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Cognitive and motor dysfunction in Parkinson's disease. Clinical, performance, and computed tomographic correlations
D G Lichter1, A J Corbett, G M Fitzgibbon
1Department of Neurology, Public Hospital, Dunedin, New Zealand.
Archives of Neurology
|August 1, 1988
Summary
Parkinson's disease (PD) patients show visuospatial and perceptual-motor deficits linked to motor symptoms. Generalized cognitive decline in PD is associated with age, disease duration, and brain atrophy.
Area of Science:
- Neurology
- Neuroscience
- Cognitive Science
Background:
- The relationship between specific cognitive deficits and generalized cognitive dysfunction in Parkinson's disease (PD) is not fully understood.
- Dopamine depletion in the caudate nucleus and mesocortical pathways is implicated in PD pathophysiology.
- Cognitive impairment is a significant non-motor symptom affecting PD patients' quality of life.
Purpose of the Study:
- To investigate the neuropathologic and pathophysiological basis of cognitive dysfunction in Parkinson's disease.
- To differentiate between specific and generalized cognitive impairments in PD patients.
- To identify factors associated with generalized cognitive decline in PD.
Main Methods:
- A study involving 39 Parkinson's disease patients.
- Utilized standardized clinical measures and computerized neuropsychological tests.
- Employed quantitative computed tomography (CT) for brain imaging analysis.
Main Results:
- Visuospatial discrimination and perceptual-motor disorders correlated closely with motor scores in PD patients.
- Caudate nuclear and mesocortical dopamine depletion were identified as contributing factors.
- Generalized cognitive dysfunction was more prevalent in older patients with longer disease duration, advanced parkinsonism, and subcortical/frontal cortical atrophy on CT scans.
Conclusions:
- Specific cognitive deficits in PD may share a common neuropathologic basis with motor symptoms.
- Generalized cognitive dysfunction in PD is linked to aging, disease progression, and specific patterns of brain atrophy.
- Further clinicopathologic studies are needed to elucidate the multifactorial causes of dementia in Parkinson's disease, including dopaminergic deficits, aging, Alzheimer's pathology, and other neurotransmitter system impairments.