Skip to main content
Top
Published in: Neurological Sciences 8/2013

01-08-2013 | Original Article

Understanding quantitative and qualitative figural fluency in patients with Parkinson’s disease

Authors: Simone Goebel, Lubomir Atanassov, Günter Köhnken, H. Maximilian Mehdorn, Bernd Leplow

Published in: Neurological Sciences | Issue 8/2013

Login to get access

Abstract

Figural fluency refers to the ability to internally generate appropriate non-verbal behaviour. Whereas deficits in verbal fluency rank among the most prominent cognitive sequelae in Parkinson’s disease (PD), little is known about figural fluency and its assessment in PD. This is the first comprehensive comparison of the psychometric properties of figural fluency tasks in PD. PD patients (n = 22) and matched normal controls (n = 27) were compared in widely used figural fluency measures. The ability to assess PD-specific cognitive morbidity was assessed via comparison with a matched neurological sample of various aetiologies (n = 22). Construct validity was assessed by means of linear regression analyses of figural fluency measures and an extensive cognitive test battery. PD patients were impaired in all measures of figural fluency tasks. PD-specific impairments were identified regarding perseverative and strategic behaviour. Importantly, only perseverative, but not repetitive, behaviour was able to identify PD-specific cognitive morbidity. Quantitative fluency can be predicted by basic cognitive functions (e.g. visuospatial ability, visuomotor speed) as well as other measures of executive functioning. However, qualitative test scores, especially of the Five-Point Test (FPT), yield important and additional diagnostic information in PD. Qualitative test parameters of figural fluency measures, especially of the FPT, offer the unique possibility to assess PD-specific cognitive impairments in the areas of perseverative and strategic behaviour.
Literature
1.
go back to reference Aarsland D, Bronnick K, Larsen JP, Tysnes OB, Alves G, NPS G et al (2009) Cognitive impairment in incident, untreated Parkinson’s disease: The Norwegian ParkWest study. Neurology 16:1121–1126CrossRef Aarsland D, Bronnick K, Larsen JP, Tysnes OB, Alves G, NPS G et al (2009) Cognitive impairment in incident, untreated Parkinson’s disease: The Norwegian ParkWest study. Neurology 16:1121–1126CrossRef
2.
go back to reference Alexander G, DeLong MR, Strick PL (1986) Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci 9:357–381PubMedCrossRef Alexander G, DeLong MR, Strick PL (1986) Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci 9:357–381PubMedCrossRef
3.
go back to reference Elgh E, Domellöf M, Linder J, Edström M, Stenlund H, Forsgren L (2009) Cognitive function in early Parkinson’s disease: a population-based study. Eur J Neurol 16:1278–1284PubMedCrossRef Elgh E, Domellöf M, Linder J, Edström M, Stenlund H, Forsgren L (2009) Cognitive function in early Parkinson’s disease: a population-based study. Eur J Neurol 16:1278–1284PubMedCrossRef
4.
go back to reference Kehagia AA, Barker RA, Robbins TW (2010) Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson’s disease. Lancet Neurol 9:1200–1213PubMedCrossRef Kehagia AA, Barker RA, Robbins TW (2010) Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson’s disease. Lancet Neurol 9:1200–1213PubMedCrossRef
5.
go back to reference Odhuba RA, van den Broek MD, Johns LC (2004) Ecological validity of measures of executive functioning. Br J Clin Psychol 44(Pt 2):269–278 Odhuba RA, van den Broek MD, Johns LC (2004) Ecological validity of measures of executive functioning. Br J Clin Psychol 44(Pt 2):269–278
6.
go back to reference Rodríguez-Ferreiro J, Cuetos F, Herrera E, Menéndez M, Ribacoba R (2010) Cognitive impairment in Parkinson’s disease without dementia. Mov Disord 25:2136–2141PubMedCrossRef Rodríguez-Ferreiro J, Cuetos F, Herrera E, Menéndez M, Ribacoba R (2010) Cognitive impairment in Parkinson’s disease without dementia. Mov Disord 25:2136–2141PubMedCrossRef
7.
go back to reference Zgaljardic DJ, Borod JC, Foldi NS, Rocco M, Mattis PJ, Gordon MF, Feigin AS, Eidelberg D (2007) Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease. Cogn Behav Neurol 20:184–192PubMedCrossRef Zgaljardic DJ, Borod JC, Foldi NS, Rocco M, Mattis PJ, Gordon MF, Feigin AS, Eidelberg D (2007) Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease. Cogn Behav Neurol 20:184–192PubMedCrossRef
8.
