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15 Mild Cognitive Impairment in Parkinson’s disease
Abstracts / Basal Ganglia 2 (2012) 257–265
Background: Action naming is the capacity to correctly identify and name an action. Although action naming has been found to be impaired in a host of neurodegenerative conditions, its neural substrates have been rarely explored. Methods: Twenty-six subjects affected with Corticobasal Syndrome (CBS) were included in the study. Action naming was assessed with Druks and Masterson Action Naming Battery; moreover all subjects underwent an extensive neuropsychological evaluation and a structural 3D MRI brain scan. Action naming data were then correlated with local gray matter densities using a voxel-wise approach. Results: CBS patients showed action naming impairments compared to age-matched healthy subjects. Moreover, a linear stepwise regression analysis showed a significant association between action naming and object naming as well as non-dominant hand Finger Tapping performance. These predictors were then included in our voxel-wise correlation between gray matter densities and action naming error rates as confounding variables. Voxel-wise analysis local maxima were localized in the bilateral inferior parietal lobule, in the right insula, in the right lateral globus pallidus, in the left middle temporal gyrus, and in the left cuneus. Discussion: Our data highlight the relationship between motor and non-motor deficits in movement disorders suggesting a specific role of right hemisphere and in particular of the inferior parietal lobule in verbal labeling of actions in neurodegenerative conditions. http://dx.doi.org/10.1016/j.baga.2012.04.014
14 Prevalence of dementia in Parkinson’s disease (PDD) A.M. Papantonio, E. Bagoj, M.A. Cusano, S. De Rosa, C. Mundi Struttura Complessa Ospedaliera di Neurologia OO.RR. Foggia, Italy Background: The Center for Neurodegenerative Diseases of the Department of Neurology of the Ospedali Riuniti of Foggia deals with the diagnosis and treatment of patients suffering from major forms of dementia and movement disorders from Foggia and from neighboring towns for many years. The prevalence (prevalence) of dementia in Parkinson’s disease (PD dementia) is reported in 40% of patients. Methods: We describe the population of patients referred to the clinic for movement disorders. Data collection took place through the outpatient consultation folders that collect the personal details of patients, all medical and clinical records. Results: Flow to the Center for Movement Disorders, every three months 389 patients with a diagnosis of movement disorders. Patients had the following characteristics: 300 patients with Parkinson’s disease (146 males and 154 females); 66 cases of essential tremor with high familiarity (32 males and 34 females); 12 cases of restless legs syndrome (8 males and 4 females); 6 cases of focal and segmental dystonia; 6 cases of other neurodegenerative diseases (Chorea, MSA, PSP, etc.). There is a distribution to the almost similar for all movement disorders between the sexes (191 males and 198 females). In the context of the population of patients with Parkinson’s disease related to the clinic only 27 patients were diagnosed with Parkinson’s dementia and of these 11 men and 16 women. With a prevalence of dementia, accounting for 9% of the population in question. The vast majority of these patients being treated with rivastigmine at doses ranging between 6 and 12 mg per day. In our small series the drug efficacy has shown good. Conclusions: More likely than patients described have cognitive impairment, but most often are misunderstood or not the same as evidenced by patients who are used to focus their attention on movement disorders and much less on non-motor disorders. In view of the effectiveness of rivastigmine, even in our small population
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would be desirable to implement all appropriate diagnostic procedures to reach an early diagnosis of dementia in Parkinson’s disease in these patients to ensure a better quality of life. http://dx.doi.org/10.1016/j.baga.2012.04.015
