Relationship between Motor Symptoms, Cognition, and Demographic Characteristics in Treated Mild/Moderate Parkinson\u27s Disease.

BACKGROUND: Although Parkinson\u27s disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms, PD patients, at all stages of the disease, can experience cognitive dysfunction. However, the relationships between cognitive and motor symptoms and specific demographic characteristics are not well defined, particularly for patients who have progressed to requiring dopaminergic medication. OBJECTIVE: To examine relationships between motor and cognitive symptoms and various demographic factors in mild to moderate, PD patients requiring anti-PD medication. METHODS: Cognitive function was assessed in 94 subjects with a variety of neuropsychological tests during baseline evaluations as part of an experimental treatment study. Data were analyzed in relation to Unified Parkinson\u27s Disease Rating Scale motor scores and demographic variables. RESULTS: Of the UPDRS subscores analyzed, posture/balance/gait was associated with the highest number of adverse cognitive outcomes followed by speech/facial expression, bradykinesia, and rigidity. No associations were detected between any of the cognitive performance measures and tremor. Motor functioning assessed in the off condition correlated primarily with disease duration; neuropsychological performance in general was primarily related to age. CONCLUSION: In PD patients who have advanced to requiring anti-PD therapies, there are salient associations between axial signs and cognitive performance and in particular, with different aspects of visuospatial function suggesting involvement of similar circuits in these functions. Associations between executive functions and bradykinesia also suggest involvement similar circuits in these functions

Relationship between Motor Symptoms, Cognition, and Demographic Characteristics in Treated Mild/Moderate Parkinson\u27s Disease.

BACKGROUND: Although Parkinson\u27s disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms, PD patients, at all stages of the disease, can experience cognitive dysfunction. However, the relationships between cognitive and motor symptoms and specific demographic characteristics are not well defined, particularly for patients who have progressed to requiring dopaminergic medication. OBJECTIVE: To examine relationships between motor and cognitive symptoms and various demographic factors in mild to moderate, PD patients requiring anti-PD medication. METHODS: Cognitive function was assessed in 94 subjects with a variety of neuropsychological tests during baseline evaluations as part of an experimental treatment study. Data were analyzed in relation to Unified Parkinson\u27s Disease Rating Scale motor scores and demographic variables. RESULTS: Of the UPDRS subscores analyzed, posture/balance/gait was associated with the highest number of adverse cognitive outcomes followed by speech/facial expression, bradykinesia, and rigidity. No associations were detected between any of the cognitive performance measures and tremor. Motor functioning assessed in the off condition correlated primarily with disease duration; neuropsychological performance in general was primarily related to age. CONCLUSION: In PD patients who have advanced to requiring anti-PD therapies, there are salient associations between axial signs and cognitive performance and in particular, with different aspects of visuospatial function suggesting involvement of similar circuits in these functions. Associations between executive functions and bradykinesia also suggest involvement similar circuits in these functions

GM1 ganglioside in Parkinson\u27s disease: Pilot study of effects on dopamine transporter binding.

OBJECTIVE: GM1 ganglioside has been suggested as a treatment for Parkinson\u27s disease (PD), potentially having symptomatic and disease modifying effects. The current pilot imaging study was performed to examine effects of GM1 on dopamine transporter binding, as a surrogate measure of disease progression, studied longitudinally. METHODS: Positron emission tomography (PET) imaging data were obtained from a subset of subjects enrolled in a delayed start clinical trial of GM1 in PD [1]: 15 Early-start (ES) subjects, 14 Delayed-start (DS) subjects, and 11 Comparison (standard-of-care) subjects. Treatment subjects were studied over a 2.5 year period while Comparison subjects were studied over 2 years. Dynamic PET scans were performed over 90 min following injection of [(11)C]methylphenidate. Regional values of binding potential (BPND) were analyzed for several striatal volumes of interest. RESULTS: Clinical results for this subset of subjects were similar to those previously reported for the larger study group. ES subjects showed early symptomatic improvement and slow symptom progression over the study period. DS and Comparison subjects were initially on the same symptom progression trajectory but diverged once DS subjects received GM1 treatment. Imaging results showed significant slowing of BPND loss in several striatal regions in GM1-treated subjects and in some cases, an increased BPND in some striatal regions was detected after GM1 use. INTERPRETATION: Results of this pilot imaging study provide additional data to suggest a potential disease modifying effect of GM1 on PD. These results need to be confirmed in a larger number of subjects

Correlations Between Neuropsychological Performance and Off UPDRS Motor Scores [r (p value)].

<p>BTA = Brief Test of Attention; RULIT = Ruff-Light Trail Learning Test; CAL = Conditional Associative Learning Test; SOC = Stockings of Cambridge</p><p>WCST = Wisconsin Card Sorting Test; SWM = Spatial Working Memory Test. Statistically significant relationships are shown in bold font.</p><p>Correlations Between Neuropsychological Performance and Off UPDRS Motor Scores [r (p value)].</p

Subject Demographics and Baseline Characteristics.

<p>Data presented as mean ± SD, unless otherwise noted.</p><p>*Dopamine agonists included pramipexole, ropinirole, pergolide and bromocriptine.</p><p>^Other medications included amantadine, trihexyphenidyl, and benztropine.</p><p>Subject Demographics and Baseline Characteristics.</p

Heat map showing the relationships between cognitive test performance (based on correlation coefficients) and subscores from the Unified Parkinson’s Disease Rating Scale (UPDRS) motor scales.

<p>Green denotes a significant negative correlation, red denotes a significant positive correlation and black denotes no significant correlation. The intensity of the color reflects the strength of the correlation.</p

Correlations Between Off-Period UPDRS Scores and Demographics [r (p value)].

<p>Statistically significant relationships are shown in bold font.</p><p>Correlations Between Off-Period UPDRS Scores and Demographics [r (p value)].</p

Correlations Between Neuropsychological Performance and Demographic Variables [r (p value)].

<p>BTA = Brief Test of Attention; RULIT = Ruff-Light Trail Learning Test; CAL = Conditional Associative Learning Test; SOC = Stockings of Cambridge</p><p>WCST = Wisconsin Card Sorting Test; SWM = Spatial Working Memory Test. Statistically significant relationships are shown in bold font.</p><p>Correlations Between Neuropsychological Performance and Demographic Variables [r (p value)].</p