scholarly journals Quantitative Electroencephalography as a Biomarker for Cognitive Dysfunction in Parkinson’s Disease

2022 ◽  
Vol 13 ◽  
Author(s):  
Kevin Novak ◽  
Bruce A. Chase ◽  
Jaishree Narayanan ◽  
Premananda Indic ◽  
Katerina Markopoulou
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Principal Component ◽  
Disease Stage ◽  
Positive Contribution ◽  
Healthy Controls ◽  
Quantitative Electroencephalography ◽  
Motor Score ◽  
Eeg Recordings

Background: Quantitative electroencephalography (qEEG) has been suggested as a biomarker for cognitive decline in Parkinson’s disease (PD).Objective: Determine if applying a wavelet-based qEEG algorithm to 21-electrode, resting-state EEG recordings obtained in a routine clinical setting has utility for predicting cognitive impairment in PD.Methods: PD subjects, evaluated by disease stage and motor score, were compared to healthy controls (N = 20 each). PD subjects with normal (PDN, MoCA 26–30, N = 6) and impaired (PDD, MoCA ≤ 25, N = 14) cognition were compared. The wavelet-transform based time-frequency algorithm assessed the instantaneous predominant frequency (IPF) at 60 ms intervals throughout entire recordings. We then determined the relative time spent by the IPF in the four standard EEG frequency bands (RTF) at each scalp location. The resting occipital rhythm (ROR) was assessed using standard power spectral analysis.Results: Comparing PD subjects to healthy controls, mean values are decreased for ROR and RTF-Beta, greater for RTF-Theta and similar for RTF-Delta and RTF-Alpha. In logistic regression models, arithmetic combinations of RTF values [e.g., (RTF-Alpha) + (RTF-Beta)/(RTF-Delta + RTF-Theta)] and RTF-Alpha values at occipital or parietal locations are most able to discriminate between PD and controls. A principal component (PC) from principal component analysis (PCA) using RTF-band values in all subjects is associated with PD status (p = 0.004, β = 0.31, AUC = 0.780). Its loadings show positive contribution from RTF-Theta at all scalp locations, and negative contributions from RTF-Beta at occipital, parietal, central, and temporal locations. Compared to cognitively normal PD subjects, cognitively impaired PD subjects have lower median RTF-Alpha and RTF-Beta values, greater RTF-Theta values and similar RTF-Delta values. A PC from PCA using RTF-band values in PD subjects is associated with cognitive status (p = 0.002, β = 0.922, AUC = 0.89). Its loadings show positive contributions from RTF-Theta at all scalp locations, negative contributions from RTF-Beta at central locations, and negative contributions from RTF-Delta at central, frontal and temporal locations. Age, disease duration and/or sex are not significant covariates. No PC was associated with motor score or disease stage.Significance: Analyzing standard EEG recordings obtained in a community practice setting using a wavelet-based qEEG algorithm shows promise as a PD biomarker and for predicting cognitive impairment in PD.

The association between cognitive impairment and neuropsychiatric symptoms in patients with Parkinson's disease dementia

2012 ◽  
Vol 24 (12) ◽  
pp. 1980-1987 ◽  
Author(s):  
Wei-Ju Lee ◽  
Chia-Fen Tsai ◽  
Serge Gauthier ◽  
Shuu-Jiun Wang ◽  
Jong-Ling Fuh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Motor Behavior ◽  
Sleep Problems ◽  
Task Force ◽  
Mmse Score ◽  
Neuropsychiatric Symptoms ◽  
Principal Component ◽  
Principal Component Factor Analysis

ABSTRACTBackground: Neuropsychiatric symptoms (NPS) are common in patients with dementia associated with Parkinson's disease (PDD). The relationship between cognition and NPS in PDD has not been well studied.Methods: Patients diagnosed with PDD were assessed for cognitive function and NPS. The instruments used were the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and semantic verbal fluency according to the recommendation of the Movement Disorder Society Task Force.Results: We evaluated 127 PDD patients (76 males/51 females; mean age 77 ± 6.3 years). Their mean MMSE score was 17 ± 6.5 and the mean NPI score was 19 ± 20.4. The most prevalent NPI items were anxiety (57.5%), sleep problems (53.5%), and apathy (52.0%). Principal component factor analysis revealed that 12 items formed three factors, namely “mood and psychosis” (delusion, hallucination, agitation, depression, anxiety, apathy, and irritability), “vegetative” (sleep and appetite problems), and “frontal” (euphoria, disinhibition, and aberrant motor behavior). Symptoms of hallucination were significantly associated with MMSE score, even after controlling for the confounding variables.Conclusion: NPS are common and diverse among patients with PDD. Three specific subgroups of NPS were identified. Hallucination was significantly correlated with cognitive impairment, and could be a predictor of cognition in PDD patients.

