Abstract
The study assessed cognitive decline in non-demented, non-depressed patients with well defined Parkinson's disease and determined the predictive value for cognitive decline of different motor symptoms. Motor disability was measured with the Unified Parkinson's disease rating scale, impairment in activities of daily living, levodopa test, and long term clinical follow up. Neuropsychological evaluations included modified mini mental state, fluency, Wechsler logical memory, Wisconsin card sorting test, and the Montgomery and Asberg depression rating scale. Fifty three patients fulfilling clinical criteria for idiopathic Parkinson's disease were studied. Cognitive performance on initial testing was significantly correlated with education and disease duration but not with age at disease onset. Cognitive performance on retesting after three years of follow up was significantly reduced. This reduction was significantly greater in the late onset group, in patients with isolated dystonic dyskinesiae, and in patients with a lower percentage of motor improvement on levodopa. Cognitive decline in idiopathic Parkinson's disease may depend on both the prevalence of non-dopaminergic lesions and the topography of dopaminergic denervation. Predictive factors for cognitive decline, especially in executive tasks, relate more to non-dopaminergic than to dopaminergic lesions.
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- Brown R. G., Marsden C. D. Cognitive function in Parkinson's disease: from description to theory. Trends Neurosci. 1990 Jan;13(1):21–29. doi: 10.1016/0166-2236(90)90058-i. [DOI] [PubMed] [Google Scholar]
- Caparros-Lefebvre D., Blond S., Pécheux N., Pasquier F., Petit H. Evaluation neuropsychologique avant et après stimulation thalamique chez 9 parkinsoniens. Rev Neurol (Paris) 1992;148(2):117–122. [PubMed] [Google Scholar]
- Caparros-Lefebvre D., Blond S., Vermersch P., Pécheux N., Guieu J. D., Petit H. Chronic thalamic stimulation improves tremor and levodopa induced dyskinesias in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1993 Mar;56(3):268–273. doi: 10.1136/jnnp.56.3.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper J. A., Sagar H. J., Jordan N., Harvey N. S., Sullivan E. V. Cognitive impairment in early, untreated Parkinson's disease and its relationship to motor disability. Brain. 1991 Oct;114(Pt 5):2095–2122. doi: 10.1093/brain/114.5.2095. [DOI] [PubMed] [Google Scholar]
- Dubois B., Pillon B., Sternic N., Lhermitte F., Agid Y. Age-induced cognitive disturbances in Parkinson's disease. Neurology. 1990 Jan;40(1):38–41. doi: 10.1212/wnl.40.1.38. [DOI] [PubMed] [Google Scholar]
- Esteguy M., Bonnet A. M., Kefalos J., Lhermitte F., Agid Y. Le test à la L-Dopa dans la maladie de Parkinson. Rev Neurol (Paris) 1985;141(5):413–415. [PubMed] [Google Scholar]
- Growdon J. H., Corkin S. Cognitive impairments in Parkinson's disease. Adv Neurol. 1987;45:383–392. [PubMed] [Google Scholar]
- Hietanen M., Teräväinen H. The effect of age of disease onset on neuropsychological performance in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1988 Feb;51(2):244–249. doi: 10.1136/jnnp.51.2.244. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hughes A. J., Daniel S. E., Kilford L., Lees A. J. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181–184. doi: 10.1136/jnnp.55.3.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jankovic J. Parkinsonism-plus syndromes. Mov Disord. 1989;4 (Suppl 1):S95–119. doi: 10.1002/mds.870040512. [DOI] [PubMed] [Google Scholar]
- Leavitt A. M., Yerby M. S., Robinson N., Sells C. J., Erickson D. M. Epilepsy in pregnancy: developmental outcome of offspring at 12 months. Neurology. 1992 Apr;42(4 Suppl 5):141–143. [PubMed] [Google Scholar]
