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Cognitive function and other non-motor features in non-demented Parkinson’s disease motor subtypes

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Among patients with Parkinson’s disease (PD), a wide range of non-motor symptoms (NMS) are evident. We assessed markers of NMS and explored their behavioral correlates with the tremor-dominant (TD) and postural instability gait difficulty (PIGD) subtypes. 110 non-demented patients with PD were evaluated and stratified into the PIGD and TD subtypes and, using stricter criteria, into predominant subgroups: p-PIGD (n = 31) and p-TD (n = 32). Non-motor signs that were assessed included cognitive function (pen and paper and a computerized battery), autonomic function (NMSQest and SCOPA-AUT), mood, and sleep. Health-related quality of life was evaluated using the PDQ-39. The p-PIGD subgroup had a higher score on the NMSQest (p = 0.033) and a higher score (i.e., worse) on the PDQ-39 (p-PIGD: 26.28 ± 12.47; p-TD: 16.93 ± 12.22; p = 0.004), compared to the p-TD subgroup, while these measures did not differ in the larger PIGD and TD group. The p-PIGD subgroup used more sleep medications compared to the p-TD subgroup (1.0 ± 1.39 vs. 0.41 ± 0.94, p = 0.05, respectively). Most cognitive scores were similar in both subgroups; however, the visuospatial components of the Montreal Cognitive Assessment and the computerized catch game were significantly worse among the p-PIGD subgroup. Mild associations were found between certain non-motor symptoms, but not cognitive function, and the PIGD score. Non-demented patients from the PIGD subtype experience more non-motor symptoms and poorer quality of life compared to the TD subtype. These findings suggest that the clinical management of non-motor and motor symptoms in patients with PD may be enhanced by a personalized approach.

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Acknowledgments

This work was funded in part by the Michael J. Fox Foundation for Parkinson’s Research. We thank the subjects for their participation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Tel Aviv Sourasky Medical Center, Center for the Study of Movement, Cognition and Mobility, 6 Weizman Street, 64239, Tel Aviv, Israel

    Talia Herman, Aner Weiss, Marina Brozgol, Adi Wilf-Yarkoni, Nir Giladi & Jeffrey M. Hausdorff

  2. The Dr. Miriam and Sheldon G. Adelson Graduate School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Talia Herman

  3. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel

    Nir Giladi & Jeffrey M. Hausdorff

  4. Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Nir Giladi

  5. Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Jeffrey M. Hausdorff

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  1. Talia Herman
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  2. Aner Weiss
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  3. Marina Brozgol
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  4. Adi Wilf-Yarkoni
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Correspondence to Jeffrey M. Hausdorff.

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Herman, T., Weiss, A., Brozgol, M. et al. Cognitive function and other non-motor features in non-demented Parkinson’s disease motor subtypes. J Neural Transm 122, 1115–1124 (2015). https://doi.org/10.1007/s00702-014-1349-1

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