title: Cognitive function and other non-motor features in non-demented Parkinson's disease motor subtypes.
abstract: Among patients with Parkinson's disease (PD), a wide range of non-motor symptoms (NMS) are evident. We assessed markers of NMS and explored their behavioral correlates with the tremor-dominant (TD) and postural instability gait difficulty (PIGD) subtypes. 110 non-demented patients with PD were evaluated and stratified into the PIGD and TD subtypes and, using stricter criteria, into predominant subgroups: p-PIGD (n = 31) and p-TD (n = 32). Non-motor signs that were assessed included cognitive function (pen and paper and a computerized battery), autonomic function (NMSQest and SCOPA-AUT), mood, and sleep. Health-related quality of life was evaluated using the PDQ-39. The p-PIGD subgroup had a higher score on the NMSQest (p = 0.033) and a higher score (i.e., worse) on the PDQ-39 (p-PIGD: 26.28 ± 12.47; p-TD: 16.93 ± 12.22; p = 0.004), compared to the p-TD subgroup, while these measures did not differ in the larger PIGD and TD group. The p-PIGD subgroup used more sleep medications compared to the p-TD subgroup (1.0 ± 1.39 vs. 0.41 ± 0.94, p = 0.05, respectively). Most cognitive scores were similar in both subgroups; however, the visuospatial components of the Montreal Cognitive Assessment and the computerized catch game were significantly worse among the p-PIGD subgroup. Mild associations were found between certain non-motor symptoms, but not cognitive function, and the PIGD score. Non-demented patients from the PIGD subtype experience more non-motor symptoms and poorer quality of life compared to the TD subtype. These findings suggest that the clinical management of non-motor and motor symptoms in patients with PD may be enhanced by a personalized approach.
authors.affiliation: Department of Neurology, Tel Aviv Sourasky Medical Center, Center for the Study of Movement, Cognition and Mobility, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Herman
authors.forename: Aner
authors.initials: A
authors.lastname: Weiss
authors.forename: Marina
authors.initials: M
authors.lastname: Brozgol
authors.forename: Adi
authors.initials: A
authors.lastname: Wilf-Yarkoni
authors.forename: Nir
authors.initials: N
authors.lastname: Giladi
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Hausdorff
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003071:Cognition; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000145:classification / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D011187:Posture; D011788:Quality of Life; D012720:Severity of Illness Index; D012890:Sleep
chemical_list: D000978:Antiparkinson Agents