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D'Iorio A, Guida P, Maggi G, Redgrave P, Santangelo G, Obeso I. Neuropsychological spectrum in early PD: Insights from controlled and automatic behavioural regulation. Neurosci Biobehav Rev 2021; 126:465-480. [PMID: 33836213 DOI: 10.1016/j.neubiorev.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/05/2021] [Accepted: 04/02/2021] [Indexed: 11/15/2022]
Abstract
Initial changes in Parkinson's disease (PD) are marked by loss of automatic movements and decline of some cognitive functions. Yet, the exact profile and extent of cognitive impairments in early stages of PD as well as their mechanisms related to automatic motor dysfunction remain unclear. Our objective was to examine the neuropsychological changes in early PD and their association to automatic and controlled modes of behavioural control. Significant relationships between early PD and cognitive dysfunction in set-shifting, abstraction ability/concept formation, processing speed, visuospatial/constructional abilities and verbal-visual memory was found. We also noted that tests with a strong effortful and controlled component were similarly affected as automatic tests by early PD, particularly those testing verbal memory, processing speed and visuospatial/constructional functions. Our findings indicate that initial stages of PD sets constraints over most of the cognitive domains normally assessed and are not easily explained in terms of either automatic or controlled mechanisms, as both appear similarly altered in early PD.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pasqualina Guida
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Peter Redgrave
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ignacio Obeso
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain.
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A meta-analytic review of prospection deficits in Parkinson's disease. Neurosci Biobehav Rev 2019; 108:34-47. [PMID: 31682884 DOI: 10.1016/j.neubiorev.2019.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/21/2022]
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative disorders, and is associated with prominent motor deficits. However, neurocognitive impairment is also a common clinical feature that can contribute greatly to the overall disease burden. In the current study, a meta-analysis was conducted to gain a clearer understanding of how PD affects one of the most functionally important domains of cognition: prospection. The results indicate that, relative to controls, PD is associated with a large deficit in the capacity to engage in planning (g = -0.81, K = 25) and a moderate-sized deficit in prospective memory (g = -0.57, K = 16). Sub-analyses indicated that these deficits are evident for both time and event-based prospective memory, as well as for prospective memory tasks that have relatively limited ecological validity. Significant impairment was also evident for both medicated and non-medicated PD sub-groups, but for planning, these deficits were substantially greater in the unmedicated sub-group. The theoretical and practical implications of these findings are discussed.
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Prospective memory in Parkinson’s disease: the role of the motor subtypes. J Neurol 2019; 266:2505-2511. [DOI: 10.1007/s00415-019-09448-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 11/24/2022]
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Jia SH, Li K, Su W, Li SH, Chen HB. Impairment in the Intention Formation and Execution Phases of Prospective Memory in Parkinson's Disease. Front Neurosci 2018. [PMID: 29527152 PMCID: PMC5829067 DOI: 10.3389/fnins.2018.00098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Patients with Parkinson's disease have prospective memory impairments. However, little is known about distinct phases of prospective memory in these patients. This study was designed to elucidate the specific phase(s) of prospective memory that are impaired in patients with Parkinson's disease. Methods: The study included 31 Parkinson's disease patients and 27 healthy controls. The four phases of prospective memory (intention formation, retention, initiation, and execution) were examined in a complex prospective memory task. In this task, the participants were asked to form a sophisticated plan for performing six subtasks to obtain the highest score, and then execute the plan following a cue embedded in a questionnaire. Global cognitive function and relevant cognitive abilities, including attention, short-term memory, working memory, and inhibition, were also evaluated during the retention phase of the prospective memory task. Results: Intention formation was impaired in Parkinson's disease patients (p < 0.001 vs. healthy controls). This impairment could not be attributed to deficits in other cognitive functions. The score of intention execution was also lower in Parkinson's disease patients (p = 0.004 vs. healthy controls). Such a difference was related to working memory deficits in Parkinson's disease. The intention retention and initiation were intact in Parkinson's disease patients. The score of intention execution correlated negatively with disease severity and disease duration. Conclusions: Prospective memory in Parkinson's disease patients is impaired at the phase of intention formation. The worsening performance of intention execution in Parkinson's disease may be related to working memory deficits. In addition, prospective memory impairment might progress with increasing disease duration and severity.
