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Bode M, Kalbe E, Liepelt-Scarfone I. Cognition and Activity of Daily Living Function in people with Parkinson's disease. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02796-w. [PMID: 38976044 DOI: 10.1007/s00702-024-02796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024]
Abstract
The ability to perform activities of daily living (ADL) function is a multifaceted construct that reflects functionality in different daily life situations. The loss of ADL function due to cognitive impairment is the core feature for the diagnosis of Parkinson's disease dementia (PDD). In contrast to Alzheimer's disease, ADL impairment in PD can be compromised by various factors, including motor and non-motor aspects. This narrative review summarizes the current state of knowledge on the association of cognition and ADL function in people with PD and introduces the concept of "cognitive ADL" impairment for those problems in everyday life that are associated with cognitive deterioration as their primary cause. Assessment of cognitive ADL impairment is challenging because self-ratings, informant-ratings, and performance-based assessments seldomly differentiate between "cognitive" and "motor" aspects of ADL. ADL function in PD is related to multiple cognitive domains, with attention, executive function, and memory being particularly relevant. Cognitive ADL impairment is characterized by behavioral anomalies such as trial-and-error behavior or task step omissions, and is associated with lower engagement in everyday behaviors, as suggested by physical activity levels and prolonged sedentary behavior. First evidence shows that physical and multi-domain interventions may improve ADL function, in general, but the evidence is confounded by motor aspects. Large multicenter randomized controlled trials with cognitive ADL function as primary outcome are needed to investigate which pharmacological and non-pharmacological interventions can effectively prevent or delay deterioration of cognitive ADL function, and ultimately the progression and conversion to PDD.
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Affiliation(s)
- Merle Bode
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
- Medical Faculty, University of Cologne, Cologne, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
- IB-Hochschule, Stuttgart, Germany.
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Ophey A, Wirtz K, Wolfsgruber S, Balzer-Geldsetzer M, Berg D, Hilker-Roggendorf R, Kassubek J, Liepelt-Scarfone I, Becker S, Mollenhauer B, Reetz K, Riedel O, Schulz JB, Storch A, Trenkwalder C, Witt K, Wittchen HU, Dodel R, Roeske S, Kalbe E. Mid- and late-life lifestyle activities as main drivers of general and domain-specific cognitive reserve in individuals with Parkinson's disease: cross-sectional and longitudinal evidence from the LANDSCAPE study. J Neurol 2024:10.1007/s00415-024-12484-0. [PMID: 38951175 DOI: 10.1007/s00415-024-12484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/06/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Cognitive reserve (CR) is considered a protective factor for cognitive function and may explain interindividual differences of cognitive performance given similar levels of neurodegeneration, e.g., in Alzheimer´s disease. Recent evidence suggests that CR is also relevant in Parkinson's disease (PD). OBJECTIVE We aimed to explore the role of life-stage specific CR for overall cognition and specific cognitive domains cross-sectionally and longitudinally in PD. METHODS The cross-sectional analysis with data from the DEMPARK/LANDSCAPE study included 81 individuals without cognitive impairment (PD-N) and 87 individuals with mild cognitive impairment (PD-MCI). Longitudinal data covered 4 years with over 500 observations. CR was operationalized with the Lifetime of Experiences Questionnaire (LEQ), capturing the complexity of lifestyle activities across distinct life-stages. Cognition was assessed using a comprehensive neuropsychological test battery. RESULTS Higher LEQ scores, particularly from mid- and late-life, were observed in PD-N compared to PD-MCI [F(1,153) = 4.609, p = .033, ηp2 = 0.029]. They were significantly associated with better cognitive performance (0.200 ≤ β ≤ 0.292). Longitudinally, linear mixed effect models (0.236 ≤ marginal R2 ≤ 0.441) revealed that LEQ scores were positively related to cognitive performance independent of time. However, the decline in overall cognition and memory over time was slightly more pronounced with higher LEQ scores. CONCLUSIONS This study emphasizes the association between complex lifestyle activities and cognition in PD. Data indicate that while CR might be related to a delay of cognitive decline, individuals with high CR may experience a more pronounced drop in overall cognition and memory. Future studies will have to replicate these findings, particularly regarding domain-specific effects and considering reverse causal mechanisms.