go back to reference Kulisevsky J, Pagonabarraga J (2009) Cognitive impairment in Parkinson’s disease: tools for diagnosis and assessment. Mov Disord 24:1103–1110PubMedCrossRef Kulisevsky J, Pagonabarraga J (2009) Cognitive impairment in Parkinson’s disease: tools for diagnosis and assessment. Mov Disord 24:1103–1110PubMedCrossRef
9.
go back to reference Henry JD, Crawford JR (2004) Verbal fluency deficits in Parkinson’s Disease: a meta-analysis. J Int Neuropsychol Soc 10:608–622PubMedCrossRef Henry JD, Crawford JR (2004) Verbal fluency deficits in Parkinson’s Disease: a meta-analysis. J Int Neuropsychol Soc 10:608–622PubMedCrossRef
10.
go back to reference Fama R, Sullivan EV, Shear PK, Cahn-Weiner DA, Yesavage JA, Tinklenberg JR, Pfefferbaum A (1998) Fluency performance patterns in Alzheimer’s disease and Parkinson’s disease. Clin Neuropsychol 12:487–499CrossRef Fama R, Sullivan EV, Shear PK, Cahn-Weiner DA, Yesavage JA, Tinklenberg JR, Pfefferbaum A (1998) Fluency performance patterns in Alzheimer’s disease and Parkinson’s disease. Clin Neuropsychol 12:487–499CrossRef
11.
go back to reference Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York
12.
go back to reference Uc EY, Rizzo M, Anderson SW, Qian S, Rodnitzky RL, Dawson JD (2005) Visual dysfunction in Parkinson disease without dementia. Neurology 65:1907–1913PubMedCrossRef Uc EY, Rizzo M, Anderson SW, Qian S, Rodnitzky RL, Dawson JD (2005) Visual dysfunction in Parkinson disease without dementia. Neurology 65:1907–1913PubMedCrossRef
13.
go back to reference Jones-Gotman M, Milner B (1977) Design Fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 15:653–664PubMedCrossRef Jones-Gotman M, Milner B (1977) Design Fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 15:653–664PubMedCrossRef
14.
go back to reference Regard M, Strauss E, Knapp P (1982) Children’s production on verbal and non-verbal fluency tasks. Percept Mot Skills 55:839–844PubMedCrossRef Regard M, Strauss E, Knapp P (1982) Children’s production on verbal and non-verbal fluency tasks. Percept Mot Skills 55:839–844PubMedCrossRef
15.
go back to reference Ruff RM (1988) Ruff Figural Fluency Test professional manual. Psychological Assessment Resources Inc., Odessa Ruff RM (1988) Ruff Figural Fluency Test professional manual. Psychological Assessment Resources Inc., Odessa
16.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) “Mini-Mental-State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-Mental-State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef
17.
go back to reference First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV axis I disorders—clinician version. American Psychiatric Press, New York First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV axis I disorders—clinician version. American Psychiatric Press, New York
18.
go back to reference Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef
19.
go back to reference Goldberg E (1986) Varieties of perseveration: a comparison of two taxonomies. J Clin Exp Neuropsychol 8:710–726PubMedCrossRef Goldberg E (1986) Varieties of perseveration: a comparison of two taxonomies. J Clin Exp Neuropsychol 8:710–726PubMedCrossRef
20.
go back to reference Rainer G, Asaad WF, Miller EK (1998) Selective representation of relevant information by neurons in the primate prefrontal cortex. Nature 393:577–579PubMedCrossRef Rainer G, Asaad WF, Miller EK (1998) Selective representation of relevant information by neurons in the primate prefrontal cortex. Nature 393:577–579PubMedCrossRef
21.
go back to reference Ross TP, Foard EL, Hiott FB, Vincent A (2003) The reliability of production strategy scores for the Ruff Figural Fluency Test. Arch Clin Neuropsychol 18:879–891PubMed Ross TP, Foard EL, Hiott FB, Vincent A (2003) The reliability of production strategy scores for the Ruff Figural Fluency Test. Arch Clin Neuropsychol 18:879–891PubMed
22.
go back to reference Lehrl S (1975) Mehrfachwahl-Wortschatztest MWT-B. Perimed Verlag, Erlangen Lehrl S (1975) Mehrfachwahl-Wortschatztest MWT-B. Perimed Verlag, Erlangen
23.
go back to reference Leonhart R (2004) Effektgrößenberechnung bei Interventionsstudien. Die Rehabil 43:241–246CrossRef Leonhart R (2004) Effektgrößenberechnung bei Interventionsstudien. Die Rehabil 43:241–246CrossRef
25.
go back to reference Suchy Y, Kraybill ML, Gidley Larson JC et al (2010) Understanding design fluency: motor and executive contributions. J Int Neuropsychol Soc 16:26–37PubMedCrossRef Suchy Y, Kraybill ML, Gidley Larson JC et al (2010) Understanding design fluency: motor and executive contributions. J Int Neuropsychol Soc 16:26–37PubMedCrossRef
26.
