Cognitive impairment in Parkinson's disease
Identifieur interne : 000251 ( Pmc/Checkpoint ); précédent : 000250; suivant : 000252Cognitive impairment in Parkinson's disease
Auteurs : D. Verbaan ; J. Marinus ; M. Visser ; S Van ; A Stiggelbout ; H. Middelkoop ; J VanSource :
- Journal of Neurology, Neurosurgery, and Psychiatry [ 0022-3050 ] ; 2007.
Abstract
Cognitive impairment plays a role in Parkinson's disease (PD) and has important consequences for patient management. However, many aspects of cognitive impairment in PD remain unclear because of the use of different and often invalid measurement instruments. In this study, a reliable and valid instrument, the SCales for Outcomes in PArkinson's disease‐COGnition (SCOPA‐COG), was used.
To evaluate cognitive functioning in a large cohort of patients with Parkinson's disease and to assess the relations with demographic, disease related and clinical variables.
A cohort of 400 patients with PD was evaluated for cognition, motor and non‐motor domains, as well as for demographic and disease related characteristics. Results were compared with 150 controls matched for overall age, sex and education distribution.
Patients with PD scored significantly lower on all cognitive subdomains compared with controls, with the largest differences for executive functioning and memory. After correction for age and years of education, 22% of patients had impaired cognition, as measured by the total SCOPA‐COG score, compared with controls. Across all patients, more severe cognitive impairment was associated with significantly more impairment in motor, autonomic, depressive and psychotic domains. Patients with the postural instability gait difficulty (PIGD) dominant phenotype showed more cognitive impairment compared with patients with the tremor dominant phenotype. Contrary to tremor scores, PIGD scores significantly worsened with increasing disease severity.
Cognition is an important domain of the clinical spectrum of PD and poorer cognitive performance is associated with greater impairment in motor and non‐motor domains in PD. The difference in cognitive scores between PIGD dominant patients and tremor dominant patients likely reflects more advanced disease.
Url:
DOI: 10.1136/jnnp.2006.112367
PubMed: 17442759
PubMed Central: 2117586
Affiliations:
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<author><name sortKey="Verbaan, D" sort="Verbaan, D" uniqKey="Verbaan D" first="D" last="Verbaan">D. Verbaan</name>
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<author><name sortKey="Marinus, J" sort="Marinus, J" uniqKey="Marinus J" first="J" last="Marinus">J. Marinus</name>
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<author><name sortKey="Visser, M" sort="Visser, M" uniqKey="Visser M" first="M" last="Visser">M. Visser</name>
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<author><name sortKey="Van Rooden, S M" sort="Van Rooden, S M" uniqKey="Van Rooden S" first="S" last="Van">S Van</name>
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<author><name sortKey="Stiggelbout, A M" sort="Stiggelbout, A M" uniqKey="Stiggelbout A" first="A" last="Stiggelbout">A Stiggelbout</name>
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<author><name sortKey="Middelkoop, H A M" sort="Middelkoop, H A M" uniqKey="Middelkoop H" first="H" last="Middelkoop">H. Middelkoop</name>
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<author><name sortKey="Van Hilten, J J" sort="Van Hilten, J J" uniqKey="Van Hilten J" first="J" last="Van">J Van</name>
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<author><name sortKey="Visser, M" sort="Visser, M" uniqKey="Visser M" first="M" last="Visser">M. Visser</name>
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<author><name sortKey="Van Rooden, S M" sort="Van Rooden, S M" uniqKey="Van Rooden S" first="S" last="Van">S Van</name>
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<author><name sortKey="Stiggelbout, A M" sort="Stiggelbout, A M" uniqKey="Stiggelbout A" first="A" last="Stiggelbout">A Stiggelbout</name>
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<author><name sortKey="Middelkoop, H A M" sort="Middelkoop, H A M" uniqKey="Middelkoop H" first="H" last="Middelkoop">H. Middelkoop</name>
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<series><title level="j">Journal of Neurology, Neurosurgery, and Psychiatry</title>
<idno type="ISSN">0022-3050</idno>
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<imprint><date when="2007">2007</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Cognitive impairment plays a role in Parkinson's disease (PD) and has important consequences for patient management. However, many aspects of cognitive impairment in PD remain unclear because of the use of different and often invalid measurement instruments. In this study, a reliable and valid instrument, the SCales for Outcomes in PArkinson's disease‐COGnition (SCOPA‐COG), was used.</p>
</sec>
<sec><title>Aim</title>
<p>To evaluate cognitive functioning in a large cohort of patients with Parkinson's disease and to assess the relations with demographic, disease related and clinical variables.</p>
</sec>
<sec><title>Methods</title>
<p>A cohort of 400 patients with PD was evaluated for cognition, motor and non‐motor domains, as well as for demographic and disease related characteristics. Results were compared with 150 controls matched for overall age, sex and education distribution.</p>
</sec>
<sec><title>Results</title>
<p>Patients with PD scored significantly lower on all cognitive subdomains compared with controls, with the largest differences for executive functioning and memory. After correction for age and years of education, 22% of patients had impaired cognition, as measured by the total SCOPA‐COG score, compared with controls. Across all patients, more severe cognitive impairment was associated with significantly more impairment in motor, autonomic, depressive and psychotic domains. Patients with the postural instability gait difficulty (PIGD) dominant phenotype showed more cognitive impairment compared with patients with the tremor dominant phenotype. Contrary to tremor scores, PIGD scores significantly worsened with increasing disease severity.</p>