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Affiliation(s)
- Shu-Hong Jia
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Kai Li
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Wen Su
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Shu-Hua Li
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Hai-Bo Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
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Marcone S, Gagnon JF, Desjardins C, David AC, Postuma RB, Montplaisir J, Joubert S, Rouleau I. Prospective memory in idiopathic REM sleep behavior disorder with or without mild cognitive impairment: A preliminary study. Clin Neuropsychol 2018; 33:571-593. [DOI: 10.1080/13854046.2018.1435825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sonia Marcone
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Jean-François Gagnon
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Catherine Desjardins
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Annie-Claude David
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Ronald B. Postuma
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
- Department of Neurology, Montreal General Hospital, Montreal, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Sven Joubert
- Institut universitaire de gériatrie de Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Isabelle Rouleau
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
- Hôpital Notre-Dame du Centre Hospitalier de l’Université de Montréal, Montreal, Canada
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Costa A, Caltagirone C, Carlesimo GA. Prospective memory functioning in individuals with Parkinson’s disease: a systematic review. Clin Neuropsychol 2017; 32:937-959. [DOI: 10.1080/13854046.2017.1407457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Alberto Costa
- Psychology Department, Niccolò Cusano University, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Carlo Caltagirone
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy
| | - Giovanni Augusto Carlesimo
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy
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The range and nature of non-motor symptoms in drug-naive Parkinson's disease patients: a state-of-the-art systematic review. NPJ PARKINSONS DISEASE 2015; 1:15013. [PMID: 28725682 PMCID: PMC5516558 DOI: 10.1038/npjparkd.2015.13] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/16/2015] [Accepted: 06/03/2015] [Indexed: 12/21/2022]
Abstract
Non-motor symptoms (NMS) are a key component of Parkinson’s disease (PD). A range of NMS, most notably impaired sense of smell, sleep dysfunction, and dysautonomia are present from the ‘pre-motor’ phase to the final palliative stage. Theories as to the pathogenesis of PD such as those proposed by Braak and others also support the occurrence of NMS in PD years before motor symptoms start. However, research addressing the range and nature of NMS in PD has been confounded by the fact that many NMS arise as part of drug-related side effects. Thus, drug-naive PD (DNPD) patients provide an ideal population to study the differences in the presentation of NMS. The aim of this paper is therefore to systematically review all the available studies of NMS in DNPD patients. We believe this is the first review of its kind. The current review confirms the increasing research being conducted into NMS in DNPD patients as well as the necessity for further investigation into less-studied NMS, such as pain. Moreover, the data confirms non-motor heterogeneity among PD patients, and, therefore, further research into the concept of non-motor subtyping is encouraged. The review suggests that the clinical assessment of NMS should be integral to any assessment of PD in clinical and research settings.
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Spalletta G, Robinson RG, Cravello L, Pontieri FE, Pierantozzi M, Stefani A, Long JD, Caltagirone C, Assogna F. The early course of affective and cognitive symptoms in de novo patients with Parkinson's disease. J Neurol 2014; 261:1126-32. [PMID: 24695996 DOI: 10.1007/s00415-014-7327-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/21/2014] [Accepted: 03/22/2014] [Indexed: 02/02/2023]
Abstract
Neuropsychiatric and cognitive symptoms are common in patients with Parkinson's disease (PD) from the early stage of the disease but their course is still unclear. In this study we investigated prospectively the progression of affective and cognitive symptoms and disorders in de novo idiopathic PD patients. Twenty-four de novo drug naïve PD patients underwent a comprehensive neurological, psychopathological and neuropsychological evaluation at the first diagnostic visit (OFF), after 4-6 months when the antiparkinsonian therapy regimen was stabilized (ON-1), and at one year following the ON-1 follow-up visit (ON-2). Generalized least squares analysis revealed a significant improvement over time in the depressive mood, short and long term episodic verbal memory, visual memory, and the motor symptoms. Pairwise comparisons showed a significant change from OFF to ON-1 for all the aforementioned variables, except for short term episodic verbal memory which approached significance. A significant improvement from ON-1 to ON-2, however, was shown for short term episodic verbal memory. An ancillary analysis indicated that overall level and change in a number of cognitive variables, but not depression, was conditional upon age of onset, education, and sometime gender. In conclusion, early stage PD is not associated with affective and cognitive deterioration. On the contrary, very specific neuropsychiatric and cognitive symptoms may improve. This study provides Class III evidence that antiparkinsonian treatment commonly used in the clinical practice improves memory performance and depression severity in de novo patients with PD.
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Affiliation(s)
- Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179, Rome, Italy,
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Abstract
Prospective memory (PM) refers to the ability to remember to carry out an intended action in the future and it is pervasive in our daily living. A failure to execute an intended action (e.g., take medication) at the appropriate juncture in future (e.g., after dinner) can negatively affect our daily functioning and at times, may have devastating effects (e.g., forgetting to turn off the gas stove before leaving the house). Patients with Parkinson's disease (PD) exhibit widespread cognitive deficits including deficits in PM. The present study provides a meta-analytic review of PM in PD. Results across nine studies indicated time and event-based PM to be similarly impaired in PD, with time-based PM compromised to a slightly larger extent (Hedges' g = -0.71) as compared to event-based PM (Hedges' g = -0.55). The impairment in PM is more likely due to failure in self-initiated retrieval of intention to be executed, rather than forgetting the content of the intention itself. Furthermore, factors such as intervening task complexity and the mediating role of other executive functions have also been proposed to be responsible for impaired PM in PD.
