title: Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson's disease.
abstract: Cognitive impairment in patients with Parkinson's disease is gaining increased clinical significance owing to the relative success of therapeutic approaches to the motor symptoms of this disorder. Early investigations contributed to the concept of subcortical dementia associated with bradyphrenia and cognitive rigidity. For cognition in parkinsonian disorders, this notion developed into the concept of mild cognitive impairment and fronto-executive dysfunction in particular, driven mainly by dopaminergic dysmodulation and manifesting as deficits in flexibility, planning, working memory, and reinforcement learning. However, patients with Parkinson's disease could also develop a syndrome of dementia that might depend on non-dopaminergic, cholinergic cortical dysfunction. Recent findings, supplemented by advances in neuroimaging and genetic research, reveal substantial heterogeneity in the range of cognitive deficits in patients with Parkinson's disease. Remediation and management prospects for these cognitive deficits are based on neuropharmacological and cognitive rehabilitation approaches.
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; Department of Experimental Psychology, University of Cambridge, UK.
authors.forename: Angie A
authors.initials: AA
authors.lastname: Kehagia
authors.affiliation: Cambridge Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, UK.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Barker
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; Department of Experimental Psychology, University of Cambridge, UK. Electronic address: twr2@cam.ac.uk.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Robbins
mesh_terms: D018678:Cholinergic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology / Q000235:genetics / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003704:Dementia / Q000209:etiology* / Q000235:genetics; D015259:Dopamine Agents / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000235:genetics / Q000523:psychology
chemical_list: D018678:Cholinergic Agents; D015259:Dopamine Agents