Cognitive function in early Parkinson’s disease: a population‐based study

Elgh, Eva; Domellöf, Magnus; Lindér, Jan; Edström, Mona; Stenlund, Hans; Forsgren, Lars

doi:10.1111/j.1468-1331.2009.02707.x

Cited by 199 publications

(143 citation statements)

References 27 publications

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“…Other defi cits of cognitive function, such as impairment of visuospatial function, can also occur in PD, 83 but language is generally intact in early PD. [73][74][75] Memory impairment in early PD could be largely due to eff ortful retrieval, as cueing improves recall and recognition memory is usually not impaired, 76,84 although defi cits in recognition memory have been found in other Review studies (reviewed elsewhere 85 ). Patients with PD have impaired implicit learning on both cognitive and motor tasks, such as the weather prediction task 86 and the serial reaction time task.…”

Section: Executive Dysfunctionmentioning

confidence: 99%

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Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Rodriguez-Oroz

Jahanshahi

Krack

et al. 2009

The Lancet Neurology

744

500

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A dopaminergic defi ciency in patients with Parkinson's disease (PD) causes abnormalities of movement, behaviour, learning, and emotions. The main motor features (ie, tremor, rigidity, and akinesia) are associated with a defi ciency of dopamine in the posterior putamen and the motor circuit. Hypokinesia and bradykinesia might have a dual anatomo-functional basis: hypokinesia mediated by brainstem mechanisms and bradykinesia by cortical mechanisms. The classic pathophysiological model for PD (ie, hyperactivity in the globus pallidus pars interna and substantia nigra pars reticulata) does not explain rigidity and tremor, which might be caused by changes in primary motor cortex activity. Executive functions (ie, planning and problem solving) are also impaired in early PD, but are usually not clinically noticed. These impairments are associated with dopamine defi ciency in the caudate nucleus and with dysfunction of the associative and other non-motor circuits. Apathy, anxiety, and depression are the main psychiatric manifestations in untreated PD, which might be caused by ventral striatum dopaminergic defi cit and depletion of serotonin and norepinephrine. In this Review we discuss the motor, cognitive, and psychiatric manifestations associated with the dopaminergic defi ciency in the early phase of the parkinsonian state and the diff erent circuits implicated, and we propose distinct mechanisms to explain the wide clinical range of PD symptoms at the time of diagnosis.

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Section: Executive Dysfunctionmentioning

confidence: 99%

“…Depending on sample characteristics and criteria used, cognitive defi cits are present in early PD in 20-40% of patients [73][74][75] but are often overshadowed by motor features.…”

Section: Executive Dysfunctionmentioning

confidence: 99%

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Rodriguez-Oroz

Jahanshahi

Krack

et al. 2009

The Lancet Neurology

744

500

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“…Extensive neuropsychological testing, covering specific cognitive domains and used for PD‐mild cognitive impairment (MCI) and PD dementia (PDD) diagnostics, was performed at 0, 1, 3, 5, and 8 years 18. MCI was diagnosed according to Movement Disorder Society criteria 19.…”

Section: Methodsmentioning

confidence: 99%

Polymorphisms in dopamine-associated genes and cognitive decline in Parkinson's disease

et al. 2017

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ObjectivesCognitive decline is common in Parkinson's disease (PD), but the underlying mechanisms for this complication are incompletely understood. Genotypes affecting dopamine transmission may be of importance. This study investigates whether genotypes associated with reduced prefrontal dopaminergic tone and/or reduced dopamine D2‐receptor availability (Catechol‐O‐methyltransferase [COMT] Val158Met genotype and DRD2 C957T genotype) affect the development of cognitive deficits in PD.Materials and methodsOne hundred and 34 patients with idiopathic PD, participating in a regional, population‐based study of incident parkinsonism, underwent genotyping. After extensive baseline investigations (including imaging and biomarker analyses), the patients were followed prospectively during 6‐10 years with neuropsychological evaluations, covering six cognitive domains. Cognitive decline (defined as the incidence of either Parkinson's disease mild cognitive impairment [PD‐MCI] or dementia [PDD], diagnosed according to published criteria and blinded to genotype) was studied as the primary outcome.ResultsBoth genotypes affected cognition, as shown by Cox proportional hazards models. While the COMT 158Val/Val genotype conferred an increased risk of mild cognitive impairment in patients with normal cognition at baseline (hazard ratio: 2.13, P = .023), the DRD2 957T/T genotype conferred an overall increased risk of PD dementia (hazard ratio: 3.22, P < .001). The poorer cognitive performance in DRD2 957T/T carriers with PD occurred mainly in episodic memory and attention.ConclusionsThe results favor the hypothesis that dopamine deficiency in PD not only relate to mild cognitive deficits in frontostriatal functions, but also to a decline in memory and attention. This could indicate that dopamine deficiency impairs a wide network of brain areas.

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“…Poor performances on tests involving posterior cortical areas such as the semantic fluency test and the copy of a figure test would be the most important predictors of cognitive decline according to some authors (William-Grays et al, 2007). However, the profile of cognitive impairment is heterogeneous, some patients presenting with memory impairment while others show more language, executive and visuospatial impairments (Elgh et al, 2009;Janvin et al, 2005;Uc et al, 2009). Identifying factors contributing to cognitive deterioration is a noteworthy goal because a diminution in quality of life and an augmentation of mortality are associated with cognitive impairment and dementia in PD.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Parkinson's Disease, Vascular Risk Factors and Cognition: A Critical Review

Doiron¹,

Simard²

2012

Neurodegeneration

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Cognitive function in early Parkinson’s disease: a population‐based study

Abstract: Cognitive dysfunction is common in untreated patients in early PD, affecting attention, psychomotor function, episodic memory, executive function and category fluency. Education level was an independent predictor of severe cognitive dysfunction.

Cited by 199 publications

References 27 publications

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Polymorphisms in dopamine-associated genes and cognitive decline in Parkinson's disease

Idiopathic Parkinson's Disease, Vascular Risk Factors and Cognition: A Critical Review

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