Objective: To evaluate whether Pisa syndrome (PS) in Parkinson’s disease (PD) is associated with a specific profile of cognitive impairment.

Background: PS is a complex and disabling axial complication of PD, affecting approximately 9% of the PD population. The pathogenesis of PS remains incompletely understood. It has been suggested that axial-dominant PD presentation can be associated with more severe cognitive impairment but literature data on the cognitive profile of PD patients with PS are still lacking. A recent study investigated for the first time the cognitive profile of PS patients, indicating an association between PS and worse performances in attention and posterior cortical function.

Method: Twelve PD patients with PS (PS+) were matched with PD patients without abnormal postures (PS-) patients for age, gender, PD duration, Hoehn and Yahr score and level of education. Both PS+ and PS- patients underwent an extensive neurological and neuropsychological assessment aimed to investigate six cognitive domains: reasoning, memory, attention, executive-functions, language and visuospatial abilities. Then, for each cognitive domain, we obtained a Cognitive Index (CI; score 0-3), corresponding to the average value of the related subtest. Descriptive statistics and nonparametric tests were used to compare neuropsychological performances in the two groups.

Results: PS+ and PS- groups outlined similar scores from measures of global cognitive status (MoCA: PS+ = 21.7±4.8; PS- = 23.5±3.9; p=0.223). PS+ group showed worse performances than PS- for attentional domain (CI: PS+ = 1.5±0.9; PS- = 0.25±0.6; p=0.001), visuo-spatial abilities (CI: PS+ = 1.5±0.9; PS- = 0.25±0.6; p=0.001), and language domain (CI: PS+ = 0.9±0.9; PS- = 0.2±0.4; p= 0.023). No significant differences were found for the others cognitive domains (reasoning, memory and executive functions).

Conclusion: Our study supports the hypothesis of a specific neuropsychological profile of PD patients with PS, possibly suggesting that PS may have a central pathogenesis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pisa-syndrome-in-parkinsons-disease-a-study-on-the-neuropsychological-profile/