@article{78291ea1d6e74e0c9a840684797ef95d,
title = "Changes in Verbal Fluency in Parkinson's Disease",
abstract = "Background: The test for semantic verbal fluency is quick and easy to administer. Decreases in semantic verbal fluency would suggest executive dysfunction among individuals with Parkinson's disease (PD). Methods: The National Parkinson Foundation's Outcomes Project is a multicenter study that seeks to determine best practices in PD management. We analyzed data from the baseline and two annual follow-up visits to determine the annual rate of verbal fluency change and determinants of that change. Linear mixed modeling was used to assess relationships between verbal fluency, clinical characteristics, quality of life, and caregiver burden. Results: There were 1,322 participants with an average age of 67.3 years, of whom 37% were women. Mean baseline verbal fluency scores at baseline were 18.81 (standard deviation = 6.25). Verbal fluency scores did not change among patients who were at our cohort's average age and average PD duration (8.4 years) and who had no other associated conditions (beta = −0.02; P = 0.80). Verbal fluency, however, did decrease for individuals with PD duration greater than the average (beta = −0.25; P = 0.03), age greater than the average (beta = −0.022; P < 0.01), a Hoehn and Yahr >=3 (beta = −0.31; P = 0.04), and in those with cardiovascular disease (beta = −0.32; P = 0.01) or psychiatric symptomatology (beta = −0.34; P = 0.01). Individuals with higher verbal fluency scores had better quality of life (P < 0.01) and decreased caregiver burden (P < 0.01). Conclusions: Clinicians should monitor verbal fluency scores to evaluate cognitive decline among individuals with PD. Modifiable risk factors for verbal fluency changes include psychiatric symptomatology and cardiovascular disease. Clinicians may use verbal fluency testing to identify individuals at risk for decreased quality of life and increased caregiver burden, allowing for focused interventions.",
keywords = "Cognition, Parkinson's disease, verbal fluency",
author = "Rosenthal, {Liana S.} and Salnikova, {Yekaterina A.} and Pontone, {Gregory M.} and Alexander Pantelyat and Mills, {Kelly A.} and Dorsey, {E. Ray} and Jiangxia Wang and Wu, {Samuel S.} and Zoltan Mari",
note = "Funding Information: Ethical Compliance Statement: We confirm that we have read the Journal{\textquoteright}s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines Funding Sources and Conflicts of Interest: The National Parkinson{\textquoteright}s Foundation Parkinson{\textquoteright}s Outcome Project is funded by the National Parkinson{\textquoteright}s Foundation. This analysis of the data generated did not receive additional support. Samuel Wu and Zoltan Mari received salary support from the National Parkinson{\textquoteright}s Foundation (NPF). Financial Disclosures for previous 12 months: Dr. Rosen-thal received salary support in the previous 12 months from the JHU Morris K. Udall Parkinson{\textquoteright}s Disease Research Center of Excellence National Institutes of Health/National Institute of Neurological Disorders and Stroke (NIH/NINDS) P50NS038377, the Johns Hopkins Biomarker Initiative (NIH/ NINDS U01 NS082133), the Marilyn and Edward Macklin Foundation, and the Michael J. Fox Foundation. She also received an honorarium from the Edmond J. Safra Foundation and Functional Neuromodulation. Ms. Salnikova received salary support in the previous 12 months from the Johns Hopkins Biomarker Initiative (NIH/NINDS U01 NS082133). Dr. Pon-tone received salary support in the previous 12 months from the NINDS. Dr. Pantelyat received salary support in the previous 12 months from the JHU Morris K. Udall Parkinson{\textquoteright}s Disease Research Center of Excellence (NIH/NINDS P50NS038377). Dr. Mills has received an honorarium from Johns Hopkins University Continuing Medical Education for being faculty in a CME activity and he received an honorarium from Medtronic. Dr. Dorsey is an advisor to, and has stock options in, Grand Rounds, is a compensated consultant to Clin-trex, mc10, Lundbeck, MedAvante, Roche, and the National Institute of Neurological and Communicative Diseases and Stroke of the NIH. He is also an unpaid advisor to SBR Health and Vidyo and he receives research support from Auspex Pharmaceuticals, Davis Phinney Foundation, Great Lakes Neu-rotechnologies, Huntington Study Group, the Michael J. Fox Foundation, the Patient-Centered Outcomes Research Institute, Prana Biotechnology, and Sage Bionetworks and has filed a patent application related to neurology and telemedicine. Ms. Wang receives salary support from the Bloomberg School of Public Health, Johns Hopkins. Dr. Wu receives grant support as co-investigators from the NIH (1R01DK099334, P30AG028740, 1R01DK099334) and American Physical Therapy Association (KK-G000790). He has also received salary support from the National Parkinson{\textquoteright}s Foundation and received consulting honoraria in the past 12 months from Bioness, Inc. Dr. Mari receives salary support from the Michael J. Fox Foundation, Avid Radiopharmaceuticals, and US Worldmeds LLC. He has also received salary support from the Dystonia Medical Research Foundation, the Morris K. Udall Parkinson{\textquoteright}s Disease Research Center of Excellence, and the JHMI Clinical Center for PD Neuroprotection Trials. He received consulting honoraria in the past 12 months from Navidea, Inc. He also received expert fees for medicolegal work Publisher Copyright: {\textcopyright} 2016 International Parkinson and Movement Disorder Society",
year = "2017",
month = jan,
day = "1",
doi = "10.1002/mdc3.12421",
language = "English (US)",
volume = "4",
pages = "84--89",
journal = "Movement Disorders Clinical Practice",
issn = "2330-1619",
publisher = "John Wiley and Sons Ltd",
number = "1",
}