Controlled study of decision-making and cognitive impairment in Parkinson's disease.
Identifieur interne : 001C56 ( Ncbi/Curation ); précédent : 001C55; suivant : 001C57Controlled study of decision-making and cognitive impairment in Parkinson's disease.
Auteurs : Javier Pagonabarraga [Espagne] ; Carmen García-Sánchez ; Gisela Llebaria ; Berta Pascual-Sedano ; Alexandre Gironell ; Jaime KulisevskySource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- MESH :
- complications : Parkinson Disease.
- etiology : Cognition Disorders.
- physiology : Decision Making.
- Aged, Case-Control Studies, Female, Humans, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Prospective Studies, Severity of Illness Index, Statistics, Nonparametric.
Abstract
Impulse control disorders (ICD) related to reward-processing dysfunction have been reported in Parkinson's disease (PD). The relationship between clinical markers of limbic dysfunction with demographic variables and cognitive status of PD is incompletely known. Our objective was to further characterize the relationship between limbic and cognitive dysfunction in a representative sample of nondemented PD patients without antecedents of ICD, as assessed by a risk-taking test of decision-making and a comprehensive neuropsychological battery. Prospective, controlled study of 35 nondemented PD patients and 31 matched controls who received the Iowa gambling task (IGT), the Mattis Dementia Rating Scale (MDRS) and verbal fluencies for global cognitive function, the Stroop and digit span tests for executive function, and the Rey Auditory Verbal Learning Test for memory. Compared to controls, PD patients performed significantly worse on the IGT. No clear relationship with demographic variables including dopaminergic treatment and motor response to levodopa (stable or fluctuating) emerged. Performance on the IGT was not related to executive function. In contrast, an inverse relationship was found between the IGT and memory and global cognitive performance, with patients with the better MDRS and memory scores performing significantly worse on the IGT. Our results confirm subclinical dysfunction of the limbic system in nondemented PD patients. Although impaired decision-making appears unrelated to executive dysfunction, patients with the better cognitive status appears more prone to assume risky behaviors.
DOI: 10.1002/mds.21457
PubMed: 17534944
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pubmed:17534944Le document en format XML
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<author><name sortKey="Garcia Sanchez, Carmen" sort="Garcia Sanchez, Carmen" uniqKey="Garcia Sanchez C" first="Carmen" last="García-Sánchez">Carmen García-Sánchez</name>
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<author><name sortKey="Pascual Sedano, Berta" sort="Pascual Sedano, Berta" uniqKey="Pascual Sedano B" first="Berta" last="Pascual-Sedano">Berta Pascual-Sedano</name>
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<author><name sortKey="Pascual Sedano, Berta" sort="Pascual Sedano, Berta" uniqKey="Pascual Sedano B" first="Berta" last="Pascual-Sedano">Berta Pascual-Sedano</name>
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<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Parkinson Disease (complications)</term>
<term>Prospective Studies</term>
<term>Severity of Illness Index</term>
<term>Statistics, Nonparametric</term>
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<term>Humans</term>
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<term>Mental Status Schedule</term>
<term>Middle Aged</term>
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<front><div type="abstract" xml:lang="en">Impulse control disorders (ICD) related to reward-processing dysfunction have been reported in Parkinson's disease (PD). The relationship between clinical markers of limbic dysfunction with demographic variables and cognitive status of PD is incompletely known. Our objective was to further characterize the relationship between limbic and cognitive dysfunction in a representative sample of nondemented PD patients without antecedents of ICD, as assessed by a risk-taking test of decision-making and a comprehensive neuropsychological battery. Prospective, controlled study of 35 nondemented PD patients and 31 matched controls who received the Iowa gambling task (IGT), the Mattis Dementia Rating Scale (MDRS) and verbal fluencies for global cognitive function, the Stroop and digit span tests for executive function, and the Rey Auditory Verbal Learning Test for memory. Compared to controls, PD patients performed significantly worse on the IGT. No clear relationship with demographic variables including dopaminergic treatment and motor response to levodopa (stable or fluctuating) emerged. Performance on the IGT was not related to executive function. In contrast, an inverse relationship was found between the IGT and memory and global cognitive performance, with patients with the better MDRS and memory scores performing significantly worse on the IGT. Our results confirm subclinical dysfunction of the limbic system in nondemented PD patients. Although impaired decision-making appears unrelated to executive dysfunction, patients with the better cognitive status appears more prone to assume risky behaviors.</div>
</front>
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