scholarly journals Sensitivity and Specificity of the ECAS in Parkinson’s Disease and Progressive Supranuclear Palsy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer A. Foley ◽  
Elaine H. Niven ◽  
Andrew Paget ◽  
Kailash P. Bhatia ◽  
Simon F. Farmer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Progressive Supranuclear Palsy ◽  
Verbal Fluency ◽  
High Sensitivity ◽  
Healthy Controls ◽  
Diagnostic Challenge ◽  
Motor Disability ◽  
Severe Motor

Disentangling Parkinson’s disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP.

scholarly journals GaborPDNet: Gabor Transformation and Deep Neural Network for Parkinson’s Disease Detection Using EEG Signals

Electronics ◽  
2021 ◽  
Vol 10 (14) ◽  
pp. 1740
Author(s):  
Hui Wen Loh ◽  
Chui Ping Ooi ◽  
Elizabeth Palmer ◽  
Prabal Datta Barua ◽  
Sengul Dogan ◽  
...  
Keyword(s):  
Neural Network ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Decision ◽  
Healthy Controls ◽  
Noninvasive Methods ◽  
Proposed Model ◽  
Tenfold Cross Validation ◽  
Eeg Recordings ◽  
Medication Status

Parkinson’s disease (PD) is globally the most common neurodegenerative movement disorder. It is characterized by a loss of dopaminergic neurons in the substantia nigra of the brain. However, current methods to diagnose PD on the basis of clinical features of Parkinsonism may lead to misdiagnoses. Hence, noninvasive methods such as electroencephalographic (EEG) recordings of PD patients can be an alternative biomarker. In this study, a deep-learning model is proposed for automated PD diagnosis. EEG recordings of 16 healthy controls and 15 PD patients were used for analysis. Using Gabor transform, EEG recordings were converted into spectrograms, which were used to train the proposed two-dimensional convolutional neural network (2D-CNN) model. As a result, the proposed model achieved high classification accuracy of 99.46% (±0.73) for 3-class classification (healthy controls, and PD patients with and without medication) using tenfold cross-validation. This indicates the potential of proposed model to simultaneously automatically detect PD patients and their medication status. The proposed model is ready to be validated with a larger database before implementation as a computer-aided diagnostic (CAD) tool for clinical-decision support.

scholarly journals Clinical utility of the INECO Frontal Screening for detecting Mild Cognitive Impairment in Parkinson’s disease

2019 ◽  
Vol 13 (4) ◽  
pp. 394-402
Author(s):  
Yunier Broche-Pérez ◽  
Danay Bartuste-Marrer ◽  
Miriam Batule-Domínguez ◽  
Filiberto Toledano-Toledano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Cognitive Deficits ◽  
Healthy Controls ◽  
Study Results ◽  
Adequate Accuracy ◽  
Low Performance

ABSTRACT Cognitive deficits in Parkinson’s disease typically affect executive functions. Recently, the concept of Mild Cognitive Impairment (MCI) has been related to PD (PD-MCI). PD-MCI is considered a transition phase to Parkinson’s disease Dementia. Therefore, it is important to identify PD-MCI in a reliable way. Objective: To evaluate the sensitivity and specificity of the INECO Frontal Screening (IFS) in detecting cognitive deficits in PD-MCI. Additionally, we compare the IFS and the Addenbrook Cognitive Examination Revised (ACE-R) between three groups; PD-MCI, MCI, and controls. Methods: The IFS and ACE-R were administered to 36 patients with PD-MCI, 31 with MCI (amnestic-multidomain subtype) and 92 healthy controls. Sensitivity and specificity were determined using ROC analysis. The groups were compared using one-way analysis of variance. Results: The IFS had adequate accuracy in differentiating patients with PD-MCI from healthy controls (AUC=0.77, sensitivity=0.82, specificity=0.77), and good accuracy in differentiating PD-MCI from MCI patients (AUC=0.80, sensitivity=0.82, specificity=0.61). However the IFS had low accuracy in differentiating MCI patients from healthy controls (AUC=0.47, sensitivity=0.52, specificity=0.41). On the ACE-R, the PD-MCI group had low performance in Fluency and Language. Only patients with PD-MCI had difficulties on the IFS, specifically in inhibitory control and visual working memory. This dysexecutive profile explains the sensitivity and specificity values found in the IFS. Conclusion: The present study results suggest that the IFS is a suitable screening tool for exploring cognitive dysfunction in PD-MCI, especially in those patients with a dysexecutive profile.