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Foster ER, Rose NS, McDaniel MA, Rendell PG. Prospective memory in Parkinson disease during a virtual week: effects of both prospective and retrospective demands. Neuropsychology 2013; 27:170-81. [PMID: 23527645 DOI: 10.1037/a0031946] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study investigated the effect of Parkinson's disease (PD) on event-based prospective memory tasks with varying demand on (1) the amount of strategic attentional monitoring required for intention retrieval (prospective component), and (2) the retrospective memory processes required to remember the contents of the intention or the entire constellation of prospective memory tasks. METHOD Twenty-four older adults with PD and 28 healthy older adults performed the computerized Virtual Week task, a multi-intention prospective memory paradigm that simulates everyday prospective memory tasks. The Virtual Week included regular (low retrospective memory demand) and irregular (high retrospective memory demand) prospective memory tasks with cues that were focal (low strategic monitoring demand) or less focal (high strategic monitoring demand) to the ongoing activity. RESULTS For the regular prospective memory tasks, PD participants were impaired when the prospective memory cues were less focal. For the irregular prospective memory tasks, PD participants were impaired regardless of prospective memory cue type. PD participants also had impaired retrospective memory for irregular tasks, which was associated with worse prospective memory for these tasks during the Virtual Week. CONCLUSIONS When retrospective memory demands are minimized, prospective memory in PD can be supported by cues that reduce the executive control demands of intention retrieval. However, PD-related deficits in self-initiated encoding or planning processes have strong negative effects on the performance of prospective memory tasks, with increased retrospective memory demand.
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Affiliation(s)
- Erin R Foster
- Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
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Tam JW, Schmitter-Edgecombe M. Event-based prospective memory and everyday forgetting in healthy older adults and individuals with mild cognitive impairment. J Clin Exp Neuropsychol 2013; 35:279-90. [PMID: 23419059 DOI: 10.1080/13803395.2013.770823] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
An event-based nonfocal task was used to evaluate prospective memory (PM) and the relationship between PM, neuropsychological testing data, and everyday forgetting. Twenty-four participants with mild cognitive impairment (MCI) and 24 age- and education-matched cognitively healthy adults responded to a nonfocal PM cue, while completing an ongoing working memory task. Neuropsychological testing data and self- and informant-report of frequency of forgetting were also gathered. Compared to healthy adults, the MCI participants exhibited significantly poorer prospective remembering and ongoing task performance, despite similar self-reported effort directed to the PM task. Both self- and informant-report indicated that the MCI group was experiencing a higher frequency of everyday forgetting than the healthy adult group. Self-report of everyday forgetting was correlated with PM task performance for the healthy adults, but not for the MCI participants. For the healthy adults, correlational analyses also showed significant relationships between PM accuracy and tests of memory and executive functioning, suggesting that both spontaneous retrieval processes and effortful, strategic monitoring may be important in supporting prospective remembering for this nonfocal PM task. The stronger relationships between PM accuracy and memory and language tests for the MCI group suggest that their poorer event-based prospective remembering might be linked to impaired spontaneous retrieval processes, which are thought to be supported by medial temporal structures.
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Affiliation(s)
- Joyce W Tam
- Department of Psychology, Washington State University, Pullman, WA 99164-4820, USA
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Ceravolo R, Pagni C, Tognoni G, Bonuccelli U. The epidemiology and clinical manifestations of dysexecutive syndrome in Parkinson's disease. Front Neurol 2012; 3:159. [PMID: 23162529 PMCID: PMC3497716 DOI: 10.3389/fneur.2012.00159] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 10/21/2012] [Indexed: 11/13/2022] Open
Abstract
This mini-review summarizes the evidence of the cognitive and behavioral features of dysexecutive syndrome in Parkinson’s disease (PD). Deficits in response inhibition, set-shifting, mental flexibility, and strategy have been frequently described from the earliest stages of PD, although there are inconsistencies in study findings due to the complexity of the executive function (EF) construct and methodological limitations. Behavioral disorders of PD, e.g., apathy, distractibility, perseverative behavior, and impulse-control disorders, may be viewed as the other side of dysexecutive syndrome. Despite the interrelationship between the cognitive and behavioral domains, some reports reveal that the two syndromes may be dissociated, suggesting that both aspects must be clinically assessed. EFs are widely associated with the prefrontal areas, although dysexecutive syndrome may be observed in patients with damage to other brain regions. EFs drive numerous abilities essential to daily life, such as prospective remembering and language comprehension, which may be impaired in PD subjects. Considering the impact of dysexecutive syndrome on independence and quality of life, early detection of executive impairment is crucial in the management of PD.
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