Objective: Investigate the relationship between global and specific cognitive functions and PIGD symptoms in Parkinson’s disease

Background: It is well known that cognition and motor symptoms worsen as Parkinson’s disease progress1,2, but the relationship between specific cognitive domains and postural instability/gait disturbance (PIGD) symptoms are not clear.

Method: Eighty one patients with Parkinson’s disease were recruited from March of 2016 to September of 2018. Among participants, 45 patients of them completed the detail neuropsychological tests (SNSB-II), including global cognition, attention, language, visuospatial, memory, and executive function. Motor symptoms were measured using the Unified Parkinson’s Disease Rating Scale (UPDRS) part III and modified Hoehn-Yahr stage (mHY). Using pull test, the patients were divided into two groups (PIGD-, PIGD+). Patients without postural instability were classified as PIGD- group, and patients with postural instability were classified as PIGD+ group. A Mann-Whitney test was performed to compare demographics and cognitive profiles between the two groups. Correlation analyses were performed to assess the relationship between cognition and PIGD symptoms with adjusting for age, disease duration and education.

Results: Thirty patients were classified as PIGD- group and 15 were as PIGD+ group. Patients in PIGD+ group were older, had a long disease duration, and had higher levodopa equivalent doses (LEDD). Parkinsonian motor symptoms were worse in PIGD+ group. Rey Complex Figure test (RCFT) copy, Seoul Verbal Learning test(SVLT) delayed recall, SVLT_recognition and stroop test_word reading domains were significantly impaired in PIGD+ group (Table 1). After adjusting for age, disease duration and education, RCFT copy was associated with greater postural instability/gait disturbance (r=-0.555, p=0.040).

Conclusion: Visuospatial, memory and executive functions were impaired in patients with Parkinson’s disease with PIGD symptoms. Also, visuospatial dysfunction was correlated with more severe PIGD symptoms. Based on the results, visuospatial dysfunction should be considered when developing PIGD compensatory strategies in patients with Parkinson’s disease.

References: Verbaan D, Marinus J, Visser M, et al. Cognitive impairment in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2007 Nov; 78(11):1182-7. Bohnen NI, Albin RL. The cholinergic system and Parkinson disease. Behav Brain Res. 2011 Aug 10; 221(2):564-73. Kelly, V. E., et al. “Association of cognitive domains with postural instability/gait disturbance in Parkinson’s disease.” Parkinsonism & related disorders 21.7 (2015): 692-697.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/visuospatial-dysfunction-correlates-with-severity-of-postural-instability-gait-disturbance-symptoms-in-parkinsons-disease/