Abstract
Understanding on the clinical features and neural mechanisms leading to cognitive impairment and dementia in Parkinson’s disease (PD) has notably increased. At time of diagnosis, nearly all PD patients present some degree of cognitive impairment not enough severe as to significantly affect functional independence. However, even mild cognitive changes have a measurable impact to functional capacity in PD. A clinically practical differentiation is based on the importance of executive deficits in the early phases of cognitive impairment in PD and on the evidence stressing the transitional role of posterior–cortical impairment on the progression of PD-MCI to dementia. However, the pattern of cognitive impairment in PD is variable not just to the extents on which are the affected cognitive domains, but also on which are those domains that became affected first. Specific diagnostic criteria for mild cognitive impairment associated with PD (PD-MCI) and dementia (PDD) and operative guidelines for the cognitive assessment have been developed. In the present review, we will describe general notions regarding the mechanisms and the profile of cognitive deterioration in PD, the diagnostic criteria for PD-MCI, and some of the currently recommended assessment approaches.
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References
Aarsland D, Andersen K, Larsen JP, Lolk A, Nielsen H, Kragh-Sorensen P (2001) Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 56:730–736
Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sorensen P (2003) Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch Neurol 60:387–392
Aarsland D, Andersen K, Larsen JP, Perry R, Wentzel-Larsen T, Lolk A, Kragh-Sorensen P (2004) The rate of cognitive decline in Parkinson disease. Arch Neurol 61:1906–1911. https://doi.org/10.1001/archneur.61.12.1906
Aarsland D, Zaccai J, Brayne C (2005) A systematic review of prevalence studies of dementia in Parkinson’s disease. Mov Disord 20:1255–1263. https://doi.org/10.1002/mds.20527
Aarsland D, Bronnick K, Larsen JP, Tysnes OB, Alves G, Norwegian ParkWest Study G (2009) Cognitive impairment in incident, untreated Parkinson disease: the Norwegian ParkWest study. Neurology 72:1121–1126. https://doi.org/10.1212/01.wnl.0000338632.00552.cb
Aarsland D et al (2010) Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 75:1062–1069. https://doi.org/10.1212/WNL.0b013e3181f39d0e
Barone P, Aarsland D, Burn D, Emre M, Kulisevsky J, Weintraub D (2011) Cognitive impairment in nondemented Parkinson’s disease. Mov Disord 26:2483–2495. https://doi.org/10.1002/mds.23919
Carbon M, Ma Y, Barnes A, Dhawan V, Chaly T, Ghilardi MF, Eidelberg D (2004) Caudate nucleus: influence of dopaminergic input on sequence learning and brain activation in Parkinsonism. NeuroImage 21:1497–1507. https://doi.org/10.1016/j.neuroimage.2003.12.014
Cools R, Stefanova E, Barker RA, Robbins TW, Owen AM (2002) Dopaminergic modulation of high-level cognition in Parkinson’s disease: the role of the prefrontal cortex revealed by PET. Brain 125:584–594
Emre M et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707. https://doi.org/10.1002/mds.21507 (quiz 1837)
Fernandez de Bobadilla R, Pagonabarraga J, Martinez-Horta S, Pascual-Sedano B, Campolongo A, Kulisevsky J (2013) Parkinson’s disease-cognitive rating scale: psychometrics for mild cognitive impairment. Mov Disord 28:1376–1383. https://doi.org/10.1002/mds.25568
Fernandez-Bobadilla R, Martinez-Horta S, Marin-Lahoz J, Horta-Barba A, Pagonabarraga J, Kulisevsky J (2017) Development and validation of an alternative version of the Parkinson’s Disease-Cognitive Rating Scale (PD-CRS). Parkinsonism Relat Disord 43:73–77. https://doi.org/10.1016/j.parkreldis.2017.07.015
Goldman JG, Holden S, Bernard B, Ouyang B, Goetz CG, Stebbins GT (2013) Defining optimal cutoff scores for cognitive impairment using Movement Disorder Society Task Force criteria for mild cognitive impairment in Parkinson’s disease. Mov Disord 28:1972–1979. https://doi.org/10.1002/mds.25655