Systematic Audiological Assessment of Auditory Functioning in Patients With Parkinson's Disease

2019 ◽  
Vol 62 (12) ◽  
pp. 4564-4577 ◽  
Author(s):  
Kim De Keyser ◽  
Miet De Letter ◽  
Evelien De Groote ◽  
Patrick Santens ◽  
Durk Talsma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Auditory Processing ◽  
Otoacoustic Emissions ◽  
Outer Hair Cell ◽  
Speech Audiometry ◽  
Disease Stage ◽  
Sensitivity Index ◽  
Healthy Controls ◽  
Dopaminergic Medication

Purpose Alterations in primary auditory functioning have been reported in patients with Parkinson's disease (PD). Despite the current findings, the pathophysiological mechanisms underlying these alterations remain unclear, and the effect of dopaminergic medication on auditory functioning in PD has been explored insufficiently. Therefore, this study aimed to systematically investigate primary auditory functioning in patients with PD by using both subjective and objective audiological measurements. Method In this case–control study, 25 patients with PD and 25 age-, gender-, and education-matched healthy controls underwent an audiological test battery consisting of tonal audiometry, short increment sensitivity index, otoacoustic emissions (OAEs), and speech audiometry. Patients with PD were tested in the on- and off-medication states. Results Increased OAE amplitudes were found when patients with PD were tested without dopaminergic medication. In addition, speech audiometry in silence and multitalker babble noise demonstrated higher phoneme scores for patients with PD in the off-medication condition. The results showed no differences in auditory functioning between patients with PD in the on-medication condition and healthy controls. No effect of disease stage or motor score was evident. Conclusions This study provides evidence for a top-down involvement in auditory processing in PD at both central and peripheral levels. Most important, the increase in OAE amplitude in the off-medication condition in PD is hypothesized to be linked to a dysfunction of the olivocochlear efferent system, which is known to have an inhibitory effect on outer hair cell functioning. Future studies may clarify whether OAEs may facilitate an early diagnosis of PD.

scholarly journals Features of GBA-associated Parkinson’s disease at presentation in the UK Tracking Parkinson’s study

2018 ◽  
Vol 89 (7) ◽  
pp. 702-709 ◽  
Author(s):  
Naveed Malek ◽  
Rimona S Weil ◽  
Catherine Bresner ◽  
Michael A Lawton ◽  
Katherine A Grosset ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Rating Scale ◽  
Disease Stage ◽  
Baseline Assessment ◽  
Mutation Carriers ◽  
Pathogenic Mutations ◽  
Motor Phenotype

