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Cognitive performance correlates with the degree of dopaminergic degeneration in the associative part of the striatum in non-demented Parkinson’s patients

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Parkinson’s disease (PD) patients show cognitive deficits that are relevant in terms of prognosis and quality of life. Degeneration of striatal dopaminergic afferents proceeds from dorsal/caudal to anterior/ventral and is discussed to account for some of these symptoms. Treatment with dopamine (DA) has differential effects on cognitive dysfunctions, improving some and worsening others. We hypothesized that cognitive performance during the dopaminergic OFF state correlates with DAT availability in the associative striatum. 16 PD patients underwent motor and cognitive examination ON and OFF DA. Global cognition was measured using the Montréal Cognitive Assessment (MoCA) test and executive functioning using a Stroop test. Nigrostriatal dopaminergic innervation was characterized with [123I]FP-CIT SPECT. A connectivity atlas of the striatum was used to assess DAT availability in functionally defined striatal subregions. Correlations between imaging data and behavioral data OFF medication were calculated. Correlations between DAT availability and MoCA performance in the dopaminergic OFF state was strongest in the associative part of the striatum (r = 0.674, p = 0.004). MoCA test performance did not differ between the ON and the OFF state. There was no correlation of DAT availability with Stroop performance in the OFF state but performance was significantly better during the ON state. Not only motor but also cognitive dysfunctions in PD are associated with striatal dopaminergic depletion. Cognitive decline in non-demented PD patients goes along with nigrostriatal degeneration, most pronounced in the associative subdivision of the striatum. In addition, the present findings suggest that executive dysfunctions are ameliorated by DA whereas global cognition is not improved by dopaminergic medication.

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Authors and Affiliations

  1. Department of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany

    Dorothee Kübler, Henning Schroll & Andrea A. Kühn

  2. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Ralph Buchert

  3. Computer Science, Chemnitz University of Technology, Straße der Nationen 62, 09111, Chemnitz, Germany

    Henning Schroll

Authors
  1. Dorothee Kübler
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  2. Henning Schroll
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  3. Ralph Buchert
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  4. Andrea A. Kühn
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Correspondence to Dorothee Kübler.

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Funding

The project was funded by the DFG (German research Council, grant KU2261/6-1) to AAK. Dorothee Kübler is a participant in the BIH-Charité Clinician Scientist Program funded by the Charité-Universitätsmedizin Berlin and the Berlin Institute of Health.

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The authors declare that they have no conflict of interest.

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Kübler, D., Schroll, H., Buchert, R. et al. Cognitive performance correlates with the degree of dopaminergic degeneration in the associative part of the striatum in non-demented Parkinson’s patients. J Neural Transm 124, 1073–1081 (2017). https://doi.org/10.1007/s00702-017-1747-2

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  • DOI: https://doi.org/10.1007/s00702-017-1747-2

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