Objective: The our intention was to investigate a dynamics of cognitive decline in patients with different side of onset parkinsonism in view of visual dysfunction appears in PD by DaTscan.

Methods: We analyzed the prospectively collected data from 37 patients with PD. The patients underwent physical and neurological examinations that included UPDRS III part, laboratory tests, standard MRI protocol and DaTscan. The clinical data and biomarkers were compared between 18 PD patients predominantly with onset in right side, 16 PD patients with left side parkinsonism and 3 patients with symmetric parkinsonism. Neuropsychological assessment were carried out during 4 years, every 12 months. Neuropsychological assessment comprised MMSE and Parkinson Neuropsychometric Dementia Assessment (PANDA). DATSCAN was obtained within 4 weeks in those patients whose latest had clinical diagnosis of PD. CSF was examined for standard parameters such as cell count, proteins, tau, phosphorylated tau and amyloid-ß 1–40 and 42, QAlbumin according to established protocols. All statistical analyses were performed using the SPSS statistical package, version 18.0 version. Statistical significance was set at p<0.05.

Results: There were no significant differences in age, sex, duration of the clinical manifestation, Parkinsonian motor symptoms by UPDRS III and CSF biomarkers between the groups. We observed significant striatal dopaminergic deficiency on the left in patients with right-handed parkinsonism especially in nucleus caudatus in DaTscan, that can explain the subcortical cognitive deficiency in patients with right side parkinsonism. By comparison of the cognitive dynamics in MMSE test we didn’t see difference in first three years, only last time we observed significant worse cognitive status in group with right-handed parkinsonism. We observed more clearly significant difference in PANDA test. During all period of observation PD patients with right-handed parkinsonism had worse cognitive status in group but initially too.

Conclusions: Our results suggest that the side of onset of motor impairment significantly influence the cognitive performances in PD in course of time. The PANDA test is more convincing demonstrated this trend than MMSE. Cognitive decline was worse in patients with right-handed parkinsonism in PD patients. Therefore, the initial side of parkinsonism might be predicts of cognitive prognosis in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-patients-with-onset-in-right-side-have-a-worse-cognitive-prognosis/