The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis
Identifieur interne : 001196 ( Istex/Corpus ); précédent : 001195; suivant : 001197The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis
Auteurs : Christina Tremblay ; Amélie M. Achim ; Joël Macoir ; Laura MonettaSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2013-11.
Abstract
Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.
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DOI: 10.1136/jnnp-2013-305021
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><author><name sortKey="Tremblay, Christina" sort="Tremblay, Christina" uniqKey="Tremblay C" first="Christina" last="Tremblay">Christina Tremblay</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Achim, Amelie M" sort="Achim, Amelie M" uniqKey="Achim A" first="Amélie M" last="Achim">Amélie M. Achim</name><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Macoir, Joel" sort="Macoir, Joel" uniqKey="Macoir J" first="Joël" last="Macoir">Joël Macoir</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Monetta, Laura" sort="Monetta, Laura" uniqKey="Monetta L" first="Laura" last="Monetta">Laura Monetta</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B3B52F2006DF8D88D1194B4B61131E52385B1473</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/jnnp-2013-305021</idno><idno type="url">https://api-v5.istex.fr/document/B3B52F2006DF8D88D1194B4B61131E52385B1473/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001196</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001196</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><author><name sortKey="Tremblay, Christina" sort="Tremblay, Christina" uniqKey="Tremblay C" first="Christina" last="Tremblay">Christina Tremblay</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Achim, Amelie M" sort="Achim, Amelie M" uniqKey="Achim A" first="Amélie M" last="Achim">Amélie M. Achim</name><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Macoir, Joel" sort="Macoir, Joel" uniqKey="Macoir J" first="Joël" last="Macoir">Joël Macoir</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author><author><name sortKey="Monetta, Laura" sort="Monetta, Laura" uniqKey="Monetta L" first="Laura" last="Monetta">Laura Monetta</name><affiliation><mods:affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-11">2013-11</date><biblScope unit="volume">84</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1265">1265</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">B3B52F2006DF8D88D1194B4B61131E52385B1473</idno><idno type="DOI">10.1136/jnnp-2013-305021</idno><idno type="href">jnnp-84-1265.pdf</idno><idno type="ArticleID">jnnp-2013-305021</idno><idno type="PMID">23606738</idno><idno type="local">jnnp;84/11/1265</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Christina Tremblay</name><affiliations><json:string>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</json:string><json:string>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</json:string></affiliations></json:item><json:item><name>Amélie M Achim</name><affiliations><json:string>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</json:string><json:string>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, Canada</json:string></affiliations></json:item><json:item><name>Joël Macoir</name><affiliations><json:string>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</json:string><json:string>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</json:string></affiliations></json:item><json:item><name>Laura Monetta</name><affiliations><json:string>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</json:string><json:string>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>PARKINSON'S DISEASE</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>COGNITION</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DEPRESSION</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>META-ANALYSIS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MOVEMENT DISORDERS</value></json:item></subject><articleId><json:string>jnnp-2013-305021</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>review-article</json:string></originalGenre><abstract>Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.</abstract><qualityIndicators><score>7.82</score><pdfWordCount>6100</pdfWordCount><pdfCharCount>39566</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>8</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>235</abstractWordCount><abstractCharCount>1568</abstractCharCount><keywordCount>5</keywordCount></qualityIndicators><title>The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><pmid><json:string>23606738</json:string></pmid><genre><json:string>review-article</json:string></genre><host><title>Journal of Neurology, Neurosurgery & Psychiatry</title><language><json:string>unknown</json:string></language><issn><json:string>0022-3050</json:string></issn><eissn><json:string>1468-330X</json:string></eissn><publisherId><json:string>jnnp</json:string></publisherId><volume>84</volume><issue>11</issue><pages><first>1265</first></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>social science</json:string><json:string>psychiatry</json:string><json:string>science</json:string><json:string>surgery</json:string><json:string>clinical neurology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>neurology & neurosurgery</json:string></scienceMetrix><inist><json:string>sciences humaines et sociales</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/jnnp-2013-305021</json:string></doi><id>B3B52F2006DF8D88D1194B4B61131E52385B1473</id><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api-v5.istex.fr/document/B3B52F2006DF8D88D1194B4B61131E52385B1473/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api-v5.istex.fr/document/B3B52F2006DF8D88D1194B4B61131E52385B1473/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api-v5.istex.fr/document/B3B52F2006DF8D88D1194B4B61131E52385B1473/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</p></availability><date>2013-04-20</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><author xml:id="author-1"><persName><forename type="first">Christina</forename><surname>Tremblay</surname></persName><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation></author><author xml:id="author-2"><persName><forename type="first">Amélie M</forename><surname>Achim</surname></persName><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation><affiliation>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, Canada</affiliation></author><author xml:id="author-3"><persName><forename type="first">Joël</forename><surname>Macoir</surname></persName><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation></author><author