scholarly journals Sensitivity and Specificity of the ECAS in Parkinson’s Disease and Progressive Supranuclear Palsy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer A. Foley ◽  
Elaine H. Niven ◽  
Andrew Paget ◽  
Kailash P. Bhatia ◽  
Simon F. Farmer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Progressive Supranuclear Palsy ◽  
Verbal Fluency ◽  
High Sensitivity ◽  
Healthy Controls ◽  
Diagnostic Challenge ◽  
Motor Disability ◽  
Severe Motor

Disentangling Parkinson’s disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP.

scholarly journals Clinical Profile of Cognitive Decline in Patients with Parkinson's Disease, Progressive Supranuclear Palsy, and Multiple System Atrophy

2017 ◽  
Vol 08 (04) ◽  
pp. 562-568 ◽  
Author(s):  
Dipti Gupta ◽  
Anjani Kumar Sharma ◽  
Naveen Kumar ◽  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Statistical Analysis ◽  
Multiple System Atrophy ◽  
Cognitive Decline ◽  
Progressive Supranuclear Palsy ◽  
Verbal Fluency ◽  
Cognitive Profile ◽  
Significant Difference

ABSTRACT Background: There are very less data on the comparison between the cognitive profile in Parkinson's disease (PD) and Parkinson's-plus groups, especially in India. Aims: The aim of this study is to compare the cognitive profile across PD, progressive supranuclear palsy (PSP), and multiple system atrophy (MSA) groups and compare them using Mini–Mental State Examination (MMSE), frontal assessment battery (FAB), and verbal fluency tests. Settings and Design: This was a cross-sectional study. Materials and Methods: MMSE, FAB, and verbal fluency tests were administered in a total of 73 patients constituting 22 patients in MSA, 26 patients in PD, and 25 patients in PSP group, respectively. Twenty-six participants both age- and gender-matched were enrolled in control group. Statistical Analysis: Statistical analysis was done using SPSS Version 20.0. Descriptive statistics were done to find out the mean and standard deviation of different variables. ANOVA was done for followed by post hoc Bonferroni test to assess the cognitive function in three groups. Results: ANOVA showed that there is a significant difference for MMSE scores (P = 0.038) being worse scores for PSP and maximum for MSA. A significant difference was found for FAB scores within three groups. There is a significant difference for FAB scores (P = 0.00003) being worse scores for PSP and highest scores obtained for PD. All the subtests of FAB test differed significantly except motor programming across MSA, PSP, and PD groups. Conclusions: Our data suggest that global cognitive impairment and executive dysfunction are worst in PSP among the three groups. Patients with MSA had significant cognitive decline as opposed to previous experience. FAB scores and verbal fluency tests are good tests to assess cognitive impairment in these diseases. Subsets of FAB score have significant differences but cannot help differentiating conclusively between these three diseases.

scholarly journals Which Neuropsychological Tests? Predicting Cognitive Decline and Dementia in Parkinson’s Disease in the ICICLE-PD Cohort

2021 ◽  
pp. 1-12
Author(s):  
Rachael A. Lawson ◽  
Caroline H. Williams-Gray ◽  
Marta Camacho ◽  
Gordon W. Duncan ◽  
Tien K. Khoo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Verbal Fluency ◽  
Neuropsychological Tests ◽  
Visual Memory ◽  
Attention And Memory ◽  
Memory And Attention ◽  
Global Cognition

Background: Cognitive impairment is common in Parkinson’s disease (PD), with 80% cumulatively developing dementia (PDD). Objective: We sought to identify tests that are sensitive to change over time above normal ageing so as to refine the neuropsychological tests predictive of PDD. Methods: Participants with newly diagnosed PD (n = 211) and age-matched controls (n = 99) completed a range of clinical and neuropsychological tests as part of the ICICLE-PD study at 18-month intervals over 72 months. Impairments on tests were determined using control means (<1-2SD) and median scores. Mild cognitive impairment (PD-MCI) was classified using 1-2SD below normative values. Linear mixed effects modelling assessed cognitive decline, while Cox regression identified baseline predictors of PDD. Results: At 72 months, 46 (cumulative probability 33.9%) participants had developed PDD; these participants declined at a faster rate in tests of global cognition, verbal fluency, memory and attention (p <  0.05) compared to those who remained dementia-free. Impaired baseline global cognition, visual memory and attention using median cut-offs were the best predictors of early PDD (area under the curve [AUC] = 0.88, p <  0.001) compared to control-generated cut-offs (AUC = 0.76–0.84, p <  0.001) and PD-MCI (AUC] = 0.64–0.81, p <  0.001). Impaired global cognition and semantic fluency were the most useful brief tests employable in a clinical setting (AUC = 0.79, p <  0.001). Conclusion: Verbal fluency, attention and memory were sensitive to change in early PDD and may be suitable tests to measure therapeutic response in future interventions. Impaired global cognition, attention and visual memory were the most accurate predictors for developing a PDD. Future studies could consider adopting these tests for patient clinical trial stratification.

