Seok Jong Chung1,2, Han Soo Yoo1, Hye Sun Lee3, Yang Hyun Lee1, KyoungWon Baik1, Jin Ho Jung1,4, Byoung Seok Ye1, Young H Sohn1, Phil Hyu Lee5,6. 1. Department of Neurology, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. 2. Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea. 3. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea. 4. Department of Neurology, Inje University Busan Paik Hospital, Busan, South Korea. 5. Department of Neurology, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. phlee@yuhs.ac. 6. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. phlee@yuhs.ac.
Abstract
OBJECTIVES: To investigate the association between cognitive function at baseline and the progression of motor disability in Parkinson's disease (PD). METHODS: We consecutively enrolled 257 drug-naïve patients with early-stage PD (follow-up > 2 years) who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to yield four cognitive function factors and composite scores thereof: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). The global cognitive composite score of each patient was calculated based on these factors. Subsequently, we assessed the effect of baseline cognitive function on long-term motor outcomes, namely levodopa-induced dyskinesia (LID), wearing-off, freezing of gait (FOG), and rate of longitudinal increases in levodopa-equivalent dose (LED). RESULTS: Cox regression analysis demonstrated that higher Factor 3 (frontal/executive) composite scores (i.e., better cognitive performance) were associated with early development of LID [hazard ratio (HR), 1.507; p = 0.003], whereas higher Factor 1 (visual memory/visuospatial) composite scores (i.e., better cognitive performance) were associated with a lower risk for FOG (HR 0.683; p = 0.017). We noted that higher global cognitive composite scores were associated with a lower risk for developing FOG (HR 0.455; p = 0.045). The linear mixed model demonstrated that higher global cognitive composite scores and better cognitive performance in visual memory/visuospatial function were associated with slower longitudinal increases in LED. CONCLUSIONS: These findings suggest that baseline cognitive profiles have prognostic implications on several motor aspects in patients with PD.
OBJECTIVES: To investigate the association between cognitive function at baseline and the progression of motor disability in Parkinson's disease (PD). METHODS: We consecutively enrolled 257 drug-naïve patients with early-stage PD (follow-up > 2 years) who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to yield four cognitive function factors and composite scores thereof: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). The global cognitive composite score of each patient was calculated based on these factors. Subsequently, we assessed the effect of baseline cognitive function on long-term motor outcomes, namely levodopa-induced dyskinesia (LID), wearing-off, freezing of gait (FOG), and rate of longitudinal increases in levodopa-equivalent dose (LED). RESULTS: Cox regression analysis demonstrated that higher Factor 3 (frontal/executive) composite scores (i.e., better cognitive performance) were associated with early development of LID [hazard ratio (HR), 1.507; p = 0.003], whereas higher Factor 1 (visual memory/visuospatial) composite scores (i.e., better cognitive performance) were associated with a lower risk for FOG (HR 0.683; p = 0.017). We noted that higher global cognitive composite scores were associated with a lower risk for developing FOG (HR 0.455; p = 0.045). The linear mixed model demonstrated that higher global cognitive composite scores and better cognitive performance in visual memory/visuospatial function were associated with slower longitudinal increases in LED. CONCLUSIONS: These findings suggest that baseline cognitive profiles have prognostic implications on several motor aspects in patients with PD.
Authors: E Y Uc; M P McDermott; K S Marder; S W Anderson; I Litvan; P G Como; P Auinger; K L Chou; J C Growdon Journal: Neurology Date: 2009-11-03 Impact factor: 9.910
Authors: Daan C Velseboer; Mark Broeders; Bart Post; Nan van Geloven; Johannes D Speelman; Ben Schmand; Rob J de Haan; Rob M A de Bie Journal: Neurology Date: 2013-01-23 Impact factor: 9.910