Objective: To analyze the cross-sectional and longitudinal association between mild behavioral impairment and cognitive impairment in Parkinson’s disease.

Background: Cognitive impairment and neuropsychiatric symptoms (NPS) are common even in the early stages of Parkinson’s Disease (PD). Mild behavioral impairment (MBI) is a validated neurobehavioral syndrome that identifies a high-risk group for incident cognitive decline by leveraging the risk associated with the emergence and persistence of neuropsychiatric symptoms in later life. The longitudinal association between MBI and cognition has not yet been investigated in PD.

Method: This is a prospective cohort of PD patients that was followed over a median of eighteen months. The Mild Behavioral Impairment Checklist (MBI-C) was applied twice (T1 and T2) to determine the evolution of neuropsychiatric symptoms, while concomitantly assessing cognition using the Montreal Cognition Assessment (MoCA) and a full neuropsychological evaluation (global and per-domain composite scores).

Results: 60 patients completed the follow-up (30% women, 69 years IQR 66-75). At baseline, the average disease duration since diagnosis was 4 years (IQR 3-8), and motor severity was considered mild (UPDRS-III 16 IQR 10-24). Fourteen (20.90%) patients demonstrated substantial neuropsychiatric burden (MBI-C≥6) and there was a significant mild increase  (p=0.043) after the follow-up. Likewise, an inverse correlation was found between MBI and baseline memory and visuospatial cognitive scores (p=0.011). After the multivariate adjustment, prospective differences in MBI and MoCA were inversely associated (β=-0.086, p=0.033). MBI status at T1 (p=0.040), and its progression over time (T2-T1), predicted a decline in language functions (ϱ=-0.267, p=0.037) as well.

Conclusion: MBI is prevalent in Parkinson’s disease patients and is inversely correlated with specific cognitive domains. Longitudinally, MBI progression co-occurs with a decrease in MoCA scores and language performance. Further studies with larger sample sizes should be carried out to comprehend better the cognitive consequences of MBI in PD.

References: 1. Ghahremani M, Nathan S, Smith EE, McGirr A, Goodyear B, Ismail Z. Functional connectivity and mild behavioral impairment in dementia-free elderly. Alzheimer Dement (N Y). 2023;9(1):e12371. Published 2023 Jan 18. doi:10.1002/trc2.12371
2. Yoon EJ, Ismail Z, Hanganu A, et al. Mild behavioral impairment is linked to worse cognition and brain atrophy in Parkinson’s disease. Neurology. 2019;93(8):e766-e777. doi:10.1212/WNL.0000000000007968

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-association-of-mild-behavioral-impairment-with-cognitive-decline-in-parkinsons-disease/