Goldman JG, Holden S, Ouyang B, Bernard B, Goetz CG, Stebbins GT (2015) Diagnosing PD-MCI by MDS Task Force criteria: how many and which neuropsychological tests? Mov Disord 30:402–406. https://doi.org/10.1002/mds.26084
Goris A et al (2007) Tau and alpha-synuclein in susceptibility to, and dementia in, Parkinson’s disease. Ann Neurol 62:145–153. https://doi.org/10.1002/ana.21192
Guerini FR et al (2009) BDNF Val66Met polymorphism is associated with cognitive impairment in Italian patients with Parkinson’s disease. Eur J Neurol 16:1240–1245. https://doi.org/10.1111/j.1468-1331.2009.02706.x
Halliday GM, Leverenz JB, Schneider JS, Adler CH (2014) The neurobiological basis of cognitive impairment in Parkinson’s disease. Mov Disord 29:634–650. https://doi.org/10.1002/mds.25857
Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG (2008) The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord 23:837–844. https://doi.org/10.1002/mds.21956
Hepp DH et al (2016) Distribution and load of amyloid-beta pathology in Parkinson disease and dementia with lewy bodies. J Neuropathol Exp Neurol 75:936–945. https://doi.org/10.1093/jnen/nlw070
Hilker R et al (2005) Dementia in Parkinson disease: functional imaging of cholinergic and dopaminergic pathways. Neurology 65:1716–1722. https://doi.org/10.1212/01.wnl.0000191154.78131.f6
Irwin DJ et al (2012) Neuropathologic substrates of Parkinson disease dementia. Ann Neurol 72:587–598. https://doi.org/10.1002/ana.23659
Johar I, Mollenhauer B, Aarsland D (2017) Cerebrospinal fluid biomarkers of cognitive decline in Parkinson’s disease. Int Rev Neurobiol 132:275–294. https://doi.org/10.1016/bs.irn.2016.12.001
Kulisevsky J, Pagonabarraga J (2009) Cognitive impairment in Parkinson’s disease: tools for diagnosis and assessment. Mov Disord 24:1103–1110. https://doi.org/10.1002/mds.22506
Kulisevsky J, Avila A, Barbanoj M, Antonijoan R, Berthier ML, Gironell A (1996) Acute effects of levodopa on neuropsychological performance in stable and fluctuating Parkinson’s disease patients at different levodopa plasma levels. Brain 119(Pt 6):2121–2132
Kulisevsky J, Garcia-Sanchez C, Berthier ML, Barbanoj M, Pascual-Sedano B, Gironell A, Estevez-Gonzalez A (2000) Chronic effects of dopaminergic replacement on cognitive function in Parkinson’s disease: a two-year follow-up study of previously untreated patients. Mov Disord 15:613–626
Kulisevsky J et al (2013) Measuring functional impact of cognitive impairment: validation of the Parkinson’s disease cognitive functional rating scale. Parkinsonism Relat Disord 19:812–817. https://doi.org/10.1016/j.parkreldis.2013.05.007
Litvan I et al (2011) MDS Task Force on mild cognitive impairment in Parkinson’s disease: critical review of PD-MCI. Mov Disord 26:1814–1824. https://doi.org/10.1002/mds.23823
Litvan I et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 27:349–356. https://doi.org/10.1002/mds.24893
Marras C, Troster AI, Kulisevsky J, Stebbins GT (2014) The tools of the trade: a state of the art “How to Assess Cognition” in the patient with Parkinson’s disease. Mov Disord 29:584–596. https://doi.org/10.1002/mds.25874
Martinez-Horta S, Kulisevsky J (2011) Is all cognitive impairment in Parkinson’s disease “mild cognitive impairment”? J Neural Transm 118:1185–1190. https://doi.org/10.1007/s00702-011-0675-9
Mata IF et al (2014) APOE, MAPT, and SNCA genes and cognitive performance in Parkinson disease. JAMA Neurol 71:1405–1412. https://doi.org/10.1001/jamaneurol.2014.1455
Mihaescu AS et al (2018) Brain degeneration in Parkinson’s disease patients with cognitive decline: a coordinate-based meta-analysis. Brain Imaging Behav. https://doi.org/10.1007/s11682-018-9922-0
Morley JF et al (2012) Genetic influences on cognitive decline in Parkinson’s disease. Mov Disord 27:512–518. https://doi.org/10.1002/mds.24946
