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Patterns of Neuropsychological Profile and Cortical Thinning in Parkinson's Disease with Punding

 Han Soo Yoo  ;  Hyuk Jin Yun  ;  Seok Jong Chung  ;  Mun Kyung Sunwoo  ;  Jong-Min Lee  ;  Young Ho Sohn  ;  Phil Hyu Lee 
 PLOS ONE, Vol.10(7) : e0134468, 2015 
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Issue Date
Aged ; Cerebral Cortex/pathology* ; Cognition Disorders/etiology ; Cognition Disorders/psychology* ; Executive Function/physiology* ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neuropsychological Tests* ; Parkinson Disease/complications* ; Parkinson Disease/psychology ; Prospective Studies ; Stereotyped Behavior*
BACKGROUND: Punding, one of dopamine replacement treatment related complications, refers to aimless and stereotyped behaviors. To identify possible neural correlates of punding behavior in patients with Parkinson's disease (PD), we investigated the patterns of cognitive profiles and cortical thinning. METHODS: Of the 186 subjects with PD screened during the study period, we prospectively enrolled 10 PD patients with punding and 43 without punding on the basis of a structured interview. We performed comprehensive neuropsychological tests and voxel-based and regions-of-interest (ROIs)-based cortical thickness analysis between PD patients with and without punding. RESULTS: The prevalence of punding in patients with PD was 5.4%. Punding behaviors were closely related to previous occupations or hobbies and showed a temporal relationship to changes of levodopa-equivalent dose (LED). Significant predisposing factors were a long duration of PD and intake of medications of PD, high total daily LED, dyskinesia, and impulse control disorder. Punding severity was correlated with LED (p = 0.029). The neurocognitive assessment revealed that PD patients with punding showed more severe cognitive deficits in the color Stroop task than did those without punding (p = 0.022). Voxel-based analysis showed that PD-punders had significant cortical thinning in the dorsolateral prefrontal area relative to controls. Additionally, ROI-based analysis revealed that cortical thinning in PD-punders relative to PD-nonpunders was localized in the prefrontal cortices, extending into orbitofrontal area. CONCLUSIONS: We demonstrated that PD patients with punding performed poorly on cognitive tasks in frontal executive functions and showed severe cortical thinning in the dorsolateral prefrontal and orbitofrontal areas. These findings suggest that prefrontal modulation may be an essential component in the development of punding behavior in patients with PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sunwoo, Mun Kyung(선우문경)
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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