Executive dysfunction using behavioral assessment of the dysexecutive syndrome in Parkinson's disease

Abstract

Abstract:The objective of this study was to evaluate the executive dysfunction (ExD) in Parkinson's disease (PD) using the Behavioral Assessment of the Dysexecutive Syndrome (BADS), which provides a wide-range assessment of ExD. The BADS and the Unified Parkinson's Disease Rating Scale (UP-DRS) were investigated in 63 nondemented PD patients who revealed scores of Ն24 points on the Mini-Mental State Examination based on the DSM-IV. Multiple logistic regression analysis was performed to evaluate the predisposing factors to ExD, which was defined as Ͻ70 points on the age-controlled standardized score. The total score on the UPDRS was a significant independent predisposing factor to ExD. Among the various parts of the UPDRS, part II was the significant factor for ExD. The profile scores of all subtests on the BADS in patients with ExD were significantly lower than those of patients without ExD. All profile scores decreased with severity of PD, but the changes among these scores differed. ExD in nondemented PD predisposed to a greater severity of PD, particularly as regards the activity of daily living impairment. Nondemented PD revealed wide-range components of ExD. All components of ExD were impaired with severity of PD, but the patterns of each component exhibited variety.

Discriminative power of different nonmotor signs in early Parkinson's disease. A case-control study

“…However, the specificity of hyposmia as an early biomarker has recently been questioned and the olfactory performance may be gender‐specific, although this has not been proven in patients with PD 20, 21. Dysexecutive signs, elegantly proven by different studies,8, 22–24 may still be too subtle to strongly discriminate between PD‐related dysfunction and unspecific ageing deficits. Furthermore, these deficits are found in only a minority of early patients with PD, ranging from 22 to 36% 24, 25.…”

The Epidemiology and Clinical Manifestations of Dysexecutive Syndrome in Parkinson’s Disease

“…Several studies have reported deficits on these tasks in early stage PD patients (Fama et al, 2000; Grace et al, 2005; Janvin et al, 2006; de Frias et al, 2007; Lima et al, 2008; Muslimovic et al, 2008; Siegert et al, 2008; Aarsland et al, 2009a), but the exact pattern of impairment is still under debate (Muslimovic et al, 2007; see for a review Watson and Leverenz, 2010). This impairment is often evident in time-constraint tests, suggesting a psychomotor slowing in PD subjects (Owen et al, 1992; Robbins et al, 1994; Kamei et al, 2008). Furthermore, some reports indicate a relative sparing of performance in EFs tasks in PD subjects (Auriacombe et al, 1993; Farina et al, 2000; Cools et al, 2001; Colman et al, 2009).…”

“…Some evidence highlights that executive dysfunction in non-demented PD patients predisposes to an increased impairment of daily activities (Kamei et al, 2008). Because of the impact on the patient’s independence and quality of life, early detection of executive impairments is crucial in the management of PD.…”

Diagnostic utility of the Key Search Test as a measure of executive functions

“…Examples of intact and distorted search routes are presented in Figure 1. Several previous studies have successfully administered the Key Search Test to patient groups of varying aetiologies, including traumatic brain injury, 6,7 dementia, 8,9 schizophrenia, 10 epilepsy, 11 and Parkinson's disease 12 . Performance on this test has been shown to correlate with other executive function measures, as well as more general intelligence indices 7 .…”