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Affiliation(s)
- Anja Ophey
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Kathrin Wirtz
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | | | - Daniela Berg
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian Albrechts-University (CAU), Campus Kiel, Kiel, Germany
| | | | - Jan Kassubek
- Department of Neurology, University Hospital Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
- IB-Hochschule, Stuttgart, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Sara Becker
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Britt Mollenhauer
- Paracelsus-Elena Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center, Goettingen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany
- JARA Institute Molecular Neuroscience and Neuroimaging (INM-11), Juelich, Aachen, Germany
| | - Oliver Riedel
- Department Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany
- JARA Institute Molecular Neuroscience and Neuroimaging (INM-11), Juelich, Aachen, Germany
| | - Alexander Storch
- Department of Neurology, University of Rostock and German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center, Goettingen, Germany
| | - Karsten Witt
- Department of Neurology, School of Medicine and Health Sciences and Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
- Department of Neurology, Evangelic Hospital Oldenburg, Oldenburg, Germany
| | - Hans-Ullrich Wittchen
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Richard Dodel
- Department of Geriatric Medicine, University Duisburg-Essen, Essen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Ophey A, Röttgen S, Pauquet J, Weiß KL, Scharfenberg D, Doppler CEJ, Seger A, Hansen C, Fink GR, Sommerauer M, Kalbe E. Cognitive training and promoting a healthy lifestyle for individuals with isolated REM sleep behavior disorder: study protocol of the delayed-start randomized controlled trial CogTrAiL-RBD. Trials 2024; 25:428. [PMID: 38943191 PMCID: PMC11214208 DOI: 10.1186/s13063-024-08265-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/18/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Isolated REM sleep behavior disorder (iRBD) is an early α-synucleinopathy often accompanied by incipient cognitive impairment. As executive dysfunctions predict earlier phenotypic conversion from iRBD to Parkinson's disease and Lewy body dementia, cognitive training focusing on executive functions could have disease-modifying effects for individuals with iRBD. METHODS The study CogTrAiL-RBD investigates the short- and long-term effectiveness and the feasibility and underlying neural mechanisms of a cognitive training intervention for individuals with iRBD. The intervention consists of a 5-week digital cognitive training accompanied by a module promoting a healthy, active lifestyle. In this monocentric, single-blinded, delayed-start randomized controlled trial, the intervention's effectiveness will be evaluated compared to an initially passive control group that receives the intervention in the second, open-label phase of the study. Eighty individuals with iRBD confirmed by polysomnography will be consecutively recruited from the continuously expanding iRBD cohort at the University Hospital Cologne. The evaluation will focus on cognition and additional neuropsychological and motor variables. Furthermore, the study will examine the feasibility of the intervention, effects on physical activity assessed by accelerometry, and interrogate the intervention's neural effects using magnetic resonance imaging and polysomnography. Besides, a healthy, age-matched control group (HC) will be examined at the first assessment time point, enabling a cross-sectional comparison between individuals with iRBD and HC. DISCUSSION This study will provide insights into whether cognitive training and psychoeducation on a healthy, active lifestyle have short- and long-term (neuro-)protective effects for individuals with iRBD. TRIAL REGISTRATION The study was prospectively registered in the German Clinical Trial Register (DRKS00024898) on 2022-03-11, https://drks.de/search/de/trial/DRKS00024898 . PROTOCOL VERSION V5 2023-04-24.
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Affiliation(s)
- Anja Ophey
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.
| | - Sinah Röttgen
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Julia Pauquet
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Kim-Lara Weiß
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Daniel Scharfenberg
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Christopher E J Doppler
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Aline Seger
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Clint Hansen
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Gereon R Fink
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Michael Sommerauer
- Cognitive Neuroscience, Institute for Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
- Center of Neurology, Department of Parkinson, Sleep and Movement Disorders, University of Bonn, Bonn, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
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Angelopoulou E, Bougea A, Hatzimanolis A, Stefanis L, Scarmeas N, Papageorgiou S. Mild Behavioral Impairment in Parkinson's Disease: An Updated Review on the Clinical, Genetic, Neuroanatomical, and Pathophysiological Aspects. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:115. [PMID: 38256375 PMCID: PMC10820007 DOI: 10.3390/medicina60010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Neuropsychiatric symptoms (NPS), including depression, anxiety, apathy, visual hallucinations, and impulse control disorders, are very common during the course of Parkinson's disease (PD), occurring even at the prodromal and premotor stages. Mild behavioral impairment (MBI) represents a recently described neurobehavioral syndrome, characterized by the emergence of persistent and impactful NPS in later life, reflecting arisk of dementia. Accumulating evidence suggests that MBI is highly prevalent in non-demented patients with PD, also being associated with an advanced disease stage, more severe motor deficits, as well as global and multiple-domain cognitive impairment. Neuroimaging studies have revealed that MBI in patients with PD may be related todistinct patterns of brain atrophy, altered neuronal connectivity, and distribution of dopamine transporter (DAT) depletion, shedding more light on its pathophysiological background. Genetic studies in PD patients have also shown that specific single-nucleotide polymorphisms (SNPs) may be associated with MBI, paving the way for future research in this field. In this review, we summarize and critically discuss the emerging evidence on the frequency, associated clinical and genetic factors, as well as neuroanatomical and neurophysiological correlates of MBI in PD, aiming to elucidate the underlying pathophysiology and its potential role as an early "marker" of cognitive decline, particularly in this population. In addition, we aim to identify research gaps, and propose novel relative areas of interest that could aid in our better understanding of the relationship of this newly defined diagnostic entity with PD.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Anastasia Bougea
