scholarly journals Perspectives of Cognitive Impairment and Behavioral Disturbances in Parkinson’s Disease Dementia

2021 ◽  
Author(s):  
Beatriz Munoz Ospina ◽  
Valentina Quintana-Peña ◽  
Daniela Alvarez ◽  
Jaime A. Valderrama ◽  
Yuri Takeuchi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Behavioral Problems ◽  
Negative Impact ◽  
Functional Independence ◽  
Parkinson’S Disease Dementia ◽  
Behavioral Disturbances ◽  
Visuospatial Abilities ◽  
Anxiety Depression

Parkinson’s disease dementia is a critical stage of the disease because that has a negative impact on the quality of life and functional independence in activities daily living. How the cognition progress to dementia is a key to be explored. The cognitive impairment shows two profiles: cortical (memory encoding, visuospatial abilities, and language) and subcortical, with a dysexecutive syndrome that includes deficits in recognition memory, attention processes, and visual perception as well as visual hallucinations and cognitive fluctuations. Behavioral problems such as apathy, anxiety, depression, and impulse control disorders take a significant part in the loss of autonomy and progression of the disease. To detect the risk of Parkinson’s disease dementia development, the integral evaluation of patients in all stages of the disease should consider the interplay of genetic and epigenetic factors, motor subtypes, and non-motor symptoms (NMS) in order to implement different therapeutics and supportive strategies when they are likely to have efficacy.

scholarly journals Predicting Future Cognitive Impairment in De Novo Parkinson's Disease Using Clinical Data and Structural MRI

2021 ◽  
Author(s):  
Nicola Smith ◽  
Owen A Williams ◽  
Lucia Ricciardi ◽  
Francesca Morgante ◽  
Thomas R Barrick ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Grey Matter ◽  
Temporal Cortex ◽  
Cognitive Status ◽  
Support Vector ◽  
Parkinson’S Disease Dementia ◽  
Lingual Gyrus

BACKGROUND Parkinson's disease is the second most common neurodegenerative condition and associated with increasing cognitive dysfunction as the disease progresses. However, subtle cognitive deficits can be detected at diagnosis in 42% of individuals, suggesting that damage may already be present. Our aim was to determine clinical and structural differences in those recently diagnosed with PD who later develop cognitive impairment, and whether these changes predict future cognitive decline. METHODS Clinical and imaging data was acquired from the Parkinson's Progression Markers Initiative for 318 individuals with a diagnosis of Parkinson's disease and baseline 3T T1-weighted MRI. The cohort was divided according to cognitive status over follow-up, with 9 individuals developing Parkinson's disease dementia, 102 developing mild cognitive impairment and 207 remaining cognitively unaffected. FINDINGS At baseline, those who went on to develop cognitive impairment (mild cognitive impairment or dementia) were older with more severe motor and non-motor symptoms (anosmia, rapid eye movement sleep behaviour disorder, depression). Grey matter loss was present in those destined for Parkinson's disease dementia in the precuneus, hippocampi, primary olfactory cortex, lingual gyrus, temporal cortex and cerebellum. Those who later developed mild cognitive impairment had an attenuated but similar pattern of grey matter loss in the temporal lobe, lingual gyrus and cerebellum. Using support vector machines with a feature selection step, future cognitive impairment could be predicted using 11 clinical variables (AUC = 0.81), structural imaging (AUC = 0.72) or a combination of these two modalities (AUC = 0.85). These models more accurately predicted those who developed dementia (subgroup sensitivity 100%). INTERPRETATION Significant abnormalities in cortical structure is present at least three years before dementia manifests in Parkinson's disease, with associated differences in clinical profiles. Combining this data provides a technique to accurately identify future cognitive impairment, providing a non-invasive way to stratify individuals early on.

scholarly journals Dynamic functional connectivity changes associated with dementia in Parkinson’s disease

Brain ◽  
2019 ◽  
Vol 142 (9) ◽  
pp. 2860-2872 ◽  
Author(s):  
Eleonora Fiorenzato ◽  
Antonio P Strafella ◽  
Jinhee Kim ◽  
Roberta Schifano ◽  
Luca Weis ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Parkinson’S Disease Dementia ◽  
Dynamic Functional Connectivity ◽  
Control Subjects ◽  
Healthy Control ◽  
Normal Cognition

AbstractDynamic functional connectivity captures temporal variations of functional connectivity during MRI acquisition and it may be a suitable method to detect cognitive changes in Parkinson’s disease. In this study, we evaluated 118 patients with Parkinson’s disease matched for age, sex and education with 35 healthy control subjects. Patients with Parkinson’s disease were classified with normal cognition (n = 52), mild cognitive impairment (n = 46), and dementia (n = 20) based on an extensive neuropsychological evaluation. Resting state functional MRI and a sliding-window approach were used to study the dynamic functional connectivity. Dynamic analysis suggested two distinct connectivity ‘States’ across the entire group: a more frequent, segregated brain state characterized by the predominance of within-network connections, State I, and a less frequent, integrated state with strongly connected functional internetwork components, State II. In Parkinson’s disease, State I occurred 13.89% more often than in healthy control subjects, paralleled by a proportional reduction of State II. Parkinson’s disease subgroups analyses showed the segregated state occurred more frequently in Parkinson’s disease dementia than in mild cognitive impairment and normal cognition groups. Further, patients with Parkinson’s disease dementia dwelled significantly longer in the segregated State I, and showed a significant lower number of transitions to the strongly interconnected State II compared to the other subgroups. Our study indicates that dementia in Parkinson’s disease is characterized by altered temporal properties in dynamic connectivity. In addition, our results show that increased dwell time in the segregated state and reduced number of transitions between states are associated with presence of dementia in Parkinson’s disease. Further studies on dynamic functional connectivity changes could help to better understand the progressive dysfunction of networks between Parkinson’s disease cognitive states.

scholarly journals Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson’s Disease Dementia and Dementia with Lewy Bodies

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tamlyn J. Watermeyer ◽  
John V. Hindle ◽  
Julie Roberts ◽  
Catherine L. Lawrence ◽  
Anthony Martyr ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Goal Setting ◽  
Technology Use ◽  
Cognitive Rehabilitation ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Functional Independence ◽  
Physical Symptoms ◽  
Parkinson’S Disease Dementia

Alongside the physical symptoms associated with Parkinson’s disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual’s needs and abilities. Fundamental to this therapy is a person’s capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson’s disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants’ goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered withISRCTN16584442(DOI 10.1186/ISRCTN16584442 13/04/2015).

scholarly journals Mild cognitive impairment as a risk factor for Parkinson's disease dementia

2017 ◽  
Vol 32 (7) ◽  
pp. 1056-1065 ◽  
Author(s):  
Jeroen Hoogland ◽  
Judith A. Boel ◽  
Rob M.A. de Bie ◽  
Ronald B. Geskus ◽  
Ben A. Schmand ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Parkinson’S Disease Dementia
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