Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease

Daniel Weintraub; Tanya Simuni; Chelsea Caspell-Garcia; Christopher Coffey; Shirley Lasch; Andrew Siderowf; Dag Aarsland; Paolo Barone; David Burn; Lama M Chahine; Jamie Eberling; Alberto J Espay; Eric D Foster; James B Leverenz; Irene Litvan; Irene Richard; Matthew D Troyer; Keith A Hawkins; Parkinson's Progression Markers Initiative

doi:10.1002/mds.26170

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Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease

Journal article

Peer reviewed

Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease

Daniel Weintraub, Tanya Simuni, Chelsea Caspell-Garcia, Christopher Coffey, Shirley Lasch, Andrew Siderowf, Dag Aarsland, Paolo Barone, David Burn, Lama M Chahine, …

Movement disorders, Vol.30(7), pp.919-927

06/2015

DOI: 10.1002/mds.26170

PMCID: PMC4855523

PMID: 25737166

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Abstract

This study was undertaken to determine the prevalence and correlates of cognitive impairment (CI) and neuropsychiatric symptoms (NPS) in early, untreated patients with Parkinson's disease (PD). Both CI and NPS are common in PD and impact disease course and quality of life. However, limited knowledge is available about cognitive abilities and NPS. Parkinson's Progression Markers Initiative (PPMI) is a multi-site study of early, untreated PD patients and healthy controls (HCs), the latter with normal cognition. At baseline, participants were assessed with a neuropsychological battery and for symptoms of depression, anxiety, impulse control disorders (ICDs), psychosis, and apathy. Baseline data of 423 PD patients and 196 HCs yielded no between-group differences in demographic characteristics. Twenty-two percent of PD patients met the PD-recommended screening cutoff for CI on the Montral Cognitive Assessment (MoCA), but only 9% met detailed neuropsychological testing criteria for mild cognitive impairment (MCI)-level impairment. The PD patients were more depressed than HCs (P < 0.001), with twice as many (14% vs. 7%) meeting criteria for clinically significant depressive symptoms. The PD patients also experienced more anxiety (P < 0.001) and apathy (P < 0.001) than HCs. Psychosis was uncommon in PD (3%), and no between-group difference was seen in ICD symptoms (P = 0.51). Approximately 10% of PD patients in the early, untreated disease state met traditional criteria of CI, which is a lower frequency compared with previous studies. Multiple dopaminergic-dependent NPS are also more common in these patients compared with the general population, but others associated with dopamine replacement therapy are not or are rare. Future analyses of this cohort will examine biological predictors and the course of CI and NPS. © 2015 International Parkinson and Movement Disorder Society.

Depression - physiopathology

Prevalence

Humans

Middle Aged

Disruptive, Impulse Control, and Conduct Disorders - etiology

Male

Depression - etiology

Psychotic Disorders - physiopathology

Apathy - physiology

Cognition Disorders - etiology

Cognitive Dysfunction - epidemiology

Aged, 80 and over

Anxiety - epidemiology

Parkinson Disease - epidemiology

Adult

Female

Mental Disorders - etiology

Severity of Illness Index

Parkinson Disease - complications

Cognition Disorders - physiopathology

Depression - epidemiology

Mental Disorders - epidemiology

Anxiety - physiopathology

Psychotic Disorders - epidemiology

Cognitive Dysfunction - etiology

Cognitive Dysfunction - physiopathology

Parkinson Disease - physiopathology

Mental Disorders - physiopathology

Disruptive, Impulse Control, and Conduct Disorders - physiopathology

Disruptive, Impulse Control, and Conduct Disorders - epidemiology

Biomarkers

Aged

Cognition Disorders - epidemiology

Anxiety - etiology

Psychotic Disorders - etiology

Details

Title: Subtitle: Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease
Creators: Daniel Weintraub - Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
Tanya Simuni - Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
Chelsea Caspell-Garcia - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
Christopher Coffey - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
Shirley Lasch - Institute for Neurodegenerative Disorders (IND) and Molecular NeuroImaging, LLC (MNI), New Haven, Connecticut, USA
Andrew Siderowf - Avid Radiopharmaceuticals, Philadelphia, Pennsylvania, USA
Dag Aarsland - Department of Neurobiology, Care Sciences and Society and the Alzheimer Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
Paolo Barone - Neurodegenerative Diseases Centre, Neuroscience Section, Department of Medicine, University of Salerno, Italy
David Burn - Institute for Ageing and Health, Newcastle University, Newcastle, England
Lama M Chahine - Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Jamie Eberling - Michael J. Fox Foundation for Parkinson's Research, New York, New York, USA
Alberto J Espay - Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA
Eric D Foster - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
James B Leverenz - Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA
Irene Litvan - UCSD Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
Irene Richard - Departments of Neurology and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
Matthew D Troyer - Medivation, Inc., San Francisco, California, USA
Keith A Hawkins - Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
Parkinson's Progression Markers Initiative
Resource Type: Journal article
Publication Details: Movement disorders, Vol.30(7), pp.919-927
DOI: 10.1002/mds.26170
PMID: 25737166
PMCID: PMC4855523
NLM abbreviation: Mov Disord
ISSN: 0885-3185
eISSN: 1531-8257
Publisher: Wiley; United States
Grant note: P50 NS053488 / NINDS NIH HHS
Language: English
Date published: 06/2015
Academic Unit: Biostatistics; College of Public Health
Record Identifier: 9983997997802771

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