</sec>
<sec><title>Conclusions</title>
<p>Cognition is an important domain of the clinical spectrum of PD and poorer cognitive performance is associated with greater impairment in motor and non‐motor domains in PD. The difference in cognitive scores between PIGD dominant patients and tremor dominant patients likely reflects more advanced disease.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id>
<journal-title>Journal of Neurology, Neurosurgery, and Psychiatry</journal-title>
<issn pub-type="ppub">0022-3050</issn>
<issn pub-type="epub">1468-330X</issn>
<publisher><publisher-name>BMJ Group</publisher-name>
</publisher>
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<article-meta><article-id pub-id-type="pmid">17442759</article-id>
<article-id pub-id-type="pmc">2117586</article-id>
<article-id pub-id-type="publisher-id">jn112367</article-id>
<article-id pub-id-type="doi">10.1136/jnnp.2006.112367</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Paper</subject>
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<title-group><article-title>Cognitive impairment in Parkinson's disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Verbaan</surname>
<given-names>D</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Marinus</surname>
<given-names>J</given-names>
</name>
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<contrib contrib-type="author"><name><surname>Visser</surname>
<given-names>M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>van Rooden</surname>
<given-names>S M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Stiggelbout</surname>
<given-names>A M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Middelkoop</surname>
<given-names>H A M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>van Hilten</surname>
<given-names>J J</given-names>
</name>
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<aff><bold>D Verbaan</bold>
,<bold>J Marinus</bold>
,<bold>M Visser</bold>
,<bold>S M van Rooden</bold>
,<bold>J J van Hilten</bold>
, Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands</aff>
<aff><bold>A M Stiggelbout</bold>
, Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands</aff>
<aff><bold>H A M Middelkoop</bold>
, Department of Neuropsychology, Leiden University Medical Centre, Leiden, the Netherlands</aff>
<author-notes><corresp>Correspondence to: D Verbaan</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="epub"><day>18</day>
<month>4</month>
<year>2007</year>
</pub-date>
<volume>78</volume>
<issue>11</issue>
<fpage>1182</fpage>
<lpage>1187</lpage>
<history><date date-type="received"><day>1</day>
<month>12</month>
<year>2006</year>
</date>
<date date-type="rev-recd"><day>7</day>
<month>3</month>
<year>2007</year>
</date>
<date date-type="accepted"><day>19</day>
<month>3</month>
<year>2007</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2007 BMJ Publishing Group Ltd</copyright-statement>
</permissions>
<abstract><sec><title>Background</title>
<p>Cognitive impairment plays a role in Parkinson's disease (PD) and has important consequences for patient management. However, many aspects of cognitive impairment in PD remain unclear because of the use of different and often invalid measurement instruments. In this study, a reliable and valid instrument, the SCales for Outcomes in PArkinson's disease‐COGnition (SCOPA‐COG), was used.</p>
</sec>
<sec><title>Aim</title>
<p>To evaluate cognitive functioning in a large cohort of patients with Parkinson's disease and to assess the relations with demographic, disease related and clinical variables.</p>
</sec>
<sec><title>Methods</title>
<p>A cohort of 400 patients with PD was evaluated for cognition, motor and non‐motor domains, as well as for demographic and disease related characteristics. Results were compared with 150 controls matched for overall age, sex and education distribution.</p>
</sec>
<sec><title>Results</title>
<p>Patients with PD scored significantly lower on all cognitive subdomains compared with controls, with the largest differences for executive functioning and memory. After correction for age and years of education, 22% of patients had impaired cognition, as measured by the total SCOPA‐COG score, compared with controls. Across all patients, more severe cognitive impairment was associated with significantly more impairment in motor, autonomic, depressive and psychotic domains. Patients with the postural instability gait difficulty (PIGD) dominant phenotype showed more cognitive impairment compared with patients with the tremor dominant phenotype. Contrary to tremor scores, PIGD scores significantly worsened with increasing disease severity.</p>
</sec>
<sec><title>Conclusions</title>
<p>Cognition is an important domain of the clinical spectrum of PD and poorer cognitive performance is associated with greater impairment in motor and non‐motor domains in PD. The difference in cognitive scores between PIGD dominant patients and tremor dominant patients likely reflects more advanced disease.</p>
</sec>
</abstract>
</article-meta>
</front>
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<tree><noCountry><name sortKey="Marinus, J" sort="Marinus, J" uniqKey="Marinus J" first="J" last="Marinus">J. Marinus</name>
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<name sortKey="Stiggelbout, A M" sort="Stiggelbout, A M" uniqKey="Stiggelbout A" first="A" last="Stiggelbout">A Stiggelbout</name>
<name sortKey="Van Hilten, J J" sort="Van Hilten, J J" uniqKey="Van Hilten J" first="J" last="Van">J Van</name>
<name sortKey="Van Rooden, S M" sort="Van Rooden, S M" uniqKey="Van Rooden S" first="S" last="Van">S Van</name>
<name sortKey="Verbaan, D" sort="Verbaan, D" uniqKey="Verbaan D" first="D" last="Verbaan">D. Verbaan</name>
<name sortKey="Visser, M" sort="Visser, M" uniqKey="Visser M" first="M" last="Visser">M. Visser</name>
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