Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of parkinson disease and evidence of interaction effects

Nicolaas I. Bohnen, Roger L. Albin, Martijn L T M Müller, Myria Petrou, Vikas Kotagal, Robert A. Koeppe, Peter J H Scott, Kirk A. Frey

Research output: Contribution to journalArticle

Abstract

IMPORTANCE Little is known about the relative contributions of multisystem degenerative processes across the spectrum of predemented cognitive decline in Parkinson disease (PD).OBJECTIVE To investigate the relative frequency of caudate nucleus dopaminergic and forebrain cholinergic deficits across a spectrum of cognitively impaired patients with PD to explore their relative, individual, and combined contributions to cognitive impairment in PD.DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study at an academic movement disorders clinic that included a predominantly nondemented cohort of 143 patients with PD. The mean (SD) age of patients was 65.5 (7.4) years and the mean (SD) Hoehn and Yahr stage was 2.4 (0.6).MAIN OUTCOMES AND MEASURES Binary classification of carbon 11-labeled [11C]PMP acetylcholinesterase and caudate nucleus [11C]DTBZ monoaminergic positron-emission tomography imaging based on normative data. The frequency of significant degenerative processes based on normative values was determined for consecutive intervals of cognitive impairment, ranging from no or minimal (z .0.5) to more severe (z ≤.2) global cognitive impairment scores, caudate nucleus dopaminergic denervation was relatively frequent in individuals with minimal or no cognitive changes (51.1%) and increased in patients with more severe cognitive impairments (χ2 = 12.8; P =.01). Cortical cholinergic denervation frequency increased monotonically with increasing cognitive impairment from 24.7% (z >.0.5) to 85.7%(z ≤.2); χ2 = 23.2; P =.001). Eighty-seven percent of patients with neocortical cholinergic deficits had caudate nucleus dopaminergic deficits. Multiple regression analysis (F = 7.51; P

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalJAMA Neurology
Volume72
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

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Caudate Nucleus
Cholinergic Agents
Parkinson Disease
Denervation
Movement Disorders
Acetylcholinesterase
Prosencephalon
Positron-Emission Tomography
Cognitive Dysfunction
Cognitive Impairment
Interaction
Nucleus
Parkinson's Disease
Carbon
Cross-Sectional Studies
Regression Analysis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Medicine(all)

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Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of parkinson disease and evidence of interaction effects. / Bohnen, Nicolaas I.; Albin, Roger L.; Müller, Martijn L T M; Petrou, Myria; Kotagal, Vikas; Koeppe, Robert A.; Scott, Peter J H; Frey, Kirk A.

In: JAMA Neurology, Vol. 72, No. 2, 01.02.2015, p. 194-200.

Research output: Contribution to journalArticle

Bohnen, Nicolaas I. ; Albin, Roger L. ; Müller, Martijn L T M ; Petrou, Myria ; Kotagal, Vikas ; Koeppe, Robert A. ; Scott, Peter J H ; Frey, Kirk A. / Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of parkinson disease and evidence of interaction effects. In: JAMA Neurology. 2015 ; Vol. 72, No. 2. pp. 194-200.
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