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Neuropsychological characteristics of parkinsonian patients with lateralized motor impairment

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Journal of Neural Transmission - Parkinson's Disease and Dementia Section

Summary

Parkinsonians with predominantly unilateral signs provide an interesting experimental means to evaluate if asymmetric nigro-striatal degeneration may affect neuropsychological functions. The aim of our study was to establish if the side of onset of idiopathic Parkinson's disease, right (PDR) or left (PDL), determines a selective pattern of cognitive performances. Furthermore, we verified if PDR and PDL groups show a different frequency of dementia. PDR and PDL patients with at least seven years of disease duration, matched for age, schooling, severity of extrapyramidal symptomatology and index of lateralization, were evaluated by using an extensive neuropsychological battery aimed at assessing hemispheric cognitive asymmetries. Current side of greater motor impairment was the same as the one affected at the onset of the disease.

Only subtle differences in the profile of neuropsychological dysfunction emerged from the comparison of PDR and PDL subjects. Moreover, the number of parkinsonians showing dementia syndrome was the same in both groups. Our results suggest that the side of onset of motor impairment does not significantly influence the cognitive performances in PD. Subcortical anatomic and/or functional asymmetries seem to play a less important role in the intellectual functions than in motor activities.

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References

  • Agniel A, Celsis P, Viallard G, Montastruc JL, Rascol O, Demonet JF, Marc-Vergnes JP, Rascol A (1991) Cognition and cerebral blood flow in lateralized parkinsonism: lack of functional lateral asymmetries. J Neurol Neurosurg Psychiatry 54: 783–786

    PubMed  Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, third ed (revised). American Psychiatric Association, Washington DC

    Google Scholar 

  • Barber J, Tomer R, Sroke H, Myslobodsky MS (1985) Does unilateral dopamine deficit contribute to depression? Psychiatry Res 15: 17–24

    Article  PubMed  Google Scholar 

  • Barbizet J, Cany E (1969) A psychometric study of various memory deficits associated with cerebral lesions. In: Talland GA, Waugh NC (eds) The pathology of memory. Academic Press, New York, pp 49–64

    Google Scholar 

  • Bentin S, Silverberg R, Gordon HW (1981) Asymmetrical cognitive deterioration in demented and parkinsonian patients. Cortex 17: 533–544

    PubMed  Google Scholar 

  • Biggins CA, Boyd JL, Harrop FM, Madeley P, Mindham RHS, Randall JI, Spokes EGS (1992) A controlled longitudinal study of dementia in Parkinson's disease. J Neurol Neurosurg Psychiatry 55: 566–571

    PubMed  Google Scholar 

  • Blonder LX, Gur RE, Gur RC, Saykin AJ, Hurtig HI (1989) Neuropsychological functioning in hemiparkinsonism. Brain Cogn 9: 244–257

    Article  PubMed  Google Scholar 

  • Boller F, Passafiume D, Keefe NC, Rogers K, Morrow L, Kim Y (1984) Visuospatial impairment in Parkinson's disease. Role of perceptual and motor performance. Arch Neurol 41: 485–490

    PubMed  Google Scholar 

  • Bowen FP, Hoehn MM, Yahr MD (1972) Parkinsonism: alterations in spatial orientation as determined by route-walking task. Neuropsychologia 10: 355–361

    Article  PubMed  Google Scholar 

  • Brown RG, Marsden CD (1990) Cognitive function in Parkinson's disease: from description to theory. TINS 13: 21–29

    PubMed  Google Scholar 

  • Capitani E, Della Sala S, Spinnler H (1990) Controversial neuropsychological issues in Alzheimer's disease: influence of onset-age and hemispheric asymmetry of impairment. Cortex 26: 133–145

