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

被引：69

作者：

Wojtala, Jennifer ^{[1
,2
,3
]}

Heber, Ines Ann ^{[1
]}

Neuser, Petra ^{[4
]}

Heller, Julia ^{[1
,2
,3
]}

Kalbe, Elke ^{[5
,6
]}

Rehberg, Sarah P. ^{[5
,6
]}

Storch, Alexander ^{[7
,8
]}

Linse, Katharina ^{[7
]}

Schneider, Christine ^{[7
]}

Graeber, Susanne ^{[9
,10
]}

Berg, Daniela ^{[9
,10
,11
]}

Dams, Judith ^{[12
]}

Balzer-Geldsetzer, Monika ^{[12
,13
]}

Hilker-Roggendorf, Rudiger ^{[5
,6
]}

Oberschmidt, Carola ^{[14
]}

Baudrexel, Simon ^{[14
]}

Witt, Karsten ^{[15
]}

Schmidt, Nele ^{[11
]}

Deuschl, Guenther ^{[9
,10
]}

Mollenhauer, Brit ^{[16
,17
]}

Trenkwalder, Claudia ^{[16
,17
]}

Liepelt-Scarfone, Inga ^{[9
,10
]}

Spottke, Annika ^{[18
]}

Roeske, Sandra ^{[18
]}

Wuellner, Ullrich ^{[18
]}

Wittchen, Hans-Ulrich ^{[19
,20
]}

Riedel, Oliver ^{[21
,22
]}

Dodel, Richard ^{[12
,13
]}

Schulz, Joerg B. ^{[1
,2
,3
]}

Reetz, Kathrin ^{[1
,2
,3
]}

机构：

[1] Rhein Westfal TH Aachen, Dept Neurol, Pauwelsstr 30, Aachen, Germany

[2] Forschungszentrum Julich, JARA Brain Inst Mol Neurosci & Neuroimaging, Aachen, Germany

[3] Rhein Westfal TH Aachen, Aachen, Germany

[4] Philipps Univ Marburg, Coordinating Ctr Clin Trials, KKS Marburg, Marburg, Germany

[5] Univ Hosp Cologne, Med Psychol | Neuropsychol & Gender Studies, Cologne, Germany

[6] Univ Hosp Cologne, Ctr Neuropsychol Diagnost & Intervent CeNDI, Cologne, Germany

[7] Tech Univ Dresden, Div Neurodegenerat Dis, Dept Neurol, Dresden, Germany

[8] Univ Rostock, Dept Neurol, Rostock, Germany

[9] German Ctr Neurodegenerat Dis, Tubingen, Germany

[10] Hertie Inst Clin Brain Res DZNE, Tubingen, Germany

[11] Christian Albrecht Univ, Dept Neurol, Kiel, Germany

[12] Philipps Univ Marburg, Dept Neurol, Marburg, Germany

[13] Univ Hosp Essen, Dept Geriatr Med, Essen, Germany

[14] Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany

[15] Carl von Ossietzky Univ Oldenburg, Res Ctr Neurosensory Sci, Dept Neurol, Sch Med & Hlth Sci,European Med Sch,Univ Oldenbur, Oldenburg, Germany

[16] Univ Med Ctr Goettingen, Paracelsus Elena Clin, Ctr Parkinsonism & Movement Disorders, Dept Neurol BM, Kassel, Germany

[17] Univ Med Ctr Goettingen, Paracelsus Elena Clin, Dept Neurosurg CT, Kassel, Germany

[18] Univ Hosp Bonn, Dept Neurol, Bonn, Germany

[19] German Ctr Neurodegenerat Dis DZNE, Bonn, Germany

[20] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Dresden, Germany

[21] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Munich, Germany

[22] Leibniz Inst Prevent Res & Epidemiol, Dept Clin Epidemiol, Bremen, Germany

来源：

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY | 2019年 / 90卷 / 02期

关键词：

CLINICAL DIAGNOSTIC-CRITERIA; DEMENTIA; IMPAIRMENT; DEFICITS; SUBTYPE; DOPAMINE;

D O I：

10.1136/jnnp-2018-319008

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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), formallexical word fluency (p= 0.043), card sorting (p= 0.006), attention (Trail Making Test version A; p= 0.024) and visuospatial abilities (Leistungsprufungssystem 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.

引用

页码：171 / 179

页数：9

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