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Alexandros Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Leonidas Stefanis
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Sokratis Papageorgiou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
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Pauly L, Rauschenberger A, Pauly C, Schröder VE, Van Cutsem G, Leist AK, Krüger R. Cognition and Other Non-Motor Symptoms in an At-Risk Cohort for Parkinson's Disease Defined by REM-Sleep Behavior Disorder and Hyposmia. JOURNAL OF PARKINSON'S DISEASE 2024; 14:545-556. [PMID: 38669560 DOI: 10.3233/jpd-230285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background REM-sleep behavior disorder (RBD) and other non-motor symptoms such as hyposmia were proposed by the Movement Disorder Society as research criteria for prodromal Parkinson's disease (P-PD). Global cognitive deficit was later added. Objective To compare non-motor symptoms, focusing on cognition, between a P-PD group and a matched control group. Methods In this cross-sectional, case-control study, in a first set of analyses, we performed extensive cognitive testing on people with (n = 76) and a control group without (n = 195) probable RBD and hyposmia. Furthermore, we assessed motor and non-motor symptoms related to Parkinson's Disease (PD). After propensity score matching, we compared 62 P-PD with 62 age- and sex-matched controls. In addition, we performed regression analyses on the total sample (n = 271). In a second set of analyses, we used, a.o., the CUPRO to evaluate retrograde procedural memory and visuo-constructive functions. Results People with P-PD showed significantly poorer performances in global cognition, visuo-constructive and executive functions, mainly in mental flexibility (p < 0.001; p = 0.004; p = 0.003), despite similar educational levels (p = 0.415). We observed significantly more motor and non-motor symptoms (p < 0.001; p = 0.004), higher scores for depression (p = 0.004) and apathy (p < 0.001) as well as lower quality of life (p < 0.001) in P-PD. CONCLUSIONS Our findings confirm that global cognitive, executive, and visuo-constructive deficits define the P-PD group. In addition, depression, apathy, and lower quality of life were more prevalent in P-PD. If replicated in other samples, executive and visuo-constructive deficits should be considered in non-motor P-PD. Determining specific patterns will support early recognition of PD, secondary prevention of complications and the development of neuroprotective treatments.
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Affiliation(s)
- Laure Pauly
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Parkinson Research Clinic, Luxembourg, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
| | - Armin Rauschenberger
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claire Pauly
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Parkinson Research Clinic, Luxembourg, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
| | - Valerie E Schröder
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Parkinson Research Clinic, Luxembourg, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
| | - Gilles Van Cutsem
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Parkinson Research Clinic, Luxembourg, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
| | - Anja K Leist
- Department of Social Sciences, Institute for Research on Socio-Economic Inequality, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Rejko Krüger
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Parkinson Research Clinic, Luxembourg, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
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Kimura N, Hirano D, Yano H, Taniguchi K, Taniguchi T. Relationship between reaction time variability on go/no go tasks and neuropsychological functioning in younger and older adults. J Clin Exp Neuropsychol 2023; 45:905-914. [PMID: 38368621 DOI: 10.1080/13803395.2024.2319266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/08/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Early detection of cognitive impairment in older adults is important for the prevention of dementia. Intra-individual variability in reaction time (IIV-RT) during go/no-go tasks can be used for the early detection of cognitive impairment in older adults living in the community. This study aimed to determine the relationship between IIV-RT and cognitive function during go/no-go tasks and the cutoff values for determining the risk of cognitive impairment in community-dwelling older adults. METHODS This study included 31 older adults without cognitive impairment, 15 community-dwelling older adults with cognitive impairment, and 34 healthy young adults. All participants performed a go/no-go task to assess the IIV-RT. Additionally, older adults underwent neuropsychological testing. Based on the results of the Japanese version of the Montreal Test of Cognitive Abilities (MoCA-J), older adults were divided into those with normal cognition and those with cognitive impairment. RESULTS There were significant differences in the IIV-RT among groups, including a higher IIV in the cognitively impaired group than in young adults and cognitively normal older adults. Moreover, the IIV-RT was correlated with the MoCA-J (r = -0.531, p < 0.001), Trail Making Test Part A (r = 0.571, p < 0.001), and Verbal Fluency Test scores (r = -0.442, p = 0.002). Receiver operating curve analysis showed that the area under the curve for IIV-RT was 0.935, and the cutoff value at which the IIV-RT identified cognitive impairment was 25.37%. CONCLUSIONS These findings indicate that the IIV-RT during go/no-go tasks is a useful early indicator of cognitive impairment in community-dwelling older adults.
