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Nonmotor Symptoms and Cognitive Decline in de novo Parkinson’s Disease

  • Kyum-Yil Kwon (a1), Sung Hoon Kang (a1), Minjik Kim (a1), Hye Mi Lee (a1), Ji Wan Jang (a1), Ju Yeon Kim (a2), Seon-Min Lee (a1) and Seong-Beom Koh (a1)...

Abstract

Background

Cognitive impairments are common in Parkinson’s disease (PD). Despite its clinical importance, the development of dementia is still difficult to predict. In this study, we investigated the possible associations between non-motor symptoms and the risk of developing dementia within a 2-year observation period in PD.

Methods

A total of 80 patients with PD participated in this study. Nonmotor symptoms (the Nonmotor Symptoms Questionnaire), PD status (Unified Parkinson’s Disease Rating Scale), depression (Geriatric d Depression Scale or Montgomery-Asberg Depression Scale), stereopsis and severity of nonmotor symptoms (Non-motor symptoms scale) were assessed. Global cognitive function (Mini-Mental State Examination) were evaluated at baseline and 2 years later.

Results

Presence of depression, vivid dreaming, REM sleep behavior disorders, hyposmia, abnormal stereopsis, non-smoking and postural instability/ gait disturbance phenotype were associated with a significantly more rapid decline of Mini-Mental State Examination. Logistic regression analyses demonstrated that depression (odds ratio=13.895), abnormal stereopsis (odds ratio=10.729), vivid dreaming (odds ratio=4.16), REM sleep behavior disorders (odds ratio=5.353) and hyposmia (odds ratio=4.911) were significant independent predictors of dementia risk within 2 years. Postural instability/ gait disturbance phenotype and age >62 years were also independent predictors of dementia risk (odd ratio=38.333, odds ratio=10.625).

Conclusion

We suggest that depression, vivid dreaming, REM sleep behavior disorders, hyposmia and abnormal stereopsis are closely associated with cognitive decline, and that presence of these nonmotor symptoms predict the subsequent development of Parkinson’s disease dementia.

Contexte

Le déficit cognitif est fréquent dans la maladie de Parkinson (MP). Malgré son importance clinique, l’apparition de la démence demeure difficile à prédire. Dans cette étude, nous avons examiné l’association possible entre les symptômes non moteurs et le risque de présenter une démence au cours d’une période d’observation de 2 ans chez des patients atteints de MP.

Méthode

Quatre-vingt patients atteints de MP ont participé à cette étude. Les symptômes non moteurs (Nonmotor Symptoms Questionnaire), le stade d’évolution de la MP (Unified Parkinson’s Disease Rating Scale), la stétéopsie et la sévérité des symptômes non moteurs (Non-motor symptoms scale) ont été évalués. La fonction cognitive globale (Mini-Mental State Examination) a été évaluée au début de l’étude et 2 ans plus tard.

Résultats

La présence de dépression, de rêves intenses et troublants, de troubles du comportement du sommeil paradoxal, d’hyposmie, d’anomalies de la stéréopsie, le fait d’être non-fumeur et l’instabilité posturale/la démarche anormale étaient associés à un déclin significativement plus rapide du score au Mini-Mental. Les analyses de régression logistique ont montré que la dépression (rapport de cotes (RC) = 13,895), la stéréopsie anormale (RC = 10,729), les rêves intenses et troublants (RC = 4,16), les troubles du comportement du sommeil paradoxal (RC = 5,353) et l’hyposmie (RC = 4,911) prédisaient de façon indépendante le risque de démence au cours des 2 prochaines années. Une instabilité posturale/une démarche anormale et un âge supérieur à 62 ans prédisaient de façon indépendante le risque de démence (RC = 38,333, RC = 10,625).

Conclusions

Nous proposons que la dépression, les rêves intenses et troublants, les perturbations du comportement du sommeil paradoxal, l’hyposmie et la stéréopsie anormale sont étroitement associés au déclin cognitif et que la présence de ces symptômes non moteurs prédit l’apparition subséquente de la démence dans la maladie de Parkinson.

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Copyright

Corresponding author

Correspondence to: Seong-Beom Koh, Department of Neurology and Parkinson’s Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, #148 Gurodong Road, GuroKu, Seoul, Republic of Korea, 152-703. Email: parkinson@korea.ac.kr

