Mild Cognitive Impairment in newly diagnosed Parkinson's disease: A longitudinal prospective study

Santangelo, Gabriella; Vitale, Carmine; Picillo, Marina; Moccia, Marcello; Cuoco, Sofia; Longo, Katia; Pezzella, D; Grazia, Assunta di; Erro, Roberto; Pellecchia, Maria Teresa; Amboni, Marianna; Trojano, Luigi; Barone, Paolo

doi:10.1016/j.parkreldis.2015.08.024

Cited by 122 publications

(96 citation statements)

References 41 publications

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“…This figure is supported by more recent studies, including some that monitored patients from the time of PD diagnosis (TABLE 1), which reported dementia prevalence of 15–20% after 5 years and 46% at 10 years 7,8 . However, lower dementia rates (5% after 4 years) have been reported elsewhere 9 . One study that selected only PD patients with normal cognition reported that nearly 50% had developed cognitive decline after 6 years 10 .…”

Section: Cognitive Syndromes In Pdmentioning

confidence: 76%

Cognitive decline in Parkinson disease

et al. 2017

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Dementia is a frequent problem encountered in advanced stages of Parkinson disease (PD). In recent years, research has focused on the pre-dementia stages of cognitive impairment in PD, including mild cognitive impairment (MCI). Several longitudinal studies have shown that MCI is a harbinger of dementia in PD, although the course is variable, and stabilization of cognition — or even reversal to normal cognition — is not uncommon. In addition to limbic and cortical spread of Lewy pathology, several other mechanisms are likely to contribute to cognitive decline in PD, and a variety of biomarker studies, some using novel structural and functional imaging techniques, have documented in vivo brain changes associated with cognitive impairment. The evidence consistently suggests that low cerebrospinal fluid levels of amyloid-β42, a marker of comorbid Alzheimer disease (AD), predict future cognitive decline and dementia in PD. Emerging genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms. Cognitive enhancing medications have some effect in PD dementia, but no convincing evidence that progression from MCI to dementia can be delayed or prevented is available, although cognitive training has shown promising results.

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Section: Cognitive Syndromes In Pdmentioning

confidence: 76%

Cognitive decline in Parkinson disease

et al. 2017

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“…Interestingly, an evolving hypothesis in PD cognitive research posits that while early, frontal lobe symptoms such as working memory and executive dysfunction can be mild and stable over time, “posterior” cortical symptoms, such as visuospatial function and verbal memory (measured by delayed recall in this study) may herald the onset of a more rapid cognitive decline to dementia [13, 27]. It is interesting that these same objective measures that may predict subsequent cognitive decline [28] are also the cognitive domains most associated with these patients’ earliest acknowledgement of slight cognitive impairment. This has implications for development of strategies to detect participants who are most at risk for dementia for inclusion in future research targeting PD dementia.…”

Section: Discussionmentioning

confidence: 97%

Cognitive impairment in Parkinson's disease: Association between patient-reported and clinically measured outcomes

Mills

Mari

Pontone

et al. 2016

Parkinsonism & Related Disorders

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Background In Parkinson’s disease, the association between objective and patient-reported measures of cognitive dysfunction is unknown and highly relevant to research and clinical care. Objective To determine which cognitive domain-specific Montreal Cognitive Assessment (MoCA) subscores are most strongly associated with patient-reported cognitive impairment on question 1 (Q1) of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Methods We analyzed data from 759 PD participants and 481 persons without PD with in a retrospective, cross sectional analysis using data from the NINDS Parkinson’s Disease Biomarkers Program (PDBP), a longitudinal, multicenter biomarker study. The relationship between a patient-reported cognitive rating (MDS- UPDRS q1.1) and objective cognitive assessments (MoCA) was assessed using multinomial logistic regression modeling and the outcomes reported as conditional odds ratios (cOR’s) representing the relative odds of a participant reporting cognitive impairment that is “slight” versus “normal” on MDS-UPDRSq1.1 for a one unit increase in a MoCA sub-score, adjusted for age and education. Results In PD participants, changes in visuospatial-executive performance and memory had the most significant impact on subjective cognitive impairment. A 1-point increase in visuospatial-executive function decreased the chance of reporting a MDS-UPDRS Q1 score of “slight” versus “normal” by a factor of 0.686 (p<0.001) and each 1 point improvement in delayed recall decreased the odds of reporting “slight” cognitive impairment by a factor of 0.836 (p<0.001). Conclusions Conversion from a PD patient’s report of “normal” to “slight” cognitive impairment may be associated with changes in visuospatial-executive dysfunction and memory more than other cognitive domains.

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“…Bélanger et al 2010). Moreover, Santangelo et al (2015) have recently suggested that among cognitive measures, the Stroop Test may be useful even for identifying patients at high risk of developing PD-MCI at the time of PD diagnosis, by suggesting that an impairment of inhibitory control might represent an early cognitive deterioration in the course of the disease.…”

Section: Discussionmentioning

confidence: 99%