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Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease

Background: There is growing interest in identifying individuals who are in the prodromal phase of Parkinson’s disease (PD), as these individuals are potentially suitable for inclusion in intervention trials to prevent clinically manifest PD. However, it is less clear whether—and to what extent—cogn...

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Autores principales: Speelberg, Daniël H. B., Janssen Daalen, Jules M., Bloem, Bastiaan R., Gagnon, Jean-François, Post, Bart, Darweesh, Sirwan K. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870093/
https://www.ncbi.nlm.nih.gov/pubmed/35203962
http://dx.doi.org/10.3390/brainsci12020199
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author Speelberg, Daniël H. B.
Janssen Daalen, Jules M.
Bloem, Bastiaan R.
Gagnon, Jean-François
Post, Bart
Darweesh, Sirwan K. L.
author_facet Speelberg, Daniël H. B.
Janssen Daalen, Jules M.
Bloem, Bastiaan R.
Gagnon, Jean-François
Post, Bart
Darweesh, Sirwan K. L.
author_sort Speelberg, Daniël H. B.
collection PubMed
description Background: There is growing interest in identifying individuals who are in the prodromal phase of Parkinson’s disease (PD), as these individuals are potentially suitable for inclusion in intervention trials to prevent clinically manifest PD. However, it is less clear whether—and to what extent—cognitive deficits are present in prodromal PD. Methods: A systematic query was conducted through PubMed and Embase for prospective observational cohort studies that (a) assessed cognitive performance in individuals free of manifest PD at baseline and (b) subsequently followed up participants for incident PD. We grouped the results by cognitive domain, and for domains that had been reported in at least three separate studies, we performed random-effects, inverse variance meta-analyses based on summary statistics. Results: We identified nine articles suitable for inclusion, with a total of 215 patients with phenoconversion and 13,524 individuals remaining disease-free at follow-up. The studies were highly heterogeneous in study design, study population, and cognitive test batteries. Studies that included only cognitive screening measures such as MMSE or MoCA reported no association between worse cognitive performance and onset of manifest PD (combined odds ratio 1.08; 95% confidence interval 0.66–1.77). By contrast, studies that used extensive cognitive testing batteries found that global cognitive deficits were associated with an increased risk of manifest PD. In domain-specific analyses, there was evidence for an association between worse executive functioning (OR 1.45; 95% CI 1.10–1.92), but not memory (OR 1.20; 95% CI 0.85–1.70) or attention (OR 0.98; 95% CI 0.23–4.26), and clinically manifest PD. Conclusion: Although some caution due to high heterogeneity among published studies is warranted, the available evidence suggests that global and executive cognitive deficits are prodromal features of PD. Collaborative prospective studies with extensive cognitive test batteries are required to shed light on domain-specific deficits, temporal relations, and subgroup differences in prodromal cognitive deficits in PD.
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spelling pubmed-88700932022-02-25 Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease Speelberg, Daniël H. B. Janssen Daalen, Jules M. Bloem, Bastiaan R. Gagnon, Jean-François Post, Bart Darweesh, Sirwan K. L. Brain Sci Systematic Review Background: There is growing interest in identifying individuals who are in the prodromal phase of Parkinson’s disease (PD), as these individuals are potentially suitable for inclusion in intervention trials to prevent clinically manifest PD. However, it is less clear whether—and to what extent—cognitive deficits are present in prodromal PD. Methods: A systematic query was conducted through PubMed and Embase for prospective observational cohort studies that (a) assessed cognitive performance in individuals free of manifest PD at baseline and (b) subsequently followed up participants for incident PD. We grouped the results by cognitive domain, and for domains that had been reported in at least three separate studies, we performed random-effects, inverse variance meta-analyses based on summary statistics. Results: We identified nine articles suitable for inclusion, with a total of 215 patients with phenoconversion and 13,524 individuals remaining disease-free at follow-up. The studies were highly heterogeneous in study design, study population, and cognitive test batteries. Studies that included only cognitive screening measures such as MMSE or MoCA reported no association between worse cognitive performance and onset of manifest PD (combined odds ratio 1.08; 95% confidence interval 0.66–1.77). By contrast, studies that used extensive cognitive testing batteries found that global cognitive deficits were associated with an increased risk of manifest PD. In domain-specific analyses, there was evidence for an association between worse executive functioning (OR 1.45; 95% CI 1.10–1.92), but not memory (OR 1.20; 95% CI 0.85–1.70) or attention (OR 0.98; 95% CI 0.23–4.26), and clinically manifest PD. Conclusion: Although some caution due to high heterogeneity among published studies is warranted, the available evidence suggests that global and executive cognitive deficits are prodromal features of PD. Collaborative prospective studies with extensive cognitive test batteries are required to shed light on domain-specific deficits, temporal relations, and subgroup differences in prodromal cognitive deficits in PD. MDPI 2022-01-31 /pmc/articles/PMC8870093/ /pubmed/35203962 http://dx.doi.org/10.3390/brainsci12020199 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Speelberg, Daniël H. B.
Janssen Daalen, Jules M.
Bloem, Bastiaan R.
Gagnon, Jean-François
Post, Bart
Darweesh, Sirwan K. L.
Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title_full Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title_fullStr Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title_full_unstemmed Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title_short Prodromal Cognitive Deficits and the Risk of Subsequent Parkinson’s Disease
title_sort prodromal cognitive deficits and the risk of subsequent parkinson’s disease
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870093/
https://www.ncbi.nlm.nih.gov/pubmed/35203962
http://dx.doi.org/10.3390/brainsci12020199
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