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Heterogeneity of Letter Fluency Impairment and Executive Dysfunction in Parkinson's Disease

Published online by Cambridge University Press:  16 August 2013

Lewis Pettit ,
Martina McCarthy ,
Richard Davenport  and
Sharon Abrahams
Lewis Pettit
Affiliation:
Human Cognitive Neuroscience - Psychology, University of Edinburgh, Edinburgh, United Kingdom Centre for Cognitive Aging and Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
Martina McCarthy
Affiliation:
Human Cognitive Neuroscience - Psychology, University of Edinburgh, Edinburgh, United Kingdom
Richard Davenport
Affiliation:
Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
Sharon Abrahams*
Affiliation:
Human Cognitive Neuroscience - Psychology, University of Edinburgh, Edinburgh, United Kingdom Centre for Cognitive Aging and Epidemiology, University of Edinburgh, Edinburgh, United Kingdom Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
*
Correspondence and reprint requests to: Sharon Abrahams, Department of Psychology, PPLS, University of Edinburgh, 7 George Square, Edinburgh, United Kingdom EH8 9JZ. E-mail: s.abrahams@ed.ac.uk
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Abstract

Letter fluency deficits are commonly detected in non-demented Parkinson's disease (PD) patients but the underlying cause remains uncertain. We investigated the role of slowed processing speed and executive dysfunction. Eighteen non-demented PD participants and nineteen controls were compared on letter fluency using a fluency index (Fi); the average time to “think” of each word, a measure independent of motor speed. Video analyses produced thinking times to switch between word clusters and generate a word within a cluster. Correlational and regression analyses were undertaken with tests of processing speed and executive functioning. The PD group exhibited significantly longer fluency indices than controls across all components. Performance on tests of executive functioning explained a significant proportion of variance whereas performance in processing speed tests did not. Moreover, PD participants with an executive functioning impairment showed significantly worse switching fluency indices only compared with Controls and PD participants without executive dysfunction. PD participants with executive dysfunction exhibited a disproportionate impairment in the time taken to switch between clusters than to think of words within clusters. Executive functioning contributed to fluency performance more than processing speed. Cognitive heterogeneity and motor slowing, may mask the profile of cognitive dysfunction in neurodegenerative disease. (JINS, 2013, 19, 1–9)

Keywords

Executive functionMovement disordersAttentionMild cognitive impairment
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 9 , October 2013 , pp. 986 - 994
Copyright
Copyright © The International Neuropsychological Society 2013 

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