title: Executive dysfunction in Parkinson's disease: a review.
abstract: Executive dysfunction can be present from the early stages of Parkinson's disease (PD). It is characterized by deficits in internal control of attention, set shifting, planning, inhibitory control, dual task performance, and on a range of decision-making and social cognition tasks. Treatment with dopaminergic medication has variable effects on executive deficits, improving some, leaving some unchanged, and worsening others. In this review, we start by defining the specific nature of executive dysfunction in PD and describe suitable neuropsychological tests. We then discuss how executive deficits relate to pathology in specific territories of the basal ganglia, consider the impact of dopaminergic treatment on executive function (EF) in this context, and review the changes in EFs with disease progression. In later sections, we summarize correlates of executive dysfunction in PD with motor performance (e.g., postural instability, freezing of gait) and a variety of psychiatric (e.g., depression, apathy) and other clinical symptoms, and finally discuss the implications of these for the patients' daily life.
authors.affiliation: Department of Clinical Neuroscience and Preventive Medicine, Danube University, Krems, Austria. m.jahanshahi@ucl.ac.uk
authors.forename: Georg
authors.initials: G
authors.lastname: Dirnberger
authors.forename: Marjan
authors.initials: M
authors.lastname: Jahanshahi
mesh_terms: D001479:Basal Ganglia / Q000473:pathology; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D018450:Disease Progression; D018491:Dopamine Agonists / Q000494:pharmacology / Q000627:therapeutic use; D056344:Executive Function / Q000187:drug effects; D006801:Humans; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D063189:Symptom Assessment
chemical_list: D018491:Dopamine Agonists
keywords: Parkinson's disease; cognition; dopamine overdose; executive function