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

Abstract

This mini-review summarizes the evidence of the cognitive and behavioral features of dysexecutive syndrome in Parkinson’s disease (PD). Deficits in response inhibition, set-shifting, mental flexibility, and strategy have been frequently described from the earliest stages of PD, although there are inconsistencies in study findings due to the complexity of the executive function (EF) construct and methodological limitations. Behavioral disorders of PD, e.g., apathy, distractibility, perseverative behavior, and impulse-control disorders, may be viewed as the other side of dysexecutive syndrome. Despite the interrelationship between the cognitive and behavioral domains, some reports reveal that the two syndromes may be dissociated, suggesting that both aspects must be clinically assessed. EFs are widely associated with the prefrontal areas, although dysexecutive syndrome may be observed in patients with damage to other brain regions. EFs drive numerous abilities essential to daily life, such as prospective remembering and language comprehension, which may be impaired in PD subjects. Considering the impact of dysexecutive syndrome on independence and quality of life, early detection of executive impairment is crucial in the management of PD.

Evolution of mild cognitive impairment in Parkinson disease

“…4,5 Previous studies have been hindered by lack of standard criteria for PD-MCI. 1 MCI was originally used to describe prodromal Alzheimer disease (AD).…”

“…4,5 Previous studies have been hindered by lack of standard criteria for PD-MCI. Two neuropsychologists independently applied the PD-MCI criteria to examine the interrater and intrarater reliability.…”

Everyday functioning of people with Parkinson’s disease and impairments in executive function: a qualitative investigation

“…Similarly, in everyday functioning, it may be rare to observe the effects of pure executive impairments. Despite numerous studies of EF in PD, there is still a lot that we do not know about executive impairment in PD [14][15][16]. There is much debate and research activity around selection and interpretation of neuropsychological tests [17][18][19], but there is little guidance on understanding and documenting the impact of cognitive difficulties on everyday functioning.…”

Self-Regulation of Driving Behavior in People with Parkinson Disease

“…Deficits in executive function begin early in many people with PD (Ceravolo et al, 2012;Zgaljardic et al, 2006). Among the numerous skills that can be affected is the ability to adapt to novel circumstances, such as driving in unfamiliar situations.…”