15 Mild Cognitive Impairment in Parkinson’s disease I. Bertaina a, C. Pasotti b, B. Minafra a, R. Zangaglia a, E. Sinforiani b, C. Pacchetti a a Parkinson’s Disease and Movement Disorders Unit, Fondazione Istituto Neurologico Nazionale IRCCS ‘‘C.Mondino’’, Pavia, Italy, b Laboratory of Neuropsychology, Fondazione Istituto Neurologico Nazionale IRCCS ‘‘C.Mondino’’, Pavia, Italy Mild Cognitive Impairment (MCI), is an intermediate stage between normal cognitive function and dementia, is common in Parkinson disease (PD) and its presence might be a risk factor for progression to dementia. The prevalence and profiles of PD-MCI are variable. The aim of this study is to evaluate the relationship between types of PD-MCI and clinical variables of disease in PD patients. Methods: We enrolled 300 PD patients consecutively referring to the surgery of Parkinson’s disease and movement disorders of IRCCS ‘‘National Institute of Neurology C. Mondino’’ Foundation of Pavia, Italy from March 2009 to December 2010 and underwent neuropsychological assessment. Of these 100 are PD without cognitive impairment, 145 PD-MCI and 55 PD whit dementia. Patients without cognitive impairment and patients with dementia are excluded. PDMCI are included. Subjects were classified as having MCI if their age and education corrected z score on one or more cognitive domains was at least 1.5 standard deviations below the mean of normative data. Results: In our population the most frequent is MCI non amnesic single domain (naMCI-SD): with logical-executive deficit (43% ), and with visuo-spatial deficit (25 %). The second most frequent MCI is non amnesic multiple domain (naMCI-MD19%). The MCI amnesic single domain (aMCI-SD) in 6% and multiple domain (aMCI-MD) in 7% of patients. The five groups are the same age, education, age of onset and disease severity (UPDRS and HY). The significant differences are a longer disease’s duration in aMCI-MD respect to naMCI-SD, meaning the parallelism between motor and cognitive worsening. Besides in this group hallucinations, anamnestic RBD and confusional episodes are most frequent. Conclusions: Our study naMCI-SD is most frequent (LE > VSP) while memory impairment may emerge later. The aMCI-MD in fact, is most frequent associated whit hallucinations, RBD, confusional episodes; could be a prelude to dementia. http://dx.doi.org/10.1016/j.baga.2012.04.016
16 Gait features in parkinsonian patients with or without mild cognitive impairment M. Amboni a,b, P. Barone c, L. Iuppariello d, I. Lista a, R. Tranfaglia d, A. Fasano e, M. Picillo d, C. Vitale a,b, G. Santangelo f, V. Agosti a,b, A. Iavarone g, G. Sorrentino a,b a University of Naples Parthenope, Italy, b IDC Hermirage-Capodimonte, Naples, Italy, c University of Salerno, Italy, d University of Naples Federico II, Italy, e Catholic University of Sacred Heart and AFaR-Fatebenefratelli Hospital, Rome, Italy, f Second University of Naples, Caserta, Italy, g CTO Hospital, AORN Ospedale dei Colli, Naples, Italy
Background: Action naming is the capacity to correctly identify and name an action. Although action naming has been found to be impaired in a host of neurodegenerative conditions, its neural substrates have been rarely explored. Methods: Twenty-six subjects affected with Corticobasal Syndrome (CBS) were included in the study. Action naming was assessed with Druks and Masterson Action Naming Battery; moreover all subjects underwent an extensive neuropsychological evaluation and a structural 3D MRI brain scan. Action naming data were then correlated with local gray matter densities using a voxel-wise approach. Results: CBS patients showed action naming impairments compared to age-matched healthy subjects. Moreover, a linear stepwise regression analysis showed a significant association between action naming and object naming as well as non-dominant hand Finger Tapping performance. These predictors were then included in our voxel-wise correlation between gray matter densities and action naming error rates as confounding variables. Voxel-wise analysis local maxima were localized in the bilateral inferior parietal lobule, in the right insula, in the right lateral globus pallidus, in the left middle temporal gyrus, and in the left cuneus. Discussion: Our data highlight the relationship between motor and non-motor deficits in movement disorders suggesting a specific role of right hemisphere and in particular of the inferior parietal lobule in verbal labeling of actions in neurodegenerative conditions. http://dx.doi.org/10.1016/j.baga.2012.04.014
