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, Kyoung Won Baik, Jin Ho Jung, Byoung Seok Ye, Young H. Sohn, Phil Hyu Lee

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)4203-4212
Number of pages10
JournalJournal of Neurology
Volume268
Issue number11
DOIs
Publication statusPublished - 2021 Nov

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2019R1A2C2085462) and the Ministry of Education (NRF-2018R1D1A1B07048959).

Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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