Objective: Characterize episodic simulation capabilities in non-depressed, non-amnestic patients with PD compared to healthy controls using autobiographical interviewing techniques.

Background: Cognitive decline in PD occurs in part from degeneration of frontal lobe circuits resulting in executive function and attention deficits. Less known, however, is the ability of patients with PD to think and plan for possible future states of themselves, defined as simulation. Expansion of medical and surgical options in PD has resulted in individuals facing more challenging treatment choices which requires preserved simulation for adequate decision-making capacity. We hypothesize that patients with PD have greater difficulty with simulation as compared to healthy controls.

Method: Five individuals aged 50-75 with idiopathic PD (Hoehn & Yahr stage 3 of lower), diagnosed according to the UK Parkinson’s Disease Society Brain Bank criteria, stable on levodopa monotherapy and five matched healthy controls will be recruited. Simulation abilities will be evaluated using our adapted autobiographical interviewing protocol. Participants will be given 3 minutes to recall past experiences and described plausible, novel future events in as much detail as possible in response to a variety of images. Narratives will be recorded, transcribed, and scored using a recognized scoring manual that focuses on the type and amount of detail provided. Participants will complete a selected frontal lobe cognitive assessment to explore correlations between frontal lobe functions and simulation capabilities.

Results: We have met our enrollment goal. We currently have collected data on four individuals (two controls, two patients with PD). Due to the small sample size, we will be using descriptive statistics to characterize our data sets.

Conclusion: This study aims to assess the ability of non-depressed, non-amnestic patients with PD to simulate novel scenarios, a vital cognitive function for decision-making and future planning. By exploring this cognitive function, we hope to inform targeted interventions and support strategies that can ultimately enhance patient care and decision-making processes in this vulnerable population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/episodic-simulation-in-parkinsons-disease-pd/