scholarly journals Verbal fluency in categories of common and proper names in the phase of mild cognitive impairment in the course of Parkinson’s disease

1970 ◽  
Author(s):  
Renata Gliwa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Executive Functions ◽  
Verbal Fluency ◽  
Proper Names ◽  
Test Group ◽  
Progressive Decrease ◽  
Test Result

Renata Gliwa, Verbal fluency in categories of common and proper names in the phase of mild cognitive impairment in the course of Parkinson’s disease. Interdisciplinary Contexts of Special Pedagogy, no. 27, Poznań 2019. Pp. 249–272. Adam Mickiewicz University Press. ISSN 2300-391X. e-ISSN 2658-283X. DOI: https://doi.org/10.14746/ikps.2019.27.12 The article is devoted to consideration of verbal fluency in MCI-PD. The VF test allows for the detection of dysfunctions within linguistic processes, semantic memory and dysfunctions of executive functions already in the early stages of Parkinson’sdisease. The article compares the results of verbal fluency tests in selected categories of proper names and common names, and assesses the effect of the MCIPD stage on the test result. The comparison of the test group results with various degrees of MCI indicates a progressive decrease in verbal fluency. The experiment showed different profiles of the verbal task in terms of common and proper names.

scholarly journals Differentiating Progressive Supranuclear Palsy and Parkinson's Disease With Head-Mounted Displays

2021 ◽  
Vol 12 ◽  
Author(s):  
Arvid Herwig ◽  
Almedin Agic ◽  
Hans-Jürgen Huppertz ◽  
Randolf Klingebiel ◽  
Frédéric Zuhorn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Eye Movements ◽  
Progressive Supranuclear Palsy ◽  
Neurodegenerative Disorder ◽  
High Sensitivity ◽  
Brain Regions ◽  
Inpatient Setting ◽  
Head Mounted Displays ◽  
Diagnostic Index

Background: Progressive supranuclear palsy (PSP) is a neurodegenerative disorder that, especially in the early stages of the disease, is clinically difficult to distinguish from Parkinson's disease (PD).Objective: This study aimed at assessing the use of eye-tracking in head-mounted displays (HMDs) for differentiating PSP and PD.Methods: Saccadic eye movements of 13 patients with PSP, 15 patients with PD, and a group of 16 healthy controls (HCs) were measured. To improve applicability in an inpatient setting and standardize the diagnosis, all the tests were conducted in a HMD. In addition, patients underwent atlas-based volumetric analysis of various brain regions based on high-resolution MRI.Results: Patients with PSP displayed unique abnormalities in vertical saccade velocity and saccade gain, while horizontal saccades were less affected. A novel diagnostic index was derived, multiplying the ratios of vertical to horizontal gain and velocity, allowing segregation of PSP from PD with high sensitivity (10/13, 77%) and specificity (14/15, 93%). As expected, patients with PSP as compared with patients with PD showed regional atrophy in midbrain volume, the midbrain plane, and the midbrain tegmentum plane. In addition, we found for the first time that oculomotor measures (vertical gain, velocity, and the diagnostic index) were correlated significantly to midbrain volume in the PSP group.Conclusions: Assessing eye movements in a HMD provides an easy to apply and highly standardized tool to differentiate PSP of patients from PD and HCs, which will aid in the diagnosis of PSP.

Verbal fluency in Parkinson's disease: results of a 2-min fluency test

2006 ◽  
Vol 18 (1) ◽  
pp. 38-41 ◽  
Author(s):  
B. Scholtissen ◽  
J. Dijkstra ◽  
J. Reithler ◽  
A. F. G. Leentjens
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Executive Functioning ◽  
Verbal Fluency ◽  
Healthy Controls ◽  
Impaired Performance ◽  
Phonemic Fluency ◽  
Retrieval Strategies ◽  
Fluency Task ◽  
Fluency Test

Background:Patients suffering from Parkinson's disease (PD) are often reported to have an impaired performance on tests measuring executive functioning, such as fluency tasks.Aim:To investigate whether verbal fluency is impaired in PD patients (n = 25) compared with healthy controls (n = 15) using a 2-min semantic and phonemic verbal fluency test. A 2-min version of the fluency task was used to allow for more switches between clusters to study retrieval strategies more adequately.Results:No differences in performance on both semantic and phonemic fluency tasks between the PD patients and the control persons were found. Moreover, both groups appeared to use the same retrieval strategies.Conclusion:Patients suffering from PD appear to use the same strategies for producing words as healthy controls do. Different pathways may be involved in switching clusters during the fluency task than in other types of switching that may be impaired in PD, such as motor switching and concept-shifting.