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Affiliation(s)
- Naotoshi Kimura
- Department of Occupational Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Chiba, Japan
| | - Daisuke Hirano
- Department of Occupational Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tokyo, Japan
| | - Hana Yano
- Department of Occupational Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Keita Taniguchi
- Department of Psychiatry and Neuroscience, Keio University Graduate School of Medicine, Tokyo, Japan
| | - Takamichi Taniguchi
- Department of Occupational Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Chiba, Japan
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tokyo, Japan
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7
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Novikov NI, Brazhnik ES, Kitchigina VF. Pathological Correlates of Cognitive Decline in Parkinson's Disease: From Molecules to Neural Networks. BIOCHEMISTRY. BIOKHIMIIA 2023; 88:1890-1904. [PMID: 38105206 DOI: 10.1134/s0006297923110172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 12/19/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder caused by the death of dopaminergic neurons in the substantia nigra and appearance of protein aggregates (Lewy bodies) consisting predominantly of α-synuclein in neurons. PD is currently recognized as a multisystem disorder characterized by severe motor impairments and various non-motor symptoms. Cognitive decline is one of the most common and worrisome non-motor symptoms. Moderate cognitive impairments (CI) are diagnosed already at the early stages of PD, usually transform into dementia. The main types of CI in PD include executive dysfunction, attention and memory decline, visuospatial impairments, and verbal deficits. According to the published data, the following mechanisms play an essential role demonstrates a crucial importance in the decline of the motor and cognitive functions in PD: (1) changes in the conformational structure of transsynaptic proteins and protein aggregation in presynapses; (2) synaptic transmission impairment; (3) neuroinflammation (pathological activation of the neuroglia); (4) mitochondrial dysfunction and oxidative stress; (5) metabolic disorders (hypometabolism of glucose, dysfunction of glycolipid metabolism; and (6) functional rearrangement of neuronal networks. These changes can lead to the death of dopaminergic cells in the substantia nigra and affect the functioning of other neurotransmitter systems, thus disturbing neuronal networks involved in the transmission of information related to the regulation of motor activity and cognitive functions. Identification of factors causing detrimental changes in PD and methods for their elimination will help in the development of new approaches to the therapy of PD. The goal of this review was to analyze pathological processes that take place in the brain and underlie the onset of cognitive disorders in PD, as well as to describe the impairments of cognitive functions in this disease.
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Affiliation(s)
- Nikolai I Novikov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia
| | - Elena S Brazhnik
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia
| | - Valentina F Kitchigina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia.
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Montanari M, Imbriani P, Bonsi P, Martella G, Peppe A. Beyond the Microbiota: Understanding the Role of the Enteric Nervous System in Parkinson's Disease from Mice to Human. Biomedicines 2023; 11:1560. [PMID: 37371655 DOI: 10.3390/biomedicines11061560] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The enteric nervous system (ENS) is a nerve network composed of neurons and glial cells that regulates the motor and secretory functions of the gastrointestinal (GI) tract. There is abundant evidence of mutual communication between the brain and the GI tract. Dysfunction of these connections appears to be involved in the pathophysiology of Parkinson's disease (PD). Alterations in the ENS have been shown to occur very early in PD, even before central nervous system (CNS) involvement. Post-mortem studies of PD patients have shown aggregation of α-synuclein (αS) in specific subtypes of neurons in the ENS. Subsequently, αS spreads retrogradely in the CNS through preganglionic vagal fibers to this nerve's dorsal motor nucleus (DMV) and other central nervous structures. Here, we highlight the role of the ENS in PD pathogenesis based on evidence observed in animal models and using a translational perspective. While acknowledging the putative role of the microbiome in the gut-brain axis (GBA), this review provides a comprehensive view of the ENS not only as a "second brain", but also as a window into the "first brain", a potentially crucial element in the search for new therapeutic approaches that can delay and even cure the disease.
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Affiliation(s)
- Martina Montanari
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
- Department of Systems Neuroscience, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Paola Imbriani
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
- Clinical Neuroscience, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Paola Bonsi
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
| | - Giuseppina Martella
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
| | - Antonella Peppe
- Clinical Neuroscience, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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