Who will remain tremor dominant? The possible role of cognitive reserve in the time course of two common Parkinson’s disease motor subtypes
In a prospective 5-year study among Parkinson’s disease (PD) tremor-dominant (TD) patients, we investigated who will remain TD and who will later convert into the postural instability gait difficulty (PIGD) phenotype. At follow-up, 38% were still considered TD. At baseline the TD non-convertors had more years of education and better cognitive function than the convertors and significantly smaller deterioration in gait, balance, cognitive function and other non-motor symptoms. These results highlight the potential role of cognition in protecting against the development of PIGD symptoms.
KeywordsParkinson’s disease Tremor dominant PIGD Gait Cognitive function
This work was supported in part by a Grant from the Michael J. Fox Foundation for Parkinson’s Research.
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Conflict of interest
TH, LA, SS declare no financial or other conflicts of interest. Prof. Hausdorff reports Grants from Michael J Fox Foundation, during the conduct of the study. Prof. Giladi serves as a member of the Editorial Board for the Journal of Parkinson’s Disease. He serves as consultant to Teva- NeuroDerm, Biogen, Pharma2B, Denali, Abbvie, AccelMed, Monfort and UCB. He receives royalties from LTI and payment for lectures at Teva, UCB, Abviee, Bial and Movement Disorder Society. He received research support from the Michael J Fox Foundation, the National Parkinson Foundation, the European Union 7th Framework Program and the Israel Science Foundation as well as from Teva NNE program, Biogen, LTI, and Pfizer.
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