Executive functions deficit in Parkinson's disease with amnestic mild cognitive impairment
Mariya Petrova1, Margarita Raycheva, Yavor Zhelev
1Department of Neurology, Medical University, Sofia, Bulgaria.
Abstract:
Recent studies suggest that onset of dementia in Parkinson's disease (PD) is preceded by a phase known as mild cognitive impairment (MCI). Different clinical subtypes of MCI in PD were found. The objective of this study was to investigate whether patients with PD diagnosed with amnestic MCI (aPD-MCI) have also subtle deficits in other cognitive domains and especially in attention/executive functions and, therefore to clarify whether all subcomponents of executive control are equally affected in aPD-MCI. We investigated 23 patients with aPD-MCI (modified Petersen's criteria) and 25 normal controls. Relative to controls, the aPD-MCI group showed significant deficits with reference to tasks that encompass various aspects of attention/executive functions, including Trail Making Test, Stroop test, Modified Card Sorting Test, and digit span backward, as well as phonemic and semantic verbal fluency. This suggests that executive dysfunction is consistently presented in PD with MCI, even in ''amnestic'' PD-MCI due to cortical-subcortical dysfunction.
Insights
Parkinson's disease patients with amnestic mild cognitive impairment (aPD-MCI) exhibit significant deficits in attention and executive functions. These findings highlight widespread cognitive dysfunction beyond memory in aPD-MCI, impacting Parkinson's disease progression.
Area of Science:
- Neurology
- Cognitive Neuroscience
Background:
- Parkinson's disease (PD) progression to dementia is often preceded by mild cognitive impairment (MCI).
- Distinct clinical subtypes of MCI in PD have been identified.
- Amnestic MCI (aPD-MCI) is one such subtype observed in PD patients.
Purpose of the Study:
- To investigate subtle cognitive deficits in non-memory domains in patients with aPD-MCI.
- To specifically assess attention and executive functions in aPD-MCI.
- To determine if all executive control subcomponents are equally affected in aPD-MCI.
Main Methods:
- Study included 23 patients diagnosed with aPD-MCI using modified Petersen's criteria.
- A control group of 25 healthy individuals was recruited for comparison.
- Cognitive functions were assessed using tests including Trail Making Test, Stroop test, Modified Card Sorting Test, digit span backward, and verbal fluency tests.
Main Results:
- Patients with aPD-MCI demonstrated significant deficits in attention and executive functions compared to controls.
- Deficits were observed across various aspects of attention/executive functions, including task switching, inhibition, cognitive flexibility, working memory, and verbal fluency.
- Performance on Trail Making Test, Stroop test, Modified Card Sorting Test, and digit span backward was impaired.
Conclusions:
- Executive dysfunction is a consistent feature in Parkinson's disease with mild cognitive impairment (PD-MCI).
- Even 'amnestic' PD-MCI is associated with broad executive control deficits, suggesting underlying cortical-subcortical dysfunction.
- These findings underscore the pervasive nature of cognitive impairment in PD-MCI.
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