ObjectivesTo examine the influence of the glucocerebrosidase (GBA) mutation carrier state on age at onset of Parkinson’s disease (PD), the motor phenotype and cognitive function at baseline assessment in a large cohort of UK patients. We also analysed the prevalence of mood and behavioural problems that may confound the assessment of cognitive function.MethodsWe prospectively recruited patients with PD in the Tracking Parkinson’s study. We fully sequenced the GBA gene in all recently diagnosed patients (≤3.5 years). We examined cognitive (Montreal Cognitive Assessment) and motor (Movement Disorder Society Unified Parkinson’s Disease Rating Scale part 3) function at a baseline assessment, at an average of 1.3 years after diagnosis. We used logistic regression to determine predictors of PD with mild cognitive impairment and PD with dementia.ResultsWe studied 1893 patients with PD: 48 (2.5%) were heterozygous carriers for known Gaucher’s disease (GD) causing pathogenic mutations; 117 (6.2%) had non-synonymous variants, previously associated with PD, and 28 (1.5%) patients carried variants of unknown significance in the GBA gene. L444P was the most common pathogenic GBA mutation. Patients with pathogenic GBA mutations were on average 5 years younger at disease onset compared with non-carriers (P=0.02). PD patients with GD-causing mutations did not have an increased family risk of PD. Patients with GBA mutations were more likely to present with the postural instability gait difficulty phenotype compared with non-carriers (P=0.02). Patients carrying pathogenic mutations in GBA had more advanced Hoehn and Yahr stage after adjustment for age and disease duration compared with non-carriers (P=0.005). There were no differences in cognitive function between GBA mutation carriers and non-carriers at this early disease stage.ConclusionsOur study confirms the influence of GBA mutations on the age of onset, disease severity and motor phenotype in patients with PD. Cognition did not differ between GBA mutation carriers and non-carriers at baseline, implying that cognitive impairment/dementia, reported in other studies at a later disease stage, is not present in recently diagnosed cases. This offers an important window of opportunity for potential disease-modifying therapy that may protect against the development of dementia in GBA-PD.Clinical trial registrationNCT02881099; Results.

Contribution of Quantitative EEG to the Diagnosis of Early Cognitive Impairment in Patients With Idiopathic Parkinson’s Disease

2016 ◽  
Vol 48 (5) ◽  
pp. 348-354 ◽  
Author(s):  
Derya Guner ◽  
Bedile Irem Tiftikcioglu ◽  
Nilgun Tuncay ◽  
Yasar Zorlu
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Neuropsychological Assessment ◽  
Verbal Memory ◽  
Quantitative Eeg ◽  
Bioelectrical Activity ◽  
Healthy Controls ◽  
Assessment Battery ◽  
Neuropsychological Assessment Battery

Cognitive dysfunction can emerge during the clinical course of Parkinson’s disease (PD) even beginning in early stages, which requires extended neuropsychological tests for diagnosis. There is need for rapid, feasible, and practical tests in clinical practice to diagnose and monitor the patients without causing any discomfort. We investigated the utility of quantitative analysis of digital EEG (qEEG) for diagnosing subtle cognitive impairment in PD patients without evident cognitive deficits (ie, “normal cognition”). We enrolled 45 patients with PD and age- matched 39 healthy controls in the study. All participants had Mini-Mental State Examination (MMSE) score greater than 25. qEEG analysis and extensive neuropsychological assessment battery were applied to all participants. Test scores for frontal executive functions, verbal memory processes, attention span, and visuospatial functions were significantly lower than healthy controls ( P < .01). qEEG analysis revealed a significant increase in delta, theta, and beta frequencies, and decrease in alpha frequency band in cerebral bioelectrical activity in patient group. In addition, power spectral ratios ([alpha + beta] / [delta + theta]) in frontal, central, temporal, parietal, and occipital regions were significantly decreased in patients compared with the controls. The slowing in EEG was moderately correlated with MMSE scores ( r = 0.411-0.593; P < .01). However, qEEG analysis and extensive neuropsychological assessment battery were only in weak correlation ( r = 0.230-0.486; P < .05). In conclusion, qEEG analysis could increase the diagnostic power in detecting subtle cognitive impairment in PD patients without evident cognitive deficit, perhaps years before the clinical onset of dementia.

scholarly journals The activity of markers of oxidative and nitrosative stresses in blood plasma of Parkinson’s disease patients at the early stages

Pathologia ◽  
2021 ◽  
Vol 18 (2) ◽  
pp. 183-188
Author(s):  
A. V. Demchenko ◽  
V. V. Biriuk ◽  
A. V. Abramov
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Blood Plasma ◽  
Emotional Disorders ◽  
Healthy Controls ◽  
Early Stages ◽  
Gpx Activity ◽  
Gst Activity ◽  
In Blood Plasma