References

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1. Levy, G, Tang, MX, Louis, ED, et al. The association of incident dementia with mortality in PD. Neurology. 2002;59(11):1708-1713.
2. Playfer, JR. Depression, cognition and quality of life in parkinsonian patients. Age Ageing. 1999;28(4):333-334.
3. Aarsland, D, Larsen, JP, Karlsen, K, Lim, NG, Tandberg, E. Mental symptoms in Parkinson's disease are important contributors to caregiver distress. Int J Geriatr Psychiatry. 1999;14(10):866-874.
4. Aarsland, D, Larsen, JP, Tandberg, E, Laake, K. Predictors of nursing home placement in Parkinson's disease: a population-based, prospective study. J Am Geriatr Soc. 2000;48(8):938-942.
5. Hobson, P, Meara, J. Risk and incidence of dementia in a cohort of older subjects with Parkinson's disease in the United Kingdom. Mov Disord. 2004;19(9):1043-1049.
6. Burn, DJ, Rowan, EN, Allan, LM, Molloy, S, O'Brien, JT, McKeith, IG. Motor subtype and cognitive decline in Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2006;77(5):585-589.
7. Apaydin, H, Ahlskog, JE, Parisi, JE, Boeve, BF, Dickson, DW. Parkinson disease neuropathology: later-developing dementia and loss of the levodopa response. Arch Neurol. 2002;59(1):102-112.
8. Kim, JS, Oh, YS, Lee, KS, Kim, YI, Yang, DW, Goldstein, DS. Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease. Neurology. 2012;79(13):1323-1331.
9. Kim, SH, Park, JH, Kim, YH, Koh, SB. Stereopsis in drug naive Parkinson's disease patients. Can J Neurol Sci. 2011;38(2):299-302.
10. Koh, SB, Suh, SI, Kim, SH, Kim, JH. Stereopsis and extrastriate cortical atrophy in Parkinson's disease: a voxel-based morphometric study. Neuroreport. 2013;24(5):229-232.
11. Meppelink, AM, de Jong, BM, Renken, R, Leenders, KL, Cornelissen, FW, van Laar, T. Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations. Brain. 2009;132(Pt 11):2980-2993.
12. Hughes, AJ, Daniel, SE, Kilford, L, Lees, AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-184.
13. Hoehn, MM, Yahr, MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427-442.
14. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003;18(7):738-750.
15. Ahn, Y, Lee, KY, Yi, JS, et al. A validation study of the Korean-version of Mongomery-Asberg depression rating scale. J Korean Neuropsychiatr Assoc. 2005;44(4):466-476.
16. Yesavage, JA, Brink, TL, Rose, TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37-49.
17. Stiasny-Kolster, K, Mayer, G, Schafer, S, Moller, JC, Heinzel-Gutenbrunner, M, Oertel, WH. The REM sleep behavior disorder screening questionnaire--a new diagnostic instrument. Mov Disord. 2007;22(16):2386-2393.
18. Garnham, L, Sloper, JJ. Effect of age on adult stereoacuity as measured by different types of stereotest. Br J Ophthalmol. 2006;90(1):91-95.
19. Jankovic, J, McDermott, M, Carter, J, et al. Variable expression of Parkinson's disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group. Neurology. 1990;40(10):1529-1534.
20. Kang, Y, Na, DL, Hahn, MA. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Asso. 1997;15(2):300-308.
21. Herzog, J, Volkmann, J, Krack, P, et al. Two-year follow-up of subthalamic deep brain stimulation in Parkinson's disease. Mov Disord. 2003;18(11):1332-1337.
22. Dubois, B, Burn, D, Goetz, C, et al. Diagnostic procedures for Parkinson's disease dementia: recommendations from the movement disorder society task force. Mov Disord. 2007;22(16):2314-2324.
23. Ahn, HJ, Chin, J, Park, A, et al. Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci., 25(7):1071-1076.
24. Hely, MA, Reid, WG, Adena, MA, Halliday, GM, Morris, JG. The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years. Mov Disord. 2008;23(6):837-844.
25. Williams-Gray, CH, Foltynie, T, Brayne, CE, Robbins, TW, Barker, RA. Evolution of cognitive dysfunction in an incident Parkinson's disease cohort. Brain. 2007;130(Pt 7):1787-1798.
26. Aarsland, D, Zaccai, J, Brayne, C. A systematic review of prevalence studies of dementia in Parkinson's disease. Mov Disord. 2005;20(10):1255-1263.
27. Vendette, M, Gagnon, JF, Decary, A, et al. REM sleep behavior disorder predicts cognitive impairment in Parkinson disease without dementia. Neurology 2007;69(19):1843-1849.
28. Postuma, RB, Bertrand, JA, Montplaisir, J, et al. Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: a prospective study. Mov Disord. 2012;27(6):720-726.
29. Baba, T, Kikuchi, A, Hirayama, K, et al. Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson's disease: a 3 year longitudinal study. Brain. 2012;135(Pt 1):161-169.
30. Mosimann, UP, Mather, G, Wesnes, KA, O'Brien, JT, Burn, DJ, McKeith, IG. Visual perception in Parkinson disease dementia and dementia with Lewy bodies. Neurology. 2004;63(11):2091-2096.

Keywords

Nonmotor Symptoms and Cognitive Decline in de novo Parkinson’s Disease

  • Kyum-Yil Kwon (a1), Sung Hoon Kang (a1), Minjik Kim (a1), Hye Mi Lee (a1), Ji Wan Jang (a1), Ju Yeon Kim (a2), Seon-Min Lee (a1) and Seong-Beom Koh (a1)...

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