Long-Term Cognitive Decline Related to the Motor Phenotype in Parkinson's Disease

Michels, Jennifer; Wurp, Hendrick van der; Kalbe, Elke; Rehberg, Sarah Petra; Storch, Alexander; Linse, Katharina; Schneider, Christine; Gräber, Susanne; Berg, Daniela; Dams, Judith; Balzer-Geldsetzer, Monika; Hilker-Roggendorf, Rüdiger; Oberschmidt, Carola; Baudrexel, Simon; Witt, Karsten; Schmidt, Nele; Deuschl, Gunther; Mollenhauer, Brit; Trenkwalder, Claudia; Liepelt-Scarfone, Inga; Spottke, Annika; Röske, Sandra; Wüllner, Ullrich; Wittchen, Hans-Ulrich; Riedel, Oliver; Kassubek, Jan; Dodel, Richard; Schulz, Jörg Bernhard; Costa, Ana Sofia und Reetz, Kathrin (2022): Long-Term Cognitive Decline Related to the Motor Phenotype in Parkinson's Disease. In: Journal of Parkinsons Disease, Bd. 12, Nr. 3: S. 905-916

Abstract

Background: Parkinson's disease (PD) is associated with various non-motor symptoms, including cognitive deterioration. Objective: Here, we used data from the DEMPARK/LANDSCAPE cohort to describe the association between progression of cognitive profiles and the PD motor phenotypes: postural instability and gait disorder (PIGD), tremor-dominant (TR-D), and not-determined (ND). Methods: Demographic, clinical, and neuropsychological six-year longitudinal data of 711 PD-patients were included (age: M= 67.57;67.4% males). We computed z-transformed composite scores for a priori defined cognitive domains. Analyses were controlled for age, gender, education, and disease duration. To minimize missing data and drop-outs, three-year followup data of 442 PD-patients was assessed with regard to the specific role of motor phenotype on cognitive decline using linear mixed modelling (age: M= 66.10;68.6% males). Results: Our study showed that in the course of the disease motor symptoms increased while MMSE and PANDA remained stable in all subgroups. After three-year follow-up, significant decline of overall cognitive performance for PIGD-patients was present and we found differences for motor phenotypes in attention (beta = -0.08, SE = 0.003, p < 0.006) and memory functions showing that PIGD-patients deteriorate per months by -0.006 compared to the ND-group (SE = 0.003, p = 0.046). Furthermore, PIGD-patients experienced more often difficulties in daily living. Conclusion: Over a period of three years, we identified distinct neuropsychological progression patterns with respect to different PD motor phenotypes, with early executive deficits yielding to a more amnestic profile in the later course. Here, in particular PIGD-patients worsened over time compared to TR-D and ND-patients, highlighting the greater risk of dementia for this motor phenotype.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1877-7171
• Sprache: Englisch