    PubMed  Google Scholar 

  • Chouza C, Romero S, Laguardia G, Pou G, Lorenzo J, Flores M, Wozniak A, Feres S, Caamano JL, Schroder A (1984) Hemiparkinsonism: clinical, neuropsychological and tomographical studies. In: Hassler RG, Christ JF (eds) Advances in neurology, vol 40. Raven Press, New York, pp 415–425

    Google Scholar 

  • Chui HC, Damasio AR (1980) Human cerebral asymmetries evaluated by CT. J Neurol Neurosurg Psychiatry 43: 873–878

    PubMed  Google Scholar 

  • De Renzi E, Faglioni P, Savoiardo M, Vignolo LA (1966) The influence of the hemispheric side of the cerebral lesion on abstract thinking. Cortex 2: 399–420

    Google Scholar 

  • Direnfeld LK, Albert ML, Volicer L, Langlais PJ, Marquis J, Kaplan E (1984) Parkinson's disease. The possible relationship of laterality to dementia and neurochemical findings. Arch Neurol 41: 935–941

    PubMed  Google Scholar 

  • Dodrill CB (1978) A neuropsychological battery for epilepsy. Epilepsia 19: 611–623

    PubMed  Google Scholar 

  • Duvoisin RC (1971) The evaluation of extrapyramidal disease. In: de Ajuriaguerra J, Gauthier G (eds) Monoamines, Noyaux Gris Centraux, et Syndrome de Parkinson. Georg, Geneve, pp 313–325

    Google Scholar 

  • Eberling JL, Richardson BC, Reed BR, Wolfe N, Jagust WJ (1994) Cortical glucose metabolism in Parkinson's disease without dementia. Neurobiol Aging 15: 329–335

    Article  PubMed  Google Scholar 

  • Ebmeier KP, Calder SA, Crawford JR, Stéwart L, Besson JAO, Mutch WJ (1990) Clinical features predicting dementia in idiopathic Parkinson's disease: a follow-up study. Neurology 40: 1222–1224

    PubMed  Google Scholar 

  • Finali G, Piccirilli M, Piccinin GL (1992) No relationship between cognitive impairment and disease duration in Parkinson's disease. In: Agnoli A, Fabbrini G, Stocchi F (eds) Parkinson's disease and extrapyramidal disorders-pathophysiology and treatment. John Libbey/CIC, Roma, pp 435–441

    Google Scholar 

  • Finali G, Piccirilli M, Rizzuto S (1994) Left hemispatial inattention in right brain-damaged non-demented Parkinson patients. In: Korczyn AD (ed) Dementia in Parkinson's disease. Monduzzi, Bologna, pp 261–264

    Google Scholar 

  • Fleminger S (1991) Left-sided Parkinson's disease is associated with greater anxiety and depression. Psychol Med 21: 629–638

    PubMed  Google Scholar 

  • Geschwind N, Galaburda AM (1985) Cerebral lateralization-biological mechanisms, associations, and pathology. I. A hypothesis and a program for research. Arch Neurol 42: 428–459

    PubMed  Google Scholar 

  • Glick SD, Ross DA, Hough LH (1982) Lateral asymmetry of neurotransmitters in human brain. Brain Res 234: 53–63

    Article  PubMed  Google Scholar 

  • Huber SJ, Freidenberg DL, Shuttleworth EC, Paulson GW, Clapp LE (1989a) Neuropsychological similarities in lateralized parkinsonism. Cortex 25: 461–470

    PubMed  Google Scholar 

  • Huber SJ, Freidenberg DL, Shuttleworth EC, Paulson GW, Christy JA (1989b) Neuropsychological impairments associated with severity of Parkinson's disease. J Neuropsychiatr Clin Neurosci 1: 154–158

    Google Scholar 

  • Huber SJ, Miller H, Bohaska L, Christy JA, Bornstein RA (1992) Asymmetrical cognitive differences associated with hemiparkinsonism. Arch Clin Neuropsychol 7: 471–480

    Article  PubMed  Google Scholar 

  • Isaacs B, Kennie A (1973) The Set test as an aid to the detection of dementia in old people. Br J Psychiatry 123: 467–470

