Involvement of specific executive functions in mobility in Parkinson's disease

Smulders, Katrijn; Nimwegen, Marlies van; Munneke, Marten; Bloem, Bastiaan R.; Kessels, Roy P. C.; Esselink, Rianne A.J.

doi:10.1016/j.parkreldis.2012.06.010

Cited by 31 publications

(35 citation statements)

References 13 publications

(15 reference statements)

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“…Better cognitive functions were seen more in patients with severe akinesia, in comparison to patients with severe tremor. Our results extend prior studies showing relationships between motor and cognitive measures in PD (Riggeal et al, 2007; Colman et al, 2009; Wylie et al, 2012; Smulders et al, 2013), and further show that the effects of MAO-I on neuropsychological, affective, and quality of life measures in PD depends on the subtypes of PD.…”

Section: Discussionsupporting

confidence: 91%

Effects of combined MAO-B inhibitors and levodopa vs. monotherapy in Parkinsonâ€™s disease

Krishna

Ali

Moustafa

2014

Front. Aging Neurosci.

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Background: Prior studies report that monoamine oxidases inhibitors (MAO-I) when used as an adjunct to levodopa ameliorate motor symptoms in Parkinson’s disease (PD), but this was not tested in relation to cognitive or psychiatric measures.Objective: Here, we tested the effects of MAO-I as an adjunct to levodopa, in comparison to levodopa or dopamine (DA) agonists alone, on various cognitive, affective and quality of life measures.Methods: We studied three groups of subjects: healthy controls, PD patients on combined levodopa and MAO-I, and PD patients on levodopa or DA agonists only.Results: We found that compared to monotherapy, combined MAO-I and levodopa seemed to improve cognition, including probabilistic learning, working memory and executive functions. There were no differences between the different medication regimes on deterministic learning, attention or memory recall. It was also found that MAO-I as an adjunct to levodopa improves affective measures such as depression, apathy, anxiety and quality of life. Interestingly, this enhancing effect of combined levodopa and MAO-I was more pronounced in PD patients with severe akinesia, compared to patients with severe tremor.Conclusion: Our data are in agreement with (a) the Continuous Dopaminergic Stimulation (CDS) theory which states that continuous stimulation of the basal ganglia enhances motor, psychiatric and cognitive functions in PD patients; and/or (b) findings that MAO-I increase the bioavailability of monoamines that have beneficial effects on motor and behavioral dysfunction in PD.

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Section: Discussionsupporting

confidence: 91%

Effects of combined MAO-B inhibitors and levodopa vs. monotherapy in Parkinsonâ€™s disease

Krishna

Ali

Moustafa

2014

Front. Aging Neurosci.

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“…Several studies have classified newly diagnosed/ untreated PD patients, or relatively mildly affected [32] into subtypes demonstrating heterogeneity in early PD [2,29,36]. This may work for ''early patients'', however, our findings indicate that categorization may be distorted in the more advanced stages of the disease.…”

Section: Considerations In Regards To Classification Into Pigd and Tdmentioning

confidence: 62%

“…Various forms of classification have been described in the literature [2,3,[28][29][30][31][32]. Clinical separation into PIGD and TD types has been the most extensively studied classification method [33,34].…”

Section: Considerations In Regards To Classification Into Pigd and Tdmentioning

confidence: 99%

Gait and balance in Parkinson’s disease subtypes: objective measures and classification considerations

et al. 2014

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Parkinson's disease (PD) is often divided into tremor dominant (TD) and postural instability gait difficulty (PIGD) subtypes. However, objective measures of gait (e.g., stride length, variability) and balance have not been well studied in these subtypes. To better understand these motor subtypes, we objectively quantified gait and balance and their behavioral correlates. 110 patients with PD underwent a clinical evaluation and were stratified into PIGD and TD subtypes. Participants walked under single and dual task conditions while wearing a single body-fixed sensor, both "OFF" and "ON" medications and at home for 3 days. We also examined performance-based tests of mobility, balance, and fall risk. Stricter criteria were also applied, dividing the subjects into predominant representative subgroups: p-PIGD and p-TD. Both the PIGD (n = 62) and TD (n = 42) groups and the p-PIGD (n = 31) and p-TD (n = 32) subgroups were similar with respect to basic disease characteristics (e.g., disease duration, p > 0.69). Surprisingly gait speed, stride length, and variability did not differ between the PIGD and TD groups (p > 0.05). In contrast, the p-PIGD group had reduced gait speed (under single and dual task conditions), shorter strides, increased stride variability, and decreased stride regularity (regularity: p-PIGD 0.66 ± 0.10; p-TD 0.74 ± 0.08; p = 0.003). The p-PIGD group also scored worse on performance-based tests, compared to the p-TD. Clinical assessments of the disturbances seen in patients with the PIGD subtype are not consistent with objective measures; overlapping between the groups is seen in many objective features of gait and balance. These findings suggest that the proposed alternate classification scheme may be useful.

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“…These results contrast with previous research demonstrating associations between working memory and gait performance in people with PD. 36 This difference may be a reflection of the medication state of the participants tested. Previous research has shown that working memory deficits are improved with dopaminergic medication.…”

Section: Cognitive and Gait Performance In Parkinson Diseasementioning

confidence: 99%

Associations Between Cognitive and Gait Performance During Single- and Dual-Task Walking in People With Parkinson Disease

et al. 2014

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Involvement of specific executive functions in mobility in Parkinson's disease

Cited by 31 publications

References 13 publications

Effects of combined MAO-B inhibitors and levodopa vs. monotherapy in Parkinsonâ€™s disease

Effects of combined MAO-B inhibitors and levodopa vs. monotherapy in Parkinsonâ€™s disease

Gait and balance in Parkinson’s disease subtypes: objective measures and classification considerations

Associations Between Cognitive and Gait Performance During Single- and Dual-Task Walking in People With Parkinson Disease

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