scholarly journals Constipation and sleep behaviour disorder associate with processing speed and attention in males with Parkinson’s disease over five years follow-up

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wee Lee Kong ◽  
Yue Huang ◽  
Elizabeth Qian ◽  
Margaret J. Morris

Abstract Constipation and REM sleep behaviour disorder (RBD) are the earliest non-motor manifestations of Parkinson’s disease (PD). Among non-motor symptoms of PD, it is unclear whether constipation and RBD at early stages of PD are related to cognitive outcomes at later stages. Herein, this study aims to investigate whether the presence of constipation and RBD have an impact on future cognitive outcomes in PD. Access to Parkinson’s Progression Markers Initiative (PPMI) database of 360 PD patients with longitudinal observation was requested. Constipation, probable RBD (pRBD) and neuropsychological task scores of PD patients were assessed at baseline and after 5 years. Linear mixed-effects modelling, controlling for gender, age, years of education and LEDD was used to evaluate the association between baseline constipation, pRBD and cognitive performance on follow-up. Gender differences in neuropsychological test performances were found, with men having worse global cognition, speed-attention processing, verbal learning and memory than women at early stages of the disease. We found constipation and pRBD are strongly associated with future decline in some cognitive measures among PD patients, more prominently in men. Our data suggest that early assessment of pRBD and constipation may allow better understanding of the progression of cognitive changes in later phases of PD.

2009 ◽  
Vol 61 (3) ◽  
pp. 164-170 ◽  
Author(s):  
Asako Yoritaka ◽  
Hideki Ohizumi ◽  
Shigeki Tanaka ◽  
Nobutaka Hattori

2019 ◽  
Vol 267 (1) ◽  
pp. 259-266
Author(s):  
Aleksander H. Erga ◽  
Guido Alves ◽  
Ole Bjørn Tysnes ◽  
Kenn Freddy Pedersen

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.


2019 ◽  
pp. jnnp-2019-320858 ◽  
Author(s):  
Panagiotis Bargiotas ◽  
Ines Debove ◽  
Ioannis Bargiotas ◽  
Martin Lenard Lachenmayer ◽  
Maria Ntafouli ◽  
...  

BackgroundAlthough rapid eye movement sleep behaviour disorder (RBD) in Parkinson’s disease (PD) is associated with increased non-motor symptoms, its impact on the deep brain stimulation (DBS) outcome remains unclear. This is the first study to compare the post-DBS outcome between PD patients with RBD (PD-RBD+) and without (PD-RBD-).MethodsWe analysed data from PD patients who were treated with bilateral DBS in the nucleus subthalamicus. Assessments included night-polysomnography (only pre-DBS), and motor and non-motor assessments pre-DBS and post-DBS.ResultsAmong 50 PD patients (29 males, mean age 62.5 years, 11.8 mean PD years), 24 (48%) had RBD. Pre-DBS, the two groups were equal in respect to sociodemographic features, disease duration and PD medications. A multivariate analysis showed that the clinical profile linked to motor, non-motor and quality of life features differed significantly between PD patients with and without RBD. The most discriminative elements were Unified Parkinson’s Disease Rating Scale (UPDRS)-III, apathy and depression scores. Post-DBS, UPDRS-III, Epworth sleepiness scale and PD questionnaire improved significantly in both groups. UPDRS-II scores significantly improved in the PD-RBD+ group (−45%) but remained unchanged in the PD-RBD- group (−14%). The depression score improved significantly in the PD-RBD+ (−34%) and remained unchanged in the PD-RBD- group. The apathy score remained unchanged in the PD-RBD+ group but increased significantly in the PD-RBD- group (+33%).ConclusionWhile pre-DBS, PD patients with and without RBD showed different clinical profiles, post-DBS, the clinical profiles were comparable between the two groups. In respect to depressive symptoms, apathy and activities of daily living, PD-RBD+ patients show favourable post-DBS outcome. These findings highlight the importance of RBD assessment prior to DBS surgery.


2019 ◽  
Vol 26 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Ece Bayram ◽  
Sarah J. Banks ◽  
Guogen Shan ◽  
Nikki Kaplan ◽  
Jessica Z.K. Caldwell

AbstractObjective:To evaluate the sex differences in cognitive course over 4 years in Parkinson’s disease (PD) patients with and without mild cognitive impairment (MCI) compared to controls.Methods:Four-year longitudinal cognitive scores of 257 cognitively intact PD, 167 PD-MCI, and 140 controls from the Parkinson’s Progression Markers Initiative were included. Longitudinal scores of men and women, and PD with and without MCI were compared.Results:Women had better verbal memory, men had better visuospatial function. There was no interaction between sex, diagnostic group, and/or time (4-year follow-up period).Conclusions:Sex differences in cognitive course in de novo PD are similar to healthy aging. Cognitive decline rates in PD with and without MCI are similar for the first 4 years of PD.


Brain ◽  
2019 ◽  
Vol 142 (7) ◽  
pp. 2051-2067 ◽  
Author(s):  
Seyed-Mohammad Fereshtehnejad ◽  
Chun Yao ◽  
Amelie Pelletier ◽  
Jacques Y Montplaisir ◽  
Jean-François Gagnon ◽  
...  

Abstract Parkinson’s disease has a long prodromal stage with various subclinical motor and non-motor manifestations; however, their evolution in the years before Parkinson’s disease is diagnosed is unclear. We traced the evolution of early motor and non-motor manifestations of synucleinopathy from the stage of idiopathic rapid eye movement (REM) sleep behaviour disorder until defined neurodegenerative disease. During 2004–16, we recruited and then annually followed 154 polysomnography-proven patients with idiopathic REM sleep behaviour disorder, of whom 55 phenoconverted to defined parkinsonism or dementia. Longitudinal data on multiple prodromal features, including the Unified Parkinson’s Disease Rating Scale parts I–III, quantitative motor tests, olfaction, colour vision, cognition, and autonomic functions were gathered annually (average = five follow-up visits, range: 2–12 years). The same measures were also assessed in 102 age- and sex-matched healthy control subjects. By looking backward from the time of dementia or parkinsonism diagnosis, we examined trajectories of each prodromal feature using mixed effect models. Based on analysis, olfactory loss was first to develop, with predicted onset >20 years before phenoconversion. This was followed by impaired colour vision, constipation, and erectile dysfunction, starting 10–16 years prior to phenoconversion. At 7–9 years before phenoconversion, slight urinary dysfunction and subtle cognitive decline could be detected. Among motor symptoms altered handwriting, turning in bed, walking, salivation, speech, and facial expression began to be disrupted starting 7–11 years prior to parkinsonism diagnosis, but remained mild until soon before phenoconversion. Motor examination abnormalities began 5–7 years before phenoconversion, with the alternate tap test having the longest interval (8 years before phenoconversion). Among cardinal motor phenotypes, bradykinesia appeared first, ∼5–6 years prior to phenoconversion, followed by rigidity (Year −3) and tremor (Year −2). With direct prospective evaluation of an idiopathic REM sleep behaviour disorder cohort during phenoconversion, we documented an evolution of prodromal manifestations similar to that predicted by pathological staging models, with predicted prodromal intervals as long as 20 years.


2010 ◽  
Vol 16 (4) ◽  
pp. 265-269 ◽  
Author(s):  
M. Zibetti ◽  
L. Rizzi ◽  
L. Colloca ◽  
A. Cinquepalmi ◽  
S. Angrisano ◽  
...  

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