    PubMed  Google Scholar 

  • Kemster PA, Gibb WRG, Stern GM, Lees AJ (1989) Asymmetry of substantia nigra neuronal loss in Parkinson's disease and its relevance to the mechanism of levodopa related motor fluctuations. J Neurol Neurosurg Psychiatry 52: 72–76

    PubMed  Google Scholar 

  • Lezak MD (1983) Neuropsychological assessment, 2nd ed. Oxford University Press, New York

    Google Scholar 

  • Mayeux R, Stern Y, Rosenstein R, Marder K, Hauser A, Cote L Fahn S (1988) An estimate of the prevalence of dementia in idiopathic Parkinson's disease. Arch Neurol 45: 260–262

    PubMed  Google Scholar 

  • Mayeux R, Chen J, Mirabello E, Marker K, Bell K, Dooneief G, Cote L, Stern Y (1990) An estimate of the incidence of dementia in idiopathic Parkinson's disease. Neurology 40: 1513–1517

    PubMed  Google Scholar 

  • Marder K, Flood P, Cote L, Mayeux R (1990) A pilot study of risk factors for dementia in Parkinson's disease. Mov Disord 5: 156–161

    Article  PubMed  Google Scholar 

  • Mendell PR, Greenhalgh M (1987) Age related differences in left and right hand skill and visuo-spatial performance: their possible relationships to the hypothesis that right hemisphere ages more rapidly than the left. Cortex 23: 431–445

    PubMed  Google Scholar 

  • Mohr E, Mann UM, Miletich RS, Sampson M, Goldberg TE, Grimes JD, Chase TN (1992) Neuropsychological and glucose metabolic profiles in asymmetric Parkinson's disease. Can J Neurol Sci 19: 163–169

    PubMed  Google Scholar 

  • Mortimer JA, Pirozzolo FJ, Hansch EC, Webster DD (1982) Relationship of motor symptoms to intellectual deficits in Parkinson's disease. Neurology 32: 133–137

    PubMed  Google Scholar 

  • Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9: 97–113

    Article  PubMed  Google Scholar 

  • Oyebode JR, Barker WA, Blessed G, Dick DJ, Britton PG (1986) Cognitive functioning in Parkinson's disease: in relation to prevalence of dementia and psychiatric diagnosis. Br J Psychiatry 149: 720–725

    PubMed  Google Scholar 

  • Piccirilli M, Piccinin GL, Agostini L (1984) Characteristic clinical aspects of parkinsonian patients with intellectual impairment. Eur Neurol 23: 44–50

    PubMed  Google Scholar 

  • Piccirilli M, D'Alessandro P, Finali G, Piccinin GL, Agostini L (1989) Frontal lobe dysfunction in Parkinson's disease: prognostic value for dementia? Eur Neurol 29: 71–76

    PubMed  Google Scholar 

  • Piccirilli M, D'Alessandro P, Finali G, Piccinin GL (1994) Neuropsychological follow-up of parkinsonian patients with and without cognitive impairment. Dementia 5: 17–22

    PubMed  Google Scholar 

  • Portin R, Rinne UK (1986) Predictive factors for cognitive deterioration and dementia in Parkinson's disease. In: Yahr MD, Bergmann KJ (eds) Advances in neurology, vol 45. Raven Press, New York, pp 413–416

    Google Scholar 

  • Rapoport SI (1988) Brain evolution and Alzheimer's disease. Rev Neurol 144: 79–90

    PubMed  Google Scholar 

  • Raven JC (1965) Guide to using the coloured progressive matrices. Lewis, London

    Google Scholar 

  • Reid WGJ, Broe GA, Hely MA, Morris JGL, Williamson PM, O'Sullivan DJ, Rail D, Genge S, Moss NG (1989) The neuropsychology of de novo patients with idiopathic Parkinson's disease: the effect of age of onset. Int J Neurosci 48: 205–217