xml:id="author-4"><persName><forename type="first">Laura</forename><surname>Monetta</surname></persName><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-11"></date><biblScope unit="volume">84</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1265">1265</biblScope></imprint></monogr><idno type="istex">B3B52F2006DF8D88D1194B4B61131E52385B1473</idno><idno type="DOI">10.1136/jnnp-2013-305021</idno><idno type="href">jnnp-84-1265.pdf</idno><idno type="ArticleID">jnnp-2013-305021</idno><idno type="PMID">23606738</idno><idno type="local">jnnp;84/11/1265</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013-04-20</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>PARKINSON'S DISEASE</term></item><item><term>COGNITION</term></item><item><term>DEPRESSION</term></item><item><term>META-ANALYSIS</term></item><item><term>MOVEMENT DISORDERS</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2013-04-20">Created</change><change when="2013-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api-v5.istex.fr/document/B3B52F2006DF8D88D1194B4B61131E52385B1473/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="review-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp-2013-305021</article-id><article-id pub-id-type="doi">10.1136/jnnp-2013-305021</article-id><article-id pub-id-type="other">jnnp;84/11/1265</article-id><article-id pub-id-type="other">jnnp;jnnp-2013-305021</article-id><article-id pub-id-type="pmid">23606738</article-id><article-id pub-id-type="other">1265</article-id><article-id pub-id-type="other">jnnp-2013-305021</article-id><article-categories><subj-group subj-group-type="heading"><subject>Movement disorders</subject></subj-group><series-title>Review</series-title></article-categories><title-group><article-title>The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Tremblay</surname><given-names>Christina</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Achim</surname><given-names>Amélie M</given-names></name><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Macoir</surname><given-names>Joël</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Monetta</surname><given-names>Laura</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec</addr-line>, <country>Canada</country></aff><aff id="af2"><label>2</label><addr-line>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec</addr-line>, <country>Canada</country></aff><aff id="af3"><label>3</label><addr-line>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec</addr-line>, <country>Canada</country></aff><author-notes><corresp><label>Correspondence to</label> Dr Laura Monetta, Department of clinical and cognitive neuroscience, Institut universitaire en santé mentale de Québec (IUSMQ), 2601, rue de la Canardière, Quebec, Canada G1J 2G3; <email>laura.monetta@rea.ulaval.ca</email></corresp></author-notes><pub-date pub-type="ppub"><month>11</month><year>2013</year></pub-date><pub-date pub-type="epub-original"><day>20</day><month>4</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>20</day><month>4</month><year>2013</year></pub-date><volume>84</volume><volume-id pub-id-type="other">84</volume-id><volume-id pub-id-type="other">84</volume-id><issue>11</issue><issue-id pub-id-type="other">jnnp;84/11</issue-id><issue-id pub-id-type="other">11</issue-id><issue-id pub-id-type="other">84/11</issue-id><fpage>1265</fpage><history><date date-type="received"><day>23</day><month>1</month><year>2013</year></date><date date-type="rev-recd"><day>19</day><month>3</month><year>2013</year></date><date date-type="accepted"><day>20</day><month>3</month><year>2013</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-84-1265.pdf"></self-uri><abstract><p>Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.</p></abstract><kwd-group><kwd>PARKINSON'S DISEASE</kwd><kwd>COGNITION</kwd><kwd>DEPRESSION</kwd><kwd>META-ANALYSIS</kwd><kwd>MOVEMENT DISORDERS</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><partName>Review</partName></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>The heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis</title><partName>Review</partName></titleInfo><name type="personal"><namePart type="given">Christina</namePart><namePart type="family">Tremblay</namePart><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Amélie M</namePart><namePart type="family">Achim</namePart><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation><affiliation>Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joël</namePart><namePart type="family">Macoir</namePart><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Monetta</namePart><affiliation>Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada</affiliation><affiliation>Department of clinical and cognitive neuroscience, Institut Universitaire en santé mentale de Québec, Quebec, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="review-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2013-11</dateIssued><dateCreated encoding="w3cdtf">2013-04-20</dateCreated><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. Some characteristics, like the predominant motor subtypes, as well as the presence of depression, are more widely used to categorise cognitive differences between patients. The goal of this study was to analyse the impact of the type of predominant motor symptoms and depression on cognition in PD. A meta-analysis of 27 studies (from 1989 to 2012) was carried out to calculate the average effect size of these factors on the most often used cognitive test during those past years to evaluate cognitive skills, the Mini-Mental State Examination. The studies analysed showed significant mean weighted effect sizes on cognition for the type of motor symptoms (d=0.42; 95% CI 0.30 to 0.54) and for depression (d=0.52; 95% CI 0.38 to 0.66). These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.</abstract><subject><genre>keywords</genre><topic>PARKINSON'S DISEASE</topic><topic>COGNITION</topic><topic>DEPRESSION</topic><topic>META-ANALYSIS</topic><topic>MOVEMENT DISORDERS</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>84</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1265</start></extent></part></relatedItem><identifier type="istex">B3B52F2006DF8D88D1194B4B61131E52385B1473</identifier><identifier type="DOI">10.1136/jnnp-2013-305021</identifier><identifier type="href">jnnp-84-1265.pdf</identifier><identifier type="ArticleID">jnnp-2013-305021</identifier><identifier type="PMID">23606738</identifier><identifier type="local">jnnp;84/11/1265</identifier><accessCondition type="use and reproduction" contentType="copyright">Published by the BMJ Publishing Group Limited. 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