The aim of the study is to investigate activity of markers of oxidative and nitrosative stresses in blood plasma of patients in the I–II stages of Parkinson’s disease (PD) and to determine correlations between their concentrations and severity of non-motor PD symptoms. Materials and methods. 67 patients at I–II PD stages and 20 healthy controls took part in the research. Cognitive functions were examined due to the Montreal Cognitive Assessment test – MoCA test. For the severity of psycho-emotional disorders evaluation the following scales and questionnaires were used: Night Sleep Assessment Questionnaire by A. M. Vein, Zung test for anxiety, apathy Starkstein scale, Boston stress-resistance test, Beck Depression Inventory (BDI-II). We performed ELISA test for determination of glutathione peroxidase (GPx) and glutathione-S-transferase (GST) activities and 3-nitrotyrosine (3-NT) level in blood plasma of participants (Elabscience® kit). Results. The middle age of PD patients and healthy controls was 64.35 ± 1.22 and 66.40 ± 0.70 years, respectively. GPx activity in plasma of patients at І–ІІ PD stages was significantly lower than in healthy controls (P < 0.001) and was higher at the I stage compared to the II PD stage (P = 0.003). Also GPx activity in PD patients with normal cognition was higher than in PD patients with cognitive impairment (P = 0.042). The GST activity in plasma of PD patients with anxiety was significantly lower (P = 0.002) compared to those without anxiety, and 3-NT blood plasma level in PD patients with moderate anxiety was higher than in those without one (P = 0.029). Conclusions. The activity of antioxidant GPx was significantly lower in PD patients at early stages compared to healthy controls, and in PD patients in the II stage of the disease compared to the I stage, and it was significantly lower in PD patients with cognitive impairment. PD patients with moderate anxiety had lower 3-NT levels and GST activity in blood plasma.

scholarly journals Neuropsychiatric Symptoms in Parkinson’s Disease with and without Mild Cognitive Impairment

2019 ◽  
Vol 34 (7) ◽  
pp. 1238-1238
Author(s):  
Y Bocanegra ◽  
A Baena ◽  
J Carmona ◽  
D C Aguirre ◽  
D Pineda ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Task Force ◽  
Neuropsychiatric Symptoms ◽  
Disease Stage ◽  
Disease Rating ◽  
Level I

Abstract Objective Neuropsychiatric symptoms (NPS) are common clinical features of patients with Parkinson’s disease (PD). However, such symptoms in non-demented PD patients have scarcely been investigated. To address this issue, we describe the neuropsychiatric profile in PD patients with and without Mild Cognitive Impairment (MCI). Participants and Method Eighty non-demented PD patients were included. The patients were divided into two groups depending on the presence or absence of MCI (PD-MCI and PD-nMCI, respectively). MCI diagnosis was made according to the Movement Disorder Society Task Force Level I criteria. NPS were evaluated using the Neuropsychiatric Inventory (NPI). For each domain, the presence and magnitude of symptoms (frequency x severity) was calculated. The total NPI score was also computed, in which higher scores suggest greater behavioral disturbance. Results PD-nMCI (n = 59, 74%) and PD-MCI (n = 21, 26%) groups were similar in the disease stage and years since diagnosis. In contrast with the PD-nMCI group, participants in the PD-MCI group were older. Fourteen PD-MCI (66%) and 45 PD-nMCI (76%) patients reported at least one neuropsychiatric symptom in the previous month. In both groups, the most frequent NPS were sleep disorders, depression, anxiety, apathy, irritability, and disinhibition. Additionally, the proportion of these symptoms between groups did not differ significantly (p &gt; 0.05). There was only a tendency of greater score in the disinhibition subscale in PD-MCI group (p &lt; 0.02). In both groups, NPS were not associated with clinical variables (years since diagnosis, Unified Parkinson's Disease Rating Scale -III) after adjusting for age. Conclusions Preliminary findings suggest that NPS are frequent in PD patients independent of the degree of cognitive impairment, and they may encompass non-motor features of the clinical spectrum of the disease. Further longitudinal investigations are needed to determine whether such symptoms may predict the cognitive decline in these patients.

scholarly journals Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE)

2008 ◽  
Vol 2 (3) ◽  
pp. 197-200 ◽  
Author(s):  
Anabel Chade ◽  
María Roca ◽  
Teresa Torralva ◽  
Ezequiel Gleichgerrcht ◽  
Nicolás Fabbro ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Status ◽  
Screening Tools ◽  
Spanish Version ◽  
Healthy Controls ◽  
Cognitive Difficulties ◽  
Dementia Patients ◽  
Addenbrooke’S Cognitive Examination

Abstract Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. Objective: The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE) is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. Methods: 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia), 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Results: Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. Conclusions: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

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