14 Prevalence of dementia in Parkinson’s disease (PDD) A.M. Papantonio, E. Bagoj, M.A. Cusano, S. De Rosa, C. Mundi Struttura Complessa Ospedaliera di Neurologia OO.RR. Foggia, Italy Background: The Center for Neurodegenerative Diseases of the Department of Neurology of the Ospedali Riuniti of Foggia deals with the diagnosis and treatment of patients suffering from major forms of dementia and movement disorders from Foggia and from neighboring towns for many years. The prevalence (prevalence) of dementia in Parkinson’s disease (PD dementia) is reported in 40% of patients. Methods: We describe the population of patients referred to the clinic for movement disorders. Data collection took place through the outpatient consultation folders that collect the personal details of patients, all medical and clinical records. Results: Flow to the Center for Movement Disorders, every three months 389 patients with a diagnosis of movement disorders. Patients had the following characteristics: 300 patients with Parkinson’s disease (146 males and 154 females); 66 cases of essential tremor with high familiarity (32 males and 34 females); 12 cases of restless legs syndrome (8 males and 4 females); 6 cases of focal and segmental dystonia; 6 cases of other neurodegenerative diseases (Chorea, MSA, PSP, etc.). There is a distribution to the almost similar for all movement disorders between the sexes (191 males and 198 females). In the context of the population of patients with Parkinson’s disease related to the clinic only 27 patients were diagnosed with Parkinson’s dementia and of these 11 men and 16 women. With a prevalence of dementia, accounting for 9% of the population in question. The vast majority of these patients being treated with rivastigmine at doses ranging between 6 and 12 mg per day. In our small series the drug efficacy has shown good. Conclusions: More likely than patients described have cognitive impairment, but most often are misunderstood or not the same as evidenced by patients who are used to focus their attention on movement disorders and much less on non-motor disorders. In view of the effectiveness of rivastigmine, even in our small population
261
would be desirable to implement all appropriate diagnostic procedures to reach an early diagnosis of dementia in Parkinson’s disease in these patients to ensure a better quality of life. http://dx.doi.org/10.1016/j.baga.2012.04.015
15 Mild Cognitive Impairment in Parkinson’s disease I. Bertaina a, C. Pasotti b, B. Minafra a, R. Zangaglia a, E. Sinforiani b, C. Pacchetti a a Parkinson’s Disease and Movement Disorders Unit, Fondazione Istituto Neurologico Nazionale IRCCS ‘‘C.Mondino’’, Pavia, Italy, b Laboratory of Neuropsychology, Fondazione Istituto Neurologico Nazionale IRCCS ‘‘C.Mondino’’, Pavia, Italy Mild Cognitive Impairment (MCI), is an intermediate stage between normal cognitive function and dementia, is common in Parkinson disease (PD) and its presence might be a risk factor for progression to dementia. The prevalence and profiles of PD-MCI are variable. The aim of this study is to evaluate the relationship between types of PD-MCI and clinical variables of disease in PD patients. Methods: We enrolled 300 PD patients consecutively referring to the surgery of Parkinson’s disease and movement disorders of IRCCS ‘‘National Institute of Neurology C. Mondino’’ Foundation of Pavia, Italy from March 2009 to December 2010 and underwent neuropsychological assessment. Of these 100 are PD without cognitive impairment, 145 PD-MCI and 55 PD whit dementia. Patients without cognitive impairment and patients with dementia are excluded. PDMCI are included. Subjects were classified as having MCI if their age and education corrected z score on one or more cognitive domains was at least 1.5 standard deviations below the mean of normative data. Results: In our population the most frequent is MCI non amnesic single domain (naMCI-SD): with logical-executive deficit (43% ), and with visuo-spatial deficit (25 %). The second most frequent MCI is non amnesic multiple domain (naMCI-MD19%). The MCI amnesic single domain (aMCI-SD) in 6% and multiple domain (aMCI-MD) in 7% of patients. The five groups are the same age, education, age of onset and disease severity (UPDRS and HY). The significant differences are a longer disease’s duration in aMCI-MD respect to naMCI-SD, meaning the parallelism between motor and cognitive worsening. Besides in this group hallucinations, anamnestic RBD and confusional episodes are most frequent. Conclusions: Our study naMCI-SD is most frequent (LE > VSP) while memory impairment may emerge later. The aMCI-MD in fact, is most frequent associated whit hallucinations, RBD, confusional episodes; could be a prelude to dementia. http://dx.doi.org/10.1016/j.baga.2012.04.016
16 Gait features in parkinsonian patients with or without mild cognitive impairment M. Amboni a,b, P. Barone c, L. Iuppariello d, I. Lista a, R. Tranfaglia d, A. Fasano e, M. Picillo d, C. Vitale a,b, G. Santangelo f, V. Agosti a,b, A. Iavarone g, G. Sorrentino a,b a University of Naples Parthenope, Italy, b IDC Hermirage-Capodimonte, Naples, Italy, c University of Salerno, Italy, d University of Naples Federico II, Italy, e Catholic University of Sacred Heart and AFaR-Fatebenefratelli Hospital, Rome, Italy, f Second University of Naples, Caserta, Italy, g CTO Hospital, AORN Ospedale dei Colli, Naples, Italy