Validation of the Italian version of the Parkinson's Disease- Cognitive Functional Rating Scale

A key distinguishing factor between mild cognitive impairment (MCI) and dementia in Parkinson's disease (PD) lies in the notable decrease in functioning due to cognitive impairment. The Parkinson's Disease-Cognitive Functional Rating Scale (PD-CRFS) was developed to assess functional limitations caused by cognitive impairment, while reducing the influence of motor impairment. The aim of this multicenter study was to (i) validate the Italian version of the PD-CFRS in PD, (ii) determine optimal cut-off scores for detecting MCI and dementia in PD, (iii) compare its performances with the most established functional assessment tool (IADL). Six hundred and sixty nine PD participants were recruited from 4 Italian Movement Disorders centers (Venice, Milan, Gravedona, and Salerno). They underwent Level-II cognitive evaluation, which resulted in 282 PD-NC, 310 PD-MCI, and 77 PDD. The PD-CFRS's psychometric and clinimetric properties, applicability, and responsiveness were analyzed. The PD-CFRS showed high acceptability. Floor and ceiling effects were acceptable. It also displayed strong internal consistency (Cronbach's α = 0.738), and test-retest reliability (ICC = .854). The PD-CFRS demonstrated higher coefficient of variation to detect dysfunction in PD-MCI patients in comparison to the IADL scale (PD-CFRS 96% vs IADL 22.5%). Convergent validity with the IADL was r = - 0.638 and - 0.527 in males and females, respectively. PD-CFRS total score negatively correlated with global cognition (MoCA corrected score r = - 0.61; p < 0.001). A cut-off score > 6.5 identified PDD with a sensitivity of 90% and specificity of 88% (AUC = .959). A cut-off value of > 1 detected PD-MCI with a sensitivity of 68% and specificity of 69% (AUC = .695). The Italian version of the PD-CFRS demonstrated to be an easy, valid and reliable tool that properly captures functional impairment due to cognitive decline in PD. It also proved to be particularly effective in the advanced stages of PD, and would be a useful support for the diagnosis of PD-MCI and PDD.

Face name matching and memory complaints in Parkinson’s disease

Objective

Memory impairment is a hallmark cognitive deficit in Parkinson’s disease (PD). However, it remains unclear which processes underlie this deficit in PD. Also, little is known on these patients’ subjective experiences of memory difficulties and their relationship with objective measures. We aim to portray memory deficits in PD by combining objective and subjective memory measures.

Methods

Fifteen PD patients and 15 controls were assessed with an extended version of the Face-Name Associative Memory Exam (FNAME) and the Memory Failures of Everyday Questionnaire (MFE-28). We also explored the relationship among clinical and cognitive variables.

Results

Participants with PD presented with more memory complaints. On the FNAME, these patients exhibited lower performance in free recall, as well as in name recognition and matching. Importantly, when controlling for initial learning, group effects disappeared, except for matching. Associative memory therefore was significantly compromised in PD and correlated with subjective memory complaints (SMC).

Conclusion

Our findings suggest that associative memory may constitute a sensitive measure to detect subtle memory deficits in PD. Moreover, the current study further clarifies the source of memory impairment in PD. Thus, our study highlights the clinical value of including associative memory tests such as the FNAME in PD neuropsychological assessment.

Facial emotion recognition in Parkinson's disease: The role of executive and affective domains

OBJECTIVE

The ability to recognize emotions from facial expression (FER) may be impaired in Parkinson's disease (PD). We aimed to explore FER in PD patients by using a dynamic presentation of emotions across different intensities and to examine the extent to which executive and affective alterations contributed to FER deficits.

METHOD

Fifteen PD patients and 15 healthy controls were assessed on the emotion recognition task (ERT). We also explored how clinical and executive factors could have contributed to ERT accuracy.

RESULTS

PD patients showed poorer performance on the ERT, specifically on angry expressions, but they benefited from increased intensity as much as controls did. Differences were also found for apathy, depression, and executive tests, especially in the inhibition domain. Importantly, differences between groups on the ERT disappeared when controlling for inhibition and the affective symptoms. A significant effect of inhibition dysfunction was also observed on the ERT performance.

CONCLUSIONS

Our findings demonstrate the presence of emotion recognition deficits of morphed facial expressions in patients with PD. Moreover, they suggest that inhibition dysfunctions may act as an important factor negatively influencing FER. The present study highlights the complex nature of emotion processing and its relation with emotional-affective and cognitive aspects to provide a better understanding of FER deficits in PD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cognitive and Behavioral Inhibition Deficits in Parkinson's Disease: The Hayling Test as a Reliable Marker

OBJECTIVE

The present study seeks to provide an overview of executive (inhibition and flexibility) deficits in Parkinson's disease (PD) by combining a cognitive and behavioral approach.

METHODS

Fifteen PD patients and 15 healthy controls underwent a neuropsychological and behavioral assessment including the Hayling and Trails Tests, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP-RS), the Behavior Rating Inventory of Executive Function (BRIEF-A), and the Short Form-36 Health Survey (SF-36). The level of awareness of executive functioning was also analyzed. We finally explored how these neuropsychological and clinical outcomes could relate to each other.

RESULTS

PD patients performed significantly worse in both neuropsychological tasks designed to evaluate inhibition abilities. They also reported more inhibition difficulties in everyday life and poorer quality of life. Associations between neuropsychological measures and self-reports were found. Moreover, as indicated by the discrepancy score, PD patients were as accurate as their relatives in self-reporting their executive daily difficulties.

CONCLUSION

Inhibition and cognitive flexibility impairments assessed by the neuropsychological tests (Hayling and Trails tests) seem to capture daily life executive problems in PD. Furthermore, our study provides a deeper understanding of PD patients' and their relatives' experience of these executive dysfunctions.

Quantifying memory deficits in amnestic mild cognitive impairment

INTRODUCTION

In the present study, we use the item-specific deficit approach (ISDA), a method for characterizing memory deficits in list-learning, to portray the memory deficits in amnestic mild cognitive impairment (aMCI).

METHODS

We applied the ISDA to compare memory performance of patients with aMCI and healthy controls in encoding, consolidation, and retrieval using the Free and Cued Selective Reminding Test.

RESULTS

The results revealed clear differences in recall performance between patients with aMCI and controls. When analyzing the ISDA deficit indices, the results revealed a prominent encoding deficit, followed by a consolidating deficit. A greater sensitivity for the encoding index confirmed that a difficulty with encoding information plays a major role in explaining the episodic memory deficits experienced by patients with aMCI.

DISCUSSION

The present study applying the ISDA reveals great sensitivity and specificity of the encoding deficit index when identifying aMCI. As aMCI constitutes a risk factor to develop Alzheimer's disease, the current findings also confirm the need to concentrate on encoding deficits as an early diagnostic sign of cognitive decline.