Daniel Weintraub1, Tanya Simuni2, Chelsea Caspell-Garcia3, Christopher Coffey3, Shirley Lasch4, Andrew Siderowf5, Dag Aarsland6, Paolo Barone7, David Burn8, Lama M Chahine9, Jamie Eberling10, Alberto J Espay11, Eric D Foster3, James B Leverenz12, Irene Litvan13, Irene Richard14, Matthew D Troyer15, Keith A Hawkins16. 1. Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. 2. Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 3. Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA. 4. Institute for Neurodegenerative Disorders (IND) and Molecular NeuroImaging, LLC (MNI), New Haven, Connecticut, USA. 5. Avid Radiopharmaceuticals, Philadelphia, Pennsylvania, USA. 6. Department of Neurobiology, Care Sciences and Society and the Alzheimer Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway. 7. Neurodegenerative Diseases Centre, Neuroscience Section, Department of Medicine, University of Salerno, Italy. 8. Institute for Ageing and Health, Newcastle University, Newcastle, England. 9. Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 10. Michael J. Fox Foundation for Parkinson's Research, New York, New York, USA. 11. Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA. 12. Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA. 13. UCSD Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA. 14. Departments of Neurology and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 15. Medivation, Inc., San Francisco, California, USA. 16. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Abstract
UNLABELLED: This study was undertaken to determine the prevalence and correlates of cognitive impairment (CI) and neuropsychiatric symptoms (NPS) in early, untreated patients with Parkinson's disease (PD). BACKGROUND: Both CI and NPS are common in PD and impact disease course and quality of life. However, limited knowledge is available about cognitive abilities and NPS. METHODS: Parkinson's Progression Markers Initiative (PPMI) is a multi-site study of early, untreated PD patients and healthy controls (HCs), the latter with normal cognition. At baseline, participants were assessed with a neuropsychological battery and for symptoms of depression, anxiety, impulse control disorders (ICDs), psychosis, and apathy. RESULTS: Baseline data of 423 PD patients and 196 HCs yielded no between-group differences in demographic characteristics. Twenty-two percent of PD patients met the PD-recommended screening cutoff for CI on the Montral Cognitive Assessment (MoCA), but only 9% met detailed neuropsychological testing criteria for mild cognitive impairment (MCI)-level impairment. The PD patients were more depressed than HCs (P < 0.001), with twice as many (14% vs. 7%) meeting criteria for clinically significant depressive symptoms. The PD patients also experienced more anxiety (P < 0.001) and apathy (P < 0.001) than HCs. Psychosis was uncommon in PD (3%), and no between-group difference was seen in ICD symptoms (P = 0.51). CONCLUSIONS: Approximately 10% of PD patients in the early, untreated disease state met traditional criteria of CI, which is a lower frequency compared with previous studies. Multiple dopaminergic-dependent NPS are also more common in these patients compared with the general population, but others associated with dopamine replacement therapy are not or are rare. Future analyses of this cohort will examine biological predictors and the course of CI and NPS.
UNLABELLED: This study was undertaken to determine the prevalence and correlates of cognitive impairment (CI) and neuropsychiatric symptoms (NPS) in early, untreated patients with Parkinson's disease (PD). BACKGROUND: Both CI and NPS are common in PD and impact disease course and quality of life. However, limited knowledge is available about cognitive abilities and NPS. METHODS:Parkinson's Progression Markers Initiative (PPMI) is a multi-site study of early, untreated PDpatients and healthy controls (HCs), the latter with normal cognition. At baseline, participants were assessed with a neuropsychological battery and for symptoms of depression, anxiety, impulse control disorders (ICDs), psychosis, and apathy. RESULTS: Baseline data of 423 PDpatients and 196 HCs yielded no between-group differences in demographic characteristics. Twenty-two percent of PDpatients met the PD-recommended screening cutoff for CI on the Montral Cognitive Assessment (MoCA), but only 9% met detailed neuropsychological testing criteria for mild cognitive impairment (MCI)-level impairment. The PDpatients were more depressed than HCs (P < 0.001), with twice as many (14% vs. 7%) meeting criteria for clinically significant depressive symptoms. The PDpatients also experienced more anxiety (P < 0.001) and apathy (P < 0.001) than HCs. Psychosis was uncommon in PD (3%), and no between-group difference was seen in ICD symptoms (P = 0.51). CONCLUSIONS: Approximately 10% of PDpatients in the early, untreated disease state met traditional criteria of CI, which is a lower frequency compared with previous studies. Multiple dopaminergic-dependent NPS are also more common in these patients compared with the general population, but others associated with dopamine replacement therapy are not or are rare. Future analyses of this cohort will examine biological predictors and the course of CI and NPS.
Authors: Daniel Weintraub; Juergen Koester; Marc N Potenza; Andrew D Siderowf; Mark Stacy; Valerie Voon; Jacqueline Whetteckey; Glen R Wunderlich; Anthony E Lang Journal: Arch Neurol Date: 2010-05
Authors: D Aarsland; K Bronnick; C Williams-Gray; D Weintraub; K Marder; J Kulisevsky; D Burn; P Barone; J Pagonabarraga; L Allcock; G Santangelo; T Foltynie; C Janvin; J P Larsen; R A Barker; M Emre Journal: Neurology Date: 2010-09-21 Impact factor: 9.910
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Authors: Christopher G Goetz; Barbara C Tilley; Stephanie R Shaftman; Glenn T Stebbins; Stanley Fahn; Pablo Martinez-Martin; Werner Poewe; Cristina Sampaio; Matthew B Stern; Richard Dodel; Bruno Dubois; Robert Holloway; Joseph Jankovic; Jaime Kulisevsky; Anthony E Lang; Andrew Lees; Sue Leurgans; Peter A LeWitt; David Nyenhuis; C Warren Olanow; Olivier Rascol; Anette Schrag; Jeanne A Teresi; Jacobus J van Hilten; Nancy LaPelle Journal: Mov Disord Date: 2008-11-15 Impact factor: 10.338
Authors: Lama M Chahine; Daniel Weintraub; Keith A Hawkins; Andrew Siderowf; Shirley Eberly; David Oakes; John Seibyl; Matthew B Stern; Kenneth Marek; Danna Jennings Journal: Mov Disord Date: 2015-08-21 Impact factor: 10.338
Authors: Kelly A Mills; Zoltan Mari; Gregory M Pontone; Alexander Pantelyat; Angela Zhang; Nadine Yoritomo; Emma Powers; Jason Brandt; Ted M Dawson; Liana S Rosenthal Journal: Parkinsonism Relat Disord Date: 2016-09-27 Impact factor: 4.891