Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease

El-Nazer, Rasheda; Adler, Charles H.; Beach, Thomas G.; Belden, Christine M.; Artz, Jonathan; Shill, Holly A.; Driver‐Dunckley, Erika; Mehta, Shyamal H.; Sabbagh, Marwan N.; Serrano, Geidy E.; Sue, Lucia I.; Zamrini, Edward; Benge, Jared F.

doi:10.1016/j.parkreldis.2019.05.014

Cited by 15 publications

(7 citation statements)

References 32 publications

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“…These results may be explained mechanistically by RBD in PD being associated with greater impairment in frontal and temporal brain circuitry, specifically with connections implicated in verbal executive functions that are unrelated to PD-specific pathology [51,52]. As neurodegeneration progresses, RBD may amplify verbal impairments found in PD, particularly those that involve switching, that already exist.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairments and Self-Reported Sleep in Early-Stage Parkinson’s Disease with Versus without Probable REM Sleep Behavior Disorder

et al. 2019

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Parkinson's disease (PD) is associated with cognitive and sleep impairments. The presence of rapid eye movement (REM) sleep behavior disorder (RBD) symptoms may represent a worse disease prognosis for PD individuals. We investigated cognitive functioning and self-reported sleep in early-stage PD individuals with (n = 19) or without (n = 31) probable RBD. Probable RBD was defined as >5 on the REM Sleep Behavior Disorder Screening Questionnaire. Inhibition, visuospatial cognitive abilities, working memory, sustained visual attention, verbal fluency, and episodic memory were assessed. Sleep impairments were assessed using the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and Patient-Reported Outcomes Measurement Information System questionnaires. Chi-squared, Mann-Whitney U, and independent sample t-tests were employed to assess group differences. Participants with PD and probable RBD performed significantly worse on word reading and switching verbal fluency tasks than PD participants without probable RBD (p < 0.05). No significant differences were found in mood, PD severity, or sleep measures between PD individuals with or without probable RBD. Cognitive tasks that involve verbal or switching components may be most impaired in PD individuals with probable RBD. Larger samples are needed to determine whether other cognitive domains and sleep features are significantly associated with RBD in PD.

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Section: Discussionmentioning

confidence: 99%

Cognitive Impairments and Self-Reported Sleep in Early-Stage Parkinson’s Disease with Versus without Probable REM Sleep Behavior Disorder

et al. 2019

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“…Secondly, this could suggest that co-occurring AD pathology accounts for semantic fluency impairment in PD-MCI. However, recent work by El-Nazer et al (2019) concluded that PD and PD/AD mixed pathologies do not differ clinically and that cognitive deficits are associated with both LB and AD pathological burden. Specifically, greater Lewy body density was found in limbic and cortical structures in PD patients with poor verbal fluency, but higher AD pathology was on trend in many of the same areas.…”

Section: Pd-mcimentioning

confidence: 99%

The Neuropsychological Profile of Mild Cognitive Impairment in Lewy Body Dementias

Ciafone

Little

Thomas

et al. 2019

J Int Neuropsychol Soc

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Objectives:Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) have substantial clinical and biological overlap, with cognitive deficits typically observed in the executive and visuospatial domains. However, the neuropsychological profiles of mild cognitive impairment (MCI) associated with these disorders are not well understood.Methods:This systematic review examined existing literature on cognition in MCI due to LB disease (MCI-LB) and PD (PD-MCI) using an electronic search of seven databases (Medline, Embase, Psychinfo, PubMed, ProQuest, Scopus, and ScienceDirect). MCI-LB results were reviewed narratively given the small number of resulting papers (n = 7). Outcome variables from PD-MCI studies (n = 13) were extracted for meta-analysis of standardised mean differences (SMD).Results:In MCI-LB, executive dysfunction and slowed processing speed were the most prominent impairments, while visuospatial and working memory (WM) functions were also poor. MCI-LB scored significantly lower on verbal memory tests relative to controls, but significantly higher than patients with MCI due to Alzheimer’s disease. Quantitative analysis of studies in PD-MCI showed a similar profile of impairment, with the largest deficits in visuospatial function (Benton Judgement of Line Orientation, SMD g = −2.09), executive function (Trail Making Test B, SMD g = −1.65), verbal ability (Naming Tests, SMD g = −0.140), and WM (Trail Making Test A, SMD g = −1.20). In both MCI-LB and PD-MCI, verbal and visuospatial memory retrieval was impaired, while encoding and storage appeared relatively intact.Conclusions:The findings of this systematic review indicate similar neuropsychological profiles in the MCI stages of DLB and PDD. Executive impairment may at least partially explain poor performance in other domains.

