Mild cognitive impairment and cognitive-motor relationships in newly diagnosed drug-naive patients with Parkinson's disease
Identifieur interne : 000034 ( Main/Exploration ); précédent : 000033; suivant : 000035Mild cognitive impairment and cognitive-motor relationships in newly diagnosed drug-naive patients with Parkinson's disease
Auteurs : Michele Poletti [Italie] ; Daniela Frosini [Italie] ; Cristina Pagni [Italie] ; Filippo Baldacci [Italie] ; Valentina Nicoletti [Italie] ; Gloria Tognoni [Italie] ; Claudio Lucetti [Italie] ; Paolo Del Dotto [Italie] ; Roberto Ceravolo [Italie] ; Ubaldo Bonuccelli [Italie]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-06.
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.
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DOI: 10.1136/jnnp-2011-301874
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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="2012-06">2012-06</date><biblScope unit="volume">83</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="601">601</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">F386F32B211EE0002A2816769E9F397F7BF506C4</idno><idno type="DOI">10.1136/jnnp-2011-301874</idno><idno type="href">jnnp-83-601.pdf</idno><idno type="ArticleID">jnnp-2011-301874</idno><idno type="PMID">22492216</idno><idno type="local">jnnp;83/6/601</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">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.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Poletti, Michele" sort="Poletti, Michele" uniqKey="Poletti M" first="Michele" last="Poletti">Michele Poletti</name></noRegion><name sortKey="Baldacci, Filippo" sort="Baldacci, Filippo" uniqKey="Baldacci F" first="Filippo" last="Baldacci">Filippo Baldacci</name><name sortKey="Baldacci, Filippo" sort="Baldacci, Filippo" uniqKey="Baldacci F" first="Filippo" last="Baldacci">Filippo Baldacci</name><name sortKey="Bonuccelli, Ubaldo" sort="Bonuccelli, Ubaldo" uniqKey="Bonuccelli U" first="Ubaldo" last="Bonuccelli">Ubaldo Bonuccelli</name><name sortKey="Bonuccelli, Ubaldo" sort="Bonuccelli, Ubaldo" uniqKey="Bonuccelli U" first="Ubaldo" last="Bonuccelli">Ubaldo Bonuccelli</name><name sortKey="Bonuccelli, Ubaldo" sort="Bonuccelli, Ubaldo" uniqKey="Bonuccelli U" first="Ubaldo" last="Bonuccelli">Ubaldo Bonuccelli</name><name sortKey="Ceravolo, Roberto" sort="Ceravolo, Roberto" uniqKey="Ceravolo R" first="Roberto" last="Ceravolo">Roberto Ceravolo</name><name sortKey="Del Dotto, Paolo" sort="Del Dotto, Paolo" uniqKey="Del Dotto P" first="Paolo" last="Del Dotto">Paolo Del Dotto</name><name sortKey="Frosini, Daniela" sort="Frosini, Daniela" uniqKey="Frosini D" first="Daniela" last="Frosini">Daniela Frosini</name><name sortKey="Lucetti, Claudio" sort="Lucetti, Claudio" uniqKey="Lucetti C" first="Claudio" last="Lucetti">Claudio Lucetti</name><name sortKey="Nicoletti, Valentina" sort="Nicoletti, Valentina" uniqKey="Nicoletti V" first="Valentina" last="Nicoletti">Valentina Nicoletti</name><name sortKey="Pagni, Cristina" sort="Pagni, Cristina" uniqKey="Pagni C" first="Cristina" last="Pagni">Cristina Pagni</name><name sortKey="Poletti, Michele" sort="Poletti, Michele" uniqKey="Poletti M" first="Michele" last="Poletti">Michele Poletti</name><name sortKey="Tognoni, Gloria" sort="Tognoni, Gloria" uniqKey="Tognoni G" first="Gloria" last="Tognoni">Gloria Tognoni</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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