Abstract
Cognitive and perceptual impairments in Parkinson’s disease (PD) contribute substantially to reduced quality of life and implicate the dysfunction of multiple systems including widespread cortical regions and the basal ganglia. Common impairments in attention, executive function, and visuospatial function reflect a disruption of neuronal circuits between the striatum and prefrontal and parietal cortices. In this chapter, we focus mainly on visuospatial cognition and perception, areas of recent growth in research. We include discussion of disparities in visuospatial and perceptual performance by PD subgroups, defined by characteristics of motor symptom onset: body side of initial symptom (left, right) and type of initial symptom (tremor, non-tremor). We describe how some of the visuocognitive impairments seen in PD may be related to changes in basic visual abilities and in visual perception, and how basal ganglia-mediated motor dysfunction, and cortical dysfunction affecting visual perception, may be associated with changes in action observation (perception–action coupling). Cognitive and perceptual impairments directly affect quality of life in PD and contribute to disability by exacerbating the tendency toward gait dysfunction and falls, especially under dual-task (cognitive–motor) conditions. Interventions are being developed that target the cognitive symptoms of PD, including cognitive and attentional training and the use of noninvasive brain stimulation techniques. Understanding the etiology and course of cognitive and perceptual symptoms will inform the further rational development of interventions to ease the burden experienced by those with PD.
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Acknowledgments
We thank the collaborators on our studies of Parkinson’s disease cited in this chapter, including Melissa Amick, Erica Appleman, Bo Cao, Ying-hui Chou, Uraina Clark, Sigurros Davidsdottir, Joseph DeGutis, Mirella Diaz-Santos, Terry Ellis, Xavier Gallart-Palau, Giorgio Ganis, Grover C. Gilmore, Amy Janes, Cheng-Chieh Lin, Samantha Mauro, Ivy Miller, Giovanni Musto, Sandy Neargarder, Daniel Norton, Tatiana Riedel, Xiaolin Ren, Megan Risi, Maya Rosen, Robert Ross, Serge Roy, Marie Saint-Hilaire, Robert Salazar, Elliot Saltzman, Haline Schendan, Daniel Seichepine, David Somers, Karina Stavitsky Gilbert, Chantal Stern, Cathi Thomas, Arash Yazdanbakhsh, and Daniel Young, and we remember with gratitude the contributions of our late colleague, Robert Wagenaar. This work was supported by grants from the National Institute of Neurological Disorders and Stroke, including RO1 NS067128 to A.C.G. and a Ruth L. Kirschstein National Research Service Award (F31 NS078919) to A.J.
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Putcha, D., Jaywant, A., Cronin-Golomb, A. (2016). Cognitive and Perceptual Impairments in Parkinson’s Disease Arising from Dysfunction of the Cortex and Basal Ganglia. In: Soghomonian, JJ. (eds) The Basal Ganglia. Innovations in Cognitive Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-319-42743-0_9
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