
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26
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Copeland JN, Lieberman A, Oravivattanakul S, Tröster AI. Accuracy of Patient and Care Partner Identification of Cognitive Impairments in Parkinson's Disease-Mild Cognitive Impairment. Mov Disord 2016; 31:693-8. [DOI: 10.1002/mds.26619] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jacquelynn N. Copeland
- Department of Clinical Neuropsychology; Barrow Neurological Institute; Phoenix Arizona USA
| | - Abraham Lieberman
- Department of Neurology and Muhammad Ali Movement Disorders Center; Barrow Neurological Institute; Phoenix Arizona USA
| | - Srivadee Oravivattanakul
- Department of Neurology and Muhammad Ali Movement Disorders Center; Barrow Neurological Institute; Phoenix Arizona USA
| | - Alexander I. Tröster
- Department of Clinical Neuropsychology; Barrow Neurological Institute; Phoenix Arizona USA
- Center for Neuromodulation; Barrow Neurological Institute; Phoenix Arizona USA
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27
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Cholerton B, Larson EB, Quinn JF, Zabetian CP, Mata IF, Keene CD, Flanagan M, Crane PK, Grabowski TJ, Montine KS, Montine TJ. Precision Medicine: Clarity for the Complexity of Dementia. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 186:500-6. [PMID: 26724389 DOI: 10.1016/j.ajpath.2015.12.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 11/08/2015] [Accepted: 12/03/2015] [Indexed: 01/11/2023]
Abstract
Three key elements to precision medicine are stratification by risk, detection of pathophysiological processes as early as possible (even before clinical presentation), and alignment of mechanism of action of intervention(s) with an individual's molecular driver(s) of disease. Used for decades in the management of some rare diseases and now gaining broad currency in cancer care, a precision medicine approach is beginning to be adapted to cognitive impairment and dementia. This review focuses on the application of precision medicine to address the clinical and biological complexity of two common neurodegenerative causes of dementia: Alzheimer disease and Parkinson disease.
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Affiliation(s)
- Brenna Cholerton
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Eric B Larson
- Group Health Research Institute, Seattle, Washington
| | - Joseph F Quinn
- Department of Neurology, Oregon Health and Science University, Portland, Oregon; Portland Veterans Affairs Medical Center, Portland, Oregon
| | - Cyrus P Zabetian
- Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington; Parkinson's Disease Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington; Department of Neurology, University of Washington, Seattle, Washington
| | - Ignacio F Mata
- Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington; Department of Neurology, University of Washington, Seattle, Washington
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, Washington
| | - Margaret Flanagan
- Department of Pathology, University of Washington, Seattle, Washington
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington
| | - Thomas J Grabowski
- Department of Neurology, University of Washington, Seattle, Washington; Department of Radiology, University of Washington, Seattle, Washington
| | | | - Thomas J Montine
- Department of Pathology, University of Washington, Seattle, Washington.
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28
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Abstract
With the growing awareness of the presence of non-motor symptoms in Parkinson's disease (PD) has come the realization that these non-motor features play a tremendously important, and sometimes dominant, role in the management and even the diagnosis of the disorder. Despite this, a reluctance to formally address and treat the non-motor symptoms of PD remains and quality of life for PD patients suffers. This review provides an overview of the impact non-motor symptoms have on persons with PD, along with a brief description of some of the more common non-motor features of PD.
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