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“…Attention, visuospatial, and executive dysfunction are cognitive hallmarks of DLB, [ 38 ] and motor parkinsonism is a core clinical feature of DLB [ 3 ]. As limbic LB pathologies is related to visuospatial and executive dysfunction in patients with DLB [ 39 ] and PD, [ 40 ] our results suggest that relative MTL hypermetabolism could be a disease monitoring biomarker for DLB, reflecting the severity of LB pathologies. Although previous studies have shown that limbic hypermetabolism correlates with dopaminergic depletion in patients with DLB [ 41 , 42 ] and RBD, [ 31 ] we could not evaluate the relationship between relative MTL hypermetabolism, dopamine transporter uptake, cognitive dysfunction, and motor parkinsonism because some of our patients with AD did not undergo FP-CIT-PET.…”

Section: Discussionmentioning

confidence: 85%

Alteration of medial temporal lobe metabolism related to Alzheimer’s disease and dementia with lewy bodies

Kang,

Jeon,

Lee

et al. 2024

Alz Res Therapy

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Background Association of medial temporal lobe (MTL) metabolism with Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) has not been evaluated considering their mixed disease (MD). Methods 131 patients with AD, 133 with DLB, 122 with MD, and 28 normal controls (NCs) underwent neuropsychological tests, assessments for parkinsonism, cognitive fluctuation (CF), and visual hallucinations (VH), and 18F-fluorodeoxyglucose PET to quantify MTL metabolism in the amygdala, hippocampus, and entorhinal cortex. The effects of AD and DLB on MTL metabolism were evaluated using general linear models (GLMs). Associations between MTL metabolism, cognition, and clinical features were evaluated using GLMs or logistic regression models separately performed for the AD spectrum (NC + AD + MD), DLB spectrum (NC + DLB + MD), and disease groups (AD + DLB + MD). Covariates included age, sex, and education. Results AD was associated with hippocampal/entorhinal hypometabolism, whereas DLB was associated with relative amygdalar/hippocampal hypermetabolism. Relative MTL hypermetabolism was associated with lower attention/visuospatial/executive scores and severe parkinsonism in both the AD and DLB spectra and disease groups. Left hippocampal/entorhinal hypometabolism was associated with lower verbal memory scores, whereas right hippocampal hypometabolism was associated with lower visual memory scores in both the AD spectrum and disease groups. Relative MTL hypermetabolism was associated with an increased risk of CF and VH in the disease group, and relative amygdalar hypermetabolism was associated with an increased risk of VH in the DLB spectrum. Conclusions Entorhinal-hippocampal hypometabolism and relative amygdala-hippocampal hypermetabolism could be characteristics of AD- and DLB-related neurodegeneration, respectively.

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Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease

Cited by 15 publications

References 32 publications

Cognitive Impairments and Self-Reported Sleep in Early-Stage Parkinson’s Disease with Versus without Probable REM Sleep Behavior Disorder

Cognitive Impairments and Self-Reported Sleep in Early-Stage Parkinson’s Disease with Versus without Probable REM Sleep Behavior Disorder

The Neuropsychological Profile of Mild Cognitive Impairment in Lewy Body Dementias

Alteration of medial temporal lobe metabolism related to Alzheimer’s disease and dementia with lewy bodies

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