title: Improvement in Language Function Correlates with Gait Improvement in Drug-naïve Parkinson's Disease Patients Taking Dopaminergic Medication.
abstract: BACKGROUND
  Dopaminergic drugs, the gold standard for motor symptoms, are known to affect cognitive function in Parkinson's disease (PD) patients.
  
  
  OBJECTIVE
  We compared the effects of dopaminergic treatment on motor and cognitive function in drug-naïve patients.
  
  
  METHODS
  Dopaminergic medication (levodopa, dopamine agonist, selegiline) was given to 27 drug-naïve PD patients and increased to a dose optimal for improved motor symptoms. Patients were tested prior to, and 4-7 months after, drug initiation. Motor function was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). Cognitive function was assessed using both the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and the Neurobehavioral Cognitive Status Examination (COGNISTAT-J). Improvements from baseline for both motor and cognitive assessment were compared.
  
  
  RESULTS
  Mean score of all motor assessments (UPDRS total score of Parts II and III, and sub-scores of tremor, rigidity, bradykinesia, gait, and postural instability) and certain cognitive assessments (MoCA-J total score and subscore of delayed recall) significantly improved with dopaminergic medication. Gait score improvement showed significant positive correlation with improvement in MoCA-J language domain and in language-comprehension subtests of COGNISTAT-J using Spearman's correlation coefficients. Furthermore, multiple regression analysis showed gait score improvement significantly correlated with improvements in the subtests of language-comprehension in COGNISTAT-J.
  
  
  CONCLUSIONS
  There is correlated improvement in both gait and language function in de novo PD patients in response to dopaminergic drugs. Gait and language dysfunction in these patients may share a common pathophysiology linked to dopamine deficits.
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Momma
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Tetsuhito
authors.initials: T
authors.lastname: Nohara
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Futamura
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Sugita
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Ishigaki
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Katoh
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Kezuka
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Ono
authors.affiliation: Medical Sciences Training Program, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Miller
authors.affiliation: Department of Neurology, School of Medicine, Showa University Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kawamura
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D005684:Gait / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D013060:Speech
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents
keywords: Parkinson’s disease; cognition; executive function; gait; language; verbal fluency disorders; working memory