Muslimovic D, Post B, Speelman JD, Schmand B (2005) Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65:1239–1245. https://doi.org/10.1212/01.wnl.0000180516.69442.95
Obeso JA et al (2017) Past, present, and future of Parkinson’s disease: a special essay on the 200th Anniversary of the Shaking Palsy. Mov Disord 32:1264–1310. https://doi.org/10.1002/mds.27115
Pagonabarraga J, Kulisevsky J, Llebaria G, Garcia-Sanchez C, Pascual-Sedano B, Gironell A (2008) Parkinson’s disease-cognitive rating scale: a new cognitive scale specific for Parkinson’s disease. Mov Disord 23:998–1005. https://doi.org/10.1002/mds.22007
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56:303–308
Postuma RB et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30:1591–1601. https://doi.org/10.1002/mds.26424
Sampedro F, Marin-Lahoz J, Martinez-Horta S, Pagonabarraga J, Kulisevsky J (2018a) Dopaminergic degeneration induces early posterior cortical thinning in Parkinson’s disease. Neurobiol Dis 124:29–35. https://doi.org/10.1016/j.nbd.2018.11.001
Sampedro F, Marin-Lahoz J, Martinez-Horta S, Pagonabarraga J, Kulisevsky J (2018b) Early gray matter volume loss in MAPT H1H1 de novo PD patients: a possible association with cognitive decline. Front Neurol 9:394. https://doi.org/10.3389/fneur.2018.00394
Sampedro F, Marin-Lahoz J, Martinez-Horta S, Pagonabarraga J, Kulisevsky J (2019) Reduced gray matter volume in cognitively preserved COMT (158)Val/Val Parkinson’s disease patients and its association with cognitive decline. Brain Imaging Behav. https://doi.org/10.1007/s11682-018-0022-y
Seto-Salvia N et al (2011) Dementia risk in Parkinson disease: disentangling the role of MAPT haplotypes. Arch Neurol 68:359–364. https://doi.org/10.1001/archneurol.2011.17
Skorvanek M et al (2018) Global scales for cognitive screening in Parkinson’s disease: Critique and recommendations. Mov Disord 33:208–218. https://doi.org/10.1002/mds.27233
Smith E, Hay P, Campbell L, Trollor JN (2011) A review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev 12:740–755. https://doi.org/10.1111/j.1467-789X.2011.00920.x
van den Berg E, Kloppenborg RP, Kessels RP, Kappelle LJ, Biessels GJ (2009) Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: a systematic comparison of their impact on cognition. Biochimica et biophysica acta 1792:470–481. https://doi.org/10.1016/j.bbadis.2008.09.004
Vesely B, Rektor I (2016) The contribution of white matter lesions (WML) to Parkinson’s disease cognitive impairment symptoms: a critical review of the literature. Parkinsonism Relat Disord 22(Suppl 1):S166–S170. https://doi.org/10.1016/j.parkreldis.2015.09.019
Wang M, Norman JE, Srinivasan VJ, Rutledge JC (2016) Metabolic, inflammatory, and microvascular determinants of white matter disease and cognitive decline. Am J Neurodegener Dis 5:171–177
Williams-Gray CH et al (2009a) The distinct cognitive syndromes of Parkinson’s disease: 5 year follow-up of the CamPaIGN cohort. Brain 132:2958–2969. https://doi.org/10.1093/brain/awp245
Williams-Gray CH, Goris A, Saiki M, Foltynie T, Compston DA, Sawcer SJ, Barker RA (2009b) Apolipoprotein E genotype as a risk factor for susceptibility to and dementia in Parkinson’s disease. J Neurol 256:493–498. https://doi.org/10.1007/s00415-009-0119-8
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JK has received consultancy or lecture fees from Zambon, UCB, Sanofi, Bial, Teva, Lundbeck, and research grants from CIBERNED, Instituto de Salud Carlos III, Fundació La Marató de TV3, Abbvie and Zambon. SMH declares no conflict of interest.
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Martinez-Horta, S., Kulisevsky, J. Mild cognitive impairment in Parkinson’s disease. J Neural Transm 126, 897–904 (2019). https://doi.org/10.1007/s00702-019-02003-1
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DOI: https://doi.org/10.1007/s00702-019-02003-1