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Baseline cognitive profile is closely associated with long-term motor prognosis in newly diagnosed Parkinson's disease

 Seok Jong Chung  ;  Han Soo Yoo  ;  Hye Sun Lee  ;  Yang Hyun Lee  ;  KyoungWon Baik  ;  Jin Ho Jung  ;  Byoung Seok Ye  ;  Young H Sohn  ;  Phil Hyu Lee 
 JOURNAL OF NEUROLOGY, Vol.268(11) : 4203-4212, 2021-11 
Journal Title
Issue Date
Cognition ; Disabled Persons* ; Gait Disorders, Neurologic* ; Humans ; Motor Disorders* ; Neuropsychological Tests ; Parkinson Disease* / complications ; Parkinson Disease* / diagnosis ; Parkinson Disease* / drug therapy ; Prognosis
Cognition ; Factor analysis ; Parkinson’s disease ; Prognosis
Objectives: To investigate the association between cognitive function at baseline and the progression of motor disability in Parkinson's disease (PD).

Methods: We consecutively enrolled 257 drug-naïve patients with early-stage PD (follow-up > 2 years) who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to yield four cognitive function factors and composite scores thereof: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). The global cognitive composite score of each patient was calculated based on these factors. Subsequently, we assessed the effect of baseline cognitive function on long-term motor outcomes, namely levodopa-induced dyskinesia (LID), wearing-off, freezing of gait (FOG), and rate of longitudinal increases in levodopa-equivalent dose (LED).

Results: Cox regression analysis demonstrated that higher Factor 3 (frontal/executive) composite scores (i.e., better cognitive performance) were associated with early development of LID [hazard ratio (HR), 1.507; p = 0.003], whereas higher Factor 1 (visual memory/visuospatial) composite scores (i.e., better cognitive performance) were associated with a lower risk for FOG (HR 0.683; p = 0.017). We noted that higher global cognitive composite scores were associated with a lower risk for developing FOG (HR 0.455; p = 0.045). The linear mixed model demonstrated that higher global cognitive composite scores and better cognitive performance in visual memory/visuospatial function were associated with slower longitudinal increases in LED.

Conclusions: These findings suggest that baseline cognitive profiles have prognostic implications on several motor aspects in patients with PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Baik, Kyoungwon(백경원) ORCID logo https://orcid.org/0000-0001-7215-375X
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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