Mild cognitive impairment and cognitive-motor relationships in newly diagnosed drug-naive patients with Parkinson's disease. Issue 6 (4th April 2012)

• Record Type: Journal Article
• Authors: Poletti, Michele; Frosini, Daniela; Pagni, Cristina; Baldacci, Filippo; Nicoletti, Valentina; Tognoni, Gloria; Lucetti, Claudio; Del Dotto, Paolo; Ceravolo, Roberto; Bonuccelli, Ubaldo
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 83:Issue 6(2012)
• Page Start: 601
• Page End: 606
• Publication Date: 2012-04-04
• Subjects: Drug-naive Parkinson's disease -- Mild Cognitive Impairment -- motor-phenotype -- tremor -- bradykinesia -- neuropsychology -- Parkinson's disease -- frontal lobe -- Alzheimer's disease -- nuclear medicine -- cerebral metabolism -- neuropsychiatry -- functional imaging -- movement disorders -- PET -- neuropharmacology -- movement disorders; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2011-301874
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background and aims: (1) To establish the prevalence of mild cognitive impairment (MCI) in newly diagnosed drug-naive patients with Parkinson's disease adopting recently proposed and more conservative preliminary research criteria. (2) To investigate the relation between cognitive performances, MCI and motor dysfunction. Methods: 132 consecutive newly diagnosed drug-naive PD patients and 100 healthy controls (HCs) underwent a neuropsychological evaluation covering different cognitive domains. Moreover, on the basis of the Unified Parkinson's Disease Rating Scale II/III, different motor scores were calculated and patients were classified in motor subtypes. 11 patients were excluded from the analysis during clinical follow-up which was continued at least 3 years from the diagnosis; therefore, the final sample included 121 patients. Results: MCI prevalence was higher in PD (14.8%) patients than in HCs (7.0%). PD patients reported lower cognitive performances than HCs in several cognitive domains; HCs also outperformed cognitively preserved PD patients in tasks of episodic verbal memory and in a screening task of executive functions. MCI-PD patients presented a more severe bradykinesia score than non-MCI PD patients and patients mainly characterised by tremor had better performances in some cognitive domains, and specific cognitive-motor relationships emerged. Conclusions: Although the adoption of more conservative diagnostic criteria identified a lower MCI prevalence, we found evidence that newly diagnosed drug-naive PD patients present a higher risk of MCI in comparison with HCs. Axial symptoms and bradykinesia represent risk factors for MCI in PD patients and a classification of PD patients that highlights the presence/absence of tremor, as proposed in this study, is probably better tailored for the early stages of PD than classifications proposed for more advanced PD stages.