go back to reference Stuss DT, Alexander MP, Benson DF, Trimble MR, Cummings JL (1997) Frontal lobe functions. In: Trimble MR, Cummings JL (eds) Contemporary behavioural neurology. Butterworth-Heinemann, Woburn Stuss DT, Alexander MP, Benson DF, Trimble MR, Cummings JL (1997) Frontal lobe functions. In: Trimble MR, Cummings JL (eds) Contemporary behavioural neurology. Butterworth-Heinemann, Woburn
27.
go back to reference Ridley RM (1994) The psychology of perserverative and stereotyped behaviour. Prog Neurobiol 44:221–231PubMedCrossRef Ridley RM (1994) The psychology of perserverative and stereotyped behaviour. Prog Neurobiol 44:221–231PubMedCrossRef
28.
go back to reference dos Santos CM, Balardin JB, Irigaray TQ, Schroder N, Rieder CR, Bromberg E (2010) Incidental encoding strategies did not improve contextual memory in Parkinson’s disease patients. Neurorehabil Neural Repair 24:450–456PubMedCrossRef dos Santos CM, Balardin JB, Irigaray TQ, Schroder N, Rieder CR, Bromberg E (2010) Incidental encoding strategies did not improve contextual memory in Parkinson’s disease patients. Neurorehabil Neural Repair 24:450–456PubMedCrossRef
29.
go back to reference Goebel S, Mehdorn HM, Leplow B (2009) Strategy instruction in Parkinson’s disease: influence on cognitive performance. Neuropsychologia 48:574–580PubMedCrossRef Goebel S, Mehdorn HM, Leplow B (2009) Strategy instruction in Parkinson’s disease: influence on cognitive performance. Neuropsychologia 48:574–580PubMedCrossRef
30.
go back to reference Gescheidt T, Czekoova K, Urbanek T, Marecek R, Mikl M, Kubikova R, Telecka S, Andrlova H, Husarova I, Bares M (2012) Iowa Gambling Task in patients with early-onset Parkinson’s disease: strategy analysis. Neurol Sci. doi:10.1007/s10072-012-1086-x Gescheidt T, Czekoova K, Urbanek T, Marecek R, Mikl M, Kubikova R, Telecka S, Andrlova H, Husarova I, Bares M (2012) Iowa Gambling Task in patients with early-onset Parkinson’s disease: strategy analysis. Neurol Sci. doi:10.​1007/​s10072-012-1086-x
31.
go back to reference Bloem BR, Grimbergen YA, van Dijk JG, Munneke M (2006) The “posture second” strategy: a review of wrong priorities in Parkinson’s disease. J Neurol Sci 248:196–204PubMedCrossRef Bloem BR, Grimbergen YA, van Dijk JG, Munneke M (2006) The “posture second” strategy: a review of wrong priorities in Parkinson’s disease. J Neurol Sci 248:196–204PubMedCrossRef
32.
go back to reference Johnson AM, Pollard CC, Vernon PA, Tomes JL, Jog MS (2005) Memory perception and strategy use in Parkinson’s disease. Parkinsonism Relat Disord 11:111–115PubMedCrossRef Johnson AM, Pollard CC, Vernon PA, Tomes JL, Jog MS (2005) Memory perception and strategy use in Parkinson’s disease. Parkinsonism Relat Disord 11:111–115PubMedCrossRef
33.
go back to reference Sinforiani E, Banchieri L, Zucchella C, Pacchetti C, Sandrini G (2004) Cognitive rehabilitation in Parkinson’s disease. Arch Gerontol Geriatr Suppl 9:387–391PubMedCrossRef Sinforiani E, Banchieri L, Zucchella C, Pacchetti C, Sandrini G (2004) Cognitive rehabilitation in Parkinson’s disease. Arch Gerontol Geriatr Suppl 9:387–391PubMedCrossRef
34.
go back to reference Reijnders JS, Ehrt U, Lousberg R, Aarsland D, Leentjens AF (2009) The association between motor subtypes and psychopathology in Parkinson’s disease. Parkinsonism Relat Disord 15:379–382PubMedCrossRef Reijnders JS, Ehrt U, Lousberg R, Aarsland D, Leentjens AF (2009) The association between motor subtypes and psychopathology in Parkinson’s disease. Parkinsonism Relat Disord 15:379–382PubMedCrossRef
35.
go back to reference Czernecki V, Pillon B, Houeto JL, Pochon JB, Levy R, Dubois B (2002) Motivation, reward, and Parkinson’s disease: influence of dopatherapy. Neuropsychologia 40:2257–2267PubMedCrossRef Czernecki V, Pillon B, Houeto JL, Pochon JB, Levy R, Dubois B (2002) Motivation, reward, and Parkinson’s disease: influence of dopatherapy. Neuropsychologia 40:2257–2267PubMedCrossRef
36.
go back to reference Leplow B, Friege L (1998) Eine Sozialformel zur Schätzung der prämorbiden Intelligenz. Zeitschrift für Klinische Psychologie 27:1–8 Leplow B, Friege L (1998) Eine Sozialformel zur Schätzung der prämorbiden Intelligenz. Zeitschrift für Klinische Psychologie 27:1–8
Metadata
Title
Understanding quantitative and qualitative figural fluency in patients with Parkinson’s disease
Authors
Simone Goebel
Lubomir Atanassov
Günter Köhnken
H. Maximilian Mehdorn
Bernd Leplow
Publication date
01-08-2013
Publisher
Springer Milan
Published in
Neurological Sciences / Issue 8/2013
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-012-1245-0

Other articles of this Issue 8/2013

Neurological Sciences 8/2013 Go to the issue