Cognitive decline in Parkinson's disease: the impact of the motor phenotype on cognition.

Autor:	Wojtala J; Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany.; JARA-Brain Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany., Heber IA; Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany., Neuser P; Coordinating Center for Clinical Trials, Philipps-University of Marburg, KKS Marburg, Marburg, Germany., Heller J; Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany.; JARA-Brain Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany., Kalbe E; Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany., Rehberg SP; Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany., Storch A; Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, Dresden, Germany.; Department of Neurology, University of Rostock, Rostock, Germany., Linse K; Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, Dresden, Germany., Schneider C; Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, Dresden, Germany., Gräber S; German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (DZNE), Tübingen, Germany., Berg D; German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (DZNE), Tübingen, Germany.; Department of Neurology, Christian Albrecht University, Kiel, Germany., Dams J; Department of Neurology, Philipps University Marburg, Marburg, Germany., Balzer-Geldsetzer M; Department of Neurology, Philipps University Marburg, Marburg, Germany.; Department of Geriatric Medicine, University Hospital Essen, Essen, Germany., Hilker-Roggendorf R; Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany., Oberschmidt C; Department of Neurology, J.W. Goethe University, Frankfurt/Main, Germany., Baudrexel S; Department of Neurology, J.W. Goethe University, Frankfurt/Main, Germany., Witt K; Research Center Neurosensory Science, Department of Neurology, School of Medicine and Health Sciences - European Medical School,University Oldenburg, Carl von Ossietzky University Oldenburg, Oldenburg, Germany., Schmidt N; Department of Neurology, Christian Albrecht University, Kiel, Germany., Deuschl G; German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (DZNE), Tübingen, Germany., Mollenhauer B; Paracelsus-Elena Clinic, Centre of Parkinsonism and Movement Disorders, Department of Neurology (BM) and Department of Neurosurgery (CT), Paracelsus-Elena Clinic, University Medical Center Goettingen, Kassel, Germany., Trenkwalder C; Paracelsus-Elena Clinic, Centre of Parkinsonism and Movement Disorders, Department of Neurology (BM) and Department of Neurosurgery (CT), Paracelsus-Elena Clinic, University Medical Center Goettingen, Kassel, Germany., Liepelt-Scarfone I; German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (DZNE), Tübingen, Germany., Spottke A; Department of Neurology, University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany., Roeske S; Department of Neurology, University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany., Wüllner U; Department of Neurology, University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany., Wittchen HU; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, München, München, Germany., Riedel O; Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany., Dodel R; Department of Neurology, Philipps University Marburg, Marburg, Germany.; Department of Geriatric Medicine, University Hospital Essen, Essen, Germany., Schulz JB; Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany.; JARA-Brain Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany., Reetz K; Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany kreetz@ukaachen.de.; JARA-Brain Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany.
Jazyk:	angličtina
Zdroj:	Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2019 Feb; Vol. 90 (2), pp. 171-179. Date of Electronic Publication: 2018 Oct 08.
DOI:	10.1136/jnnp-2018-319008
Abstrakt:	Objectives: Parkinson's disease (PD) is the second most common neurodegenerative disorder and is further associated with progressive cognitive decline. In respect to motor phenotype, there is some evidence that akinetic-rigid PD is associated with a faster rate of cognitive decline in general and a greater risk of developing dementia.The objective of this study was to examine cognitive profiles among patients with PD by motor phenotypes and its relation to cognitive function. Methods: Demographic, clinical and neuropsychological cross-sectional baseline data of the DEMPARK/LANDSCAPE study, a multicentre longitudinal cohort study of 538 patients with PD were analysed, stratified by motor phenotype and cognitive syndrome. Analyses were performed for all patients and for each diagnostic group separately, controlling for age, gender, education and disease duration. Results: Compared with the tremor-dominant phenotype, akinetic-rigid patients performed worse in executive functions such as working memory (Wechsler Memory Scale-Revised backward; p=0.012), formal-lexical word fluency (p=0.043), card sorting (p=0.006), attention (Trail Making Test version A; p=0.024) and visuospatial abilities (Leistungsprüfungssystem test 9; p=0.006). Akinetic-rigid neuropsychological test scores for the executive and attentive domain correlated negatively with non-tremor motor scores. Covariate-adjusted binary logistic regression analyses showed significant odds for PD-mild cognitive impairment for not-determined as compared with tremor-dominant (OR=3.198) and akinetic-rigid PD (OR=2.059). The odds for PD-dementia were significant for akinetic-rigid as compared with tremor-dominant phenotype (OR=8.314). Conclusion: The three motor phenotypes of PD differ in cognitive performance, showing that cognitive deficits seem to be less severe in tremor-dominant PD. While these data are cross-sectional, longitudinal data are needed to shed more light on these differential findings. Competing Interests: Competing interests: GD has received lecture fees from Boston Scientific and has been serving as a consultant for Boston Scientific. He received royalties from Thieme Publishers. He is a government employee and receives through his institution funding for his research from the German Research Council, the German Ministry of Education and Research, and Medtronic. KW received reimbursement of congress fees from BIAL and Desitin; and grants from the Federal Ministry of Education and Research and the German Research Foundation. (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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