What predicts cognitive decline in de novo Parkinson's disease?

Dario Arnaldi, Claudio Campus, Michela Ferrara, Francesco Famà, Agnese Picco, Fabrizio De Carli, Jennifer Accardo, Andrea Brugnolo, Gianmario Sambuceti, Silvia Morbelli, Flavio Nobili

Research output: Contribution to journalArticlepeer-review

Abstract

Subtle cognitive impairment can be detected in early Parkinson's disease (PD). In a consecutive series of de novo, drug-naive PD patients, we applied stepwise regression analysis to assess which clinical, neuropsychological, and functional neuroimaging (dopamine transporter [DAT] and perfusion single photon emission computed tomography [SPECT]) characteristics at baseline was predictive of cognitive decline during an average follow-up time of about 4 years. Decline both in executive (R2 = 0.54; p = 0.0001) and visuospatial (R2 = 0.56; p = 0.0001) functions was predicted by the couple of Unified Parkinson's Disease Rating Scale (UPDRS)-III score and caudate dopamine transporter (DAT) uptake in the less affected hemisphere (LAH). Verbal memory and language decline was predicted instead by caudate DAT uptake and brain perfusion in a posterior parieto-temporal area of the less affected hemisphere (R2 = 0.42; p = 0.0005). No significant effect was shown for age, baseline neuropsychological scores, and levodopa equivalent dose at follow-up. The combined use of clinical structured examination and brain functional assessment by means of dual single photon emission computed tomography imaging appears as a powerful approach to predict cognitive decline in de novo PD patients.

Original languageEnglish
JournalNeurobiology of Aging
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Cognitive decline
  • Dopamine transporter SPECT
  • Neuropsychological tests
  • Parkinson's disease
  • Perfusion SPECT

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Ageing
  • Developmental Biology
  • Geriatrics and Gerontology

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