    PubMed  Google Scholar 

  • Rey A (1958) L'examen clinique en psychologie. PUF, Paris

    Google Scholar 

  • Richards M, Stern Y, Marder K, Cote L, Mayeux R (1993) Relationship between extrapyramidal sings and cognitive function in a community-dwelling cohort of patients with Parkinson's disease and normal elderly individuals. Ann Neurol 33: 267–274

    Article  PubMed  Google Scholar 

  • Salganik I, Korczyn A (1990) Risk factors for dementia in Parkinson's disease. In: Streifler MD, Korczyn AD, Melamed E, Youdim MBH (eds) Advances in neurology, vol 53. Raven Press, New York, pp 343–347

    Google Scholar 

  • Spicer KB, Roberts RJ, Le Witt PA (1988) Neuropsychological performances in lateralized parkinsonism. Arch Neurol 45: 429–432

    PubMed  Google Scholar 

  • Starkstein S, Leiguarda R, Gershanik O, Bethier M (1987) Neuropsychological disturbances in hemiparkinson's disease. Neurology 37: 1762–1764

    PubMed  Google Scholar 

  • Starkstein SE, Leiguarda R (1993) Neuropsychological correlates of brain atrophy in Parkinson's disease: a CT-scan study. Mov Disord 8: 51–55

    Article  PubMed  Google Scholar 

  • Starkstein SE, Mayberg HS, Leiguarda R, Preziosi T, Robinson RG (1992) A prospective longitudinal study of depression, cognitive decline, and physical impairments in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 55: 377–382

    PubMed  Google Scholar 

  • Stern Y, Marder K, Xi Tang M, Mayeux R (1994) Antecedent clinical features associated with dementia in Parkinson's disease. Neurology 43: 1690–1692

    Google Scholar 

  • Tatemichi TK, Desmond DW, Stern Y, Sano M, Bagiella E (1994) Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatry 57: 202–207

    PubMed  Google Scholar 

  • Taylor AE, Saint-Cyr JA, Lang AE (1986) Frontal lobe dysfunction in Parkinson's disease. Brain 109: 845–883

    PubMed  Google Scholar 

  • Tomer R, Levin BE, Weiner WJ (1993) Side of onset of motor symptoms influences cognition in Parkinson's disease. Ann Neurol 34: 579–584

    Article  PubMed  Google Scholar 

  • Viitanen M, Mortimer JA, Webster DD (1994) Association between presenting symptoms and the risk of cognitive impairment in Parkinson's disease. J Neurol Neurosurg Psychiatry 57: 1023–1027

    Google Scholar 

  • Villardita C, Smirni P, Zappala G (1983) Visual neglect in Parkinson's disease. Arch Neurol 40: 737–739

    PubMed  Google Scholar 

  • Wechsler D (1955) Wechsler Adult Intelligence Scale. Psychological Corporation, New York

    Google Scholar 

  • Yokochi F, Nakamura R, Narabayashi H (1985) Reactive time of patients with Parkinson's disease, with reference to asymmetry of neurological signs. J Neurol Neurosurg Psychiatry 43: 702–705

    Google Scholar 

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  1. G. Finali

    Present address: Clinica Neurologica, Istituto di Clinica Neurologica, Università di Perugia, Via Enrico Dal Pozzo 95, I-06100, Perugia, Italy

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  1. Clinica Neurologica, Istituto di Clinica Neurologica, Università di Perugia, Via Enrico Dal Pozzo 95, I-06100, Perugia, Italy

    M. Piccirilli & S. Rizzuto

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Finali, G., Piccirilli, M. & Rizzuto, S. Neuropsychological characteristics of parkinsonian patients with lateralized motor impairment. J Neural Transm Gen Sect 9, 165–176 (1995). https://doi.org/10.1007/BF02259658

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  • DOI: https://doi.org/10.1007/BF02259658

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