- Lees A. J. Parkinson's disease and dementia. Lancet. 1985 Jan 5;1(8419):43–44. doi: 10.1016/s0140-6736(85)90986-9. [DOI] [PubMed] [Google Scholar]
- Lhermitte F., Agid Y., Feuerstein C., Serre F., Signoret J. L., Studler J. M., Bonnet A. M. Mouvements anormaux provoqués par la L-DOPA dans la maladie de Parkinson: corrélation avec les concentrations plasmatiques de DOPA et de O-méthyl-DOPA. Rev Neurol (Paris) 1977 Aug-Sep;133(8-9):445–454. [PubMed] [Google Scholar]
- Lhermitte F., Agid Y., Signoret J. L. Onset and end-of-dose levodopa-induced dyskinesias. Possible treatment by increasing the daily doses of levodopa. Arch Neurol. 1978 May;35(5):261–263. doi: 10.1001/archneur.1978.00500290007002. [DOI] [PubMed] [Google Scholar]
- Marconi R., Lefebvre-Caparros D., Bonnet A. M., Vidailhet M., Dubois B., Agid Y. Levodopa-induced dyskinesias in Parkinson's disease phenomenology and pathophysiology. Mov Disord. 1994 Jan;9(1):2–12. doi: 10.1002/mds.870090103. [DOI] [PubMed] [Google Scholar]
- Mayeux R., Stern Y., Rosen J., Leventhal J. Depression, intellectual impairment, and Parkinson disease. Neurology. 1981 Jun;31(6):645–650. doi: 10.1212/wnl.31.6.645. [DOI] [PubMed] [Google Scholar]
- Montgomery S. A., Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979 Apr;134:382–389. doi: 10.1192/bjp.134.4.382. [DOI] [PubMed] [Google Scholar]
- Mortimer J. A., Pirozzolo F. J., Hansch E. C., Webster D. D. Relationship of motor symptoms to intellectual deficits in Parkinson disease. Neurology. 1982 Feb;32(2):133–137. doi: 10.1212/wnl.32.2.133. [DOI] [PubMed] [Google Scholar]
- Nelson H. E. A modified card sorting test sensitive to frontal lobe defects. Cortex. 1976 Dec;12(4):313–324. doi: 10.1016/s0010-9452(76)80035-4. [DOI] [PubMed] [Google Scholar]
- Pillon B., Dubois B., Bonnet A. M., Esteguy M., Guimaraes J., Vigouret J. M., Lhermitte F., Agid Y. Cognitive slowing in Parkinson's disease fails to respond to levodopa treatment: the 15-objects test. Neurology. 1989 Jun;39(6):762–768. doi: 10.1212/wnl.39.6.762. [DOI] [PubMed] [Google Scholar]
- Pillon B., Dubois B., Cusimano G., Bonnet A. M., Lhermitte F., Agid Y. Does cognitive impairment in Parkinson's disease result from non-dopaminergic lesions? J Neurol Neurosurg Psychiatry. 1989 Feb;52(2):201–206. doi: 10.1136/jnnp.52.2.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Portin R., Rinne U. K. Predictive factors for cognitive deterioration and dementia in Parkinson's disease. Adv Neurol. 1987;45:413–416. [PubMed] [Google Scholar]
- Rajput A. H., Offord K., Beard C. M., Kurland L. T. Epidemiological survey of dementia in parkinsonism and control population. Adv Neurol. 1984;40:229–234. [PubMed] [Google Scholar]
- Ransmayr G., Poewe W., Ploerer S., Birbamer G., Gerstenbrand F. Psychometric findings in clinical subtypes of Parkinson's disease. Adv Neurol. 1987;45:409–411. [PubMed] [Google Scholar]
- Sagar H. J., Sullivan E. V., Gabrieli J. D., Corkin S., Growdon J. H. Temporal ordering and short-term memory deficits in Parkinson's disease. Brain. 1988 Jun;111(Pt 3):525–539. doi: 10.1093/brain/111.3.525. [DOI] [PubMed] [Google Scholar]
- Stern Y., Mayeux R. Intellectual impairment in Parkinson's disease. Adv Neurol. 1987;45:405–408. [PubMed] [Google Scholar]
- Vermersch P., Delacourte A., Javoy-Agid F., Hauw J. J., Agid Y. Dementia in Parkinson's disease: biochemical evidence for cortical involvement using the immunodetection of abnormal Tau proteins. Ann Neurol. 1993 May;33(5):445–450. doi: 10.1002/ana.410330506. [DOI] [PubMed] [Google Scholar]
- de la Monte S. M., Wells S. E., Hedley-Whyte T., Growdon J. H. Neuropathological distinction between Parkinson's dementia and Parkinson's plus Alzheimer's disease. Ann Neurol. 1989 Sep;26(3):309–320. doi: 10.1002/ana.410260302. [DOI] [PubMed] [Google Scholar]