6533b7d6fe1ef96bd1266791

RESEARCH PRODUCT

Cognitive impairment and levodopa induced dyskinesia in Parkinson’s disease: a longitudinal study from the PACOS cohort

Alessandra NicolettiVincenzo RestivoRoberto MonasteroRoberta BaschiCalogero Edoardo CiceroGiovanni MostileMario ZappiaMarco DavìAntonina Luca

subject

Male0301 basic medicineDyskinesia Drug-InducedLevodopamedicine.medical_specialtyParkinson's diseaseScienceNeuropsychological TestsSeverity of Illness IndexArticleCohort StudiesLevodopaExecutive Function03 medical and health sciences0302 clinical medicineInternal medicinemedicineHumansAttentionCognitive DysfunctionLongitudinal StudiesAgedProportional Hazards ModelsLevodopa-induced dyskinesiaMultidisciplinarybusiness.industryQRNeuropsychologyParkinson DiseaseCognitionMiddle Agedmedicine.diseaseAged Attention Cognitive Dysfunction Cohort Studies Dyskinesia Drug-Induced Executive Function Female Humans Levodopa Longitudinal Studies Male Middle Aged Neuropsychological Tests Parkinson Disease Proportional Hazards Models Severity of Illness Index030104 developmental biologyNeurologyRisk factorsDyskinesiaCohortMedicineFemalemedicine.symptombusiness030217 neurology & neurosurgerymedicine.drugCohort study

description

AbstractAim of the study was to evaluate possible associations between cognitive dysfunctions and development of Levodopa Induced Dyskinesia (LID). PD patients from the Parkinson’s disease Cognitive impairment Study cohort who underwent a baseline and follow-up neuropsychological evaluations were enrolled. Mild Cognitive Impairment (PD-MCI) was diagnosed according to MDS level II criteria. The following cognitive domains were evaluated: episodic memory, attention, executive function, visuo-spatial function and language. A domain was considered as impaired when the subject scored 2 standard deviation below normality cut-off values in at least one test for each domain. Levodopa equivalent dose, UPDRS-ME and LID were recorded at baseline and follow-up. To identify possible neuropsychological predictors associated with the probability of LID development at follow-up, Cox proportional-hazards regression model was used. Out of 139 PD patients enrolled (87 men, mean age 65.7 ± 9.4), 18 (12.9%) were dyskinetic at baseline. Out of 121 patients non-dyskinetic at baseline, 22 (18.1%) developed LID at follow-up. The impairment of the attention and executive domains strongly predicted the development of LID (HR 4.45;95%CI 1.49–13.23 and HR 3.46; 95%CI 1.26–9.48 respectively). Impairment of the attention and executive domains increased the risk of dyskinesia reflecting the alteration of common cortical network.

yearjournalcountryeditionlanguage
2021-01-13Scientific Reports
https://doi.org/10.1038/s41598-020-79110-7