COGNITIVE IMPAIRMENT IN EARLY, UNTREATED PARKINSON'S DISEASE AND ITS RELATIONSHIP TO MOTOR DISABILITY

Brain ◽  
1991 ◽  
Vol 114 (5) ◽  
pp. 2095-2122 ◽  
Author(s):  
JAMES A. COOPER ◽  
HARVEY J. SAGAR ◽  
NIGEL JORDAN ◽  
NORMAN S. HARVEY ◽  
EDITH V. SULLIVAN
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Motor Disability

scholarly journals Presence of Skin α-Synuclein Deposits Discriminates Parkinson’s Disease from Progressive Supranuclear Palsy and Corticobasal Syndrome

2021 ◽  
pp. 1-7
Author(s):  
Maria Pia Giannoccaro ◽  
Patrizia Avoni ◽  
Giovanni Rizzo ◽  
Alex Incensi ◽  
Rossella Infante ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Differential Diagnosis ◽  
Progressive Supranuclear Palsy ◽  
Clinical Diagnosis ◽  
Corticobasal Syndrome ◽  
Healthy Controls ◽  
Mri Findings ◽  
Chi Square ◽  
Clinical Diagnostic Criteria

Background: Previous studies reported skin phosphorylated α-synuclein (p-syn) deposits in Parkinson’s disease (PD) patients but not in patients with parkinsonism due to tauopathies, although data on the latter are limited. Objective: We aimed to assess the presence of skin p-syn deposits in patients with clinical diagnosis of parkinsonism usually due to tauopathy and PD. Methods: We consecutively recruited 26 patients, 18 fulfilling clinical diagnostic criteria of progressive supranuclear palsy (PSP) and 8 of corticobasal syndrome (CBS), 26 patients with PD, and 26 healthy controls (HC). All subjects underwent skin biopsy to study p-syn deposits in skin nerves by immunofluorescence. Results: Skin p-syn deposits were present in only two of the PSP/CBS patients and none of the HC. Conversely, all PD patients showed p-syn deposition (p <  0.001, Chi-square). The two p-syn positive patients were diagnosed with PSP and CBS, respectively. Although clinical and MRI findings supported these diagnoses, both patients had some atypical features more typical of synucleinopathies. Conclusion: The detection of skin p-syn deposits may help in the differential diagnosis of parkinsonism. Indeed, in this study, all PD patients and only two out of 26 with a clinical diagnosis of PSP/CBS had skin p-syn deposits. Furthermore, these two patients showed clinical features that could suggest an atypical synucleinopathy presentation or a mixed pathology.

scholarly journals Quantitative Electroencephalography as a Biomarker for Cognitive Dysfunction in Parkinson’s Disease

2022 ◽  
Vol 13 ◽  
Author(s):  
Kevin Novak ◽  
Bruce A. Chase ◽  
Jaishree Narayanan ◽  
Premananda Indic ◽  
Katerina Markopoulou
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Principal Component ◽  
Disease Stage ◽  
Positive Contribution ◽  
Healthy Controls ◽  
Quantitative Electroencephalography ◽  
Motor Score ◽  
Eeg Recordings

Background: Quantitative electroencephalography (qEEG) has been suggested as a biomarker for cognitive decline in Parkinson’s disease (PD).Objective: Determine if applying a wavelet-based qEEG algorithm to 21-electrode, resting-state EEG recordings obtained in a routine clinical setting has utility for predicting cognitive impairment in PD.Methods: PD subjects, evaluated by disease stage and motor score, were compared to healthy controls (N = 20 each). PD subjects with normal (PDN, MoCA 26–30, N = 6) and impaired (PDD, MoCA ≤ 25, N = 14) cognition were compared. The wavelet-transform based time-frequency algorithm assessed the instantaneous predominant frequency (IPF) at 60 ms intervals throughout entire recordings. We then determined the relative time spent by the IPF in the four standard EEG frequency bands (RTF) at each scalp location. The resting occipital rhythm (ROR) was assessed using standard power spectral analysis.Results: Comparing PD subjects to healthy controls, mean values are decreased for ROR and RTF-Beta, greater for RTF-Theta and similar for RTF-Delta and RTF-Alpha. In logistic regression models, arithmetic combinations of RTF values [e.g., (RTF-Alpha) + (RTF-Beta)/(RTF-Delta + RTF-Theta)] and RTF-Alpha values at occipital or parietal locations are most able to discriminate between PD and controls. A principal component (PC) from principal component analysis (PCA) using RTF-band values in all subjects is associated with PD status (p = 0.004, β = 0.31, AUC = 0.780). Its loadings show positive contribution from RTF-Theta at all scalp locations, and negative contributions from RTF-Beta at occipital, parietal, central, and temporal locations. Compared to cognitively normal PD subjects, cognitively impaired PD subjects have lower median RTF-Alpha and RTF-Beta values, greater RTF-Theta values and similar RTF-Delta values. A PC from PCA using RTF-band values in PD subjects is associated with cognitive status (p = 0.002, β = 0.922, AUC = 0.89). Its loadings show positive contributions from RTF-Theta at all scalp locations, negative contributions from RTF-Beta at central locations, and negative contributions from RTF-Delta at central, frontal and temporal locations. Age, disease duration and/or sex are not significant covariates. No PC was associated with motor score or disease stage.Significance: Analyzing standard EEG recordings obtained in a community practice setting using a wavelet-based qEEG algorithm shows promise as a PD biomarker and for predicting cognitive impairment in PD.

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