Features of cognitive impairment in Parkinson's disease (review)

Features of cognitive impairment in Parkinson's disease (review)

 

Authors

 

V.A. Mikhailov

Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation

L.V. Lukina

Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation

S.M. Radnaeva

Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation

A.I. Fadeev

Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology” of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation

 

https://doi.org/10.26617/1810-3111-2025-2(127)-119-130

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2025; 2 (127):  119-130.

 

Abstract

Background. Cognitive impairment in Parkinson's disease (PD) is characterized by significant heterogeneity of symptoms and affects the quality of life of patients and caregivers, as well as increases the financial burden on the healthcare system. As the disease progresses at later stages, cognitive impairment can become the determining factor in the clinical picture, and often doctors initiate specific treatment only at a late stage, when dementia has already developed. This determines the relevance of early diagnosis of cognitive impairment, recognition of their specificity in various forms of PD and dictates the need to search for informative biomarkers that should facilitate the identification of cognitive decline at the initial clinical stage and even in its latent phase, since the earliest possible initiation of treatment will delay the development of dementia. The objective of the reviewis to systematize the literature on the features of cognitive impairment in Parkinson's disease. Materials and Methods. The analysis of modern Russian and foreign scientific publications devoted to the features of cognitive impairment in Parkinson's disease, published over the past 10 years, was carried out. Scientometric databases (PubMed, eLibrary, Google Scholar) were used to search for literary sources. Results and Discussion. The article presents current concepts of the epidemiology, etiology, pathogenesis, classifications, risk factors and clinical manifestations of cognitive impairment in Parkinson's disease. Currently, this raises a number of questions, such as the lack of uniform standards for assessing cognitive impairment in Parkinson's disease, the biological basis of cognitive impairment, and the impact of affective disorders on them. It is emphasized that a multidisciplinary approach that allows comparing clinical data with the neuropsychological profile of patients and neuroimaging data seems to be the most promising for obtaining answers to open questions about the early diagnosis of cognitive impairment in Parkinson's disease. Conclusion. Despite the long history of research, many of the issues discussed remain unresolved, which requires further scientific and practical development.

 

Keywords: Parkinson's disease, mild cognitive impairment, subjective cognitive impairment, dementia, neurodegeneration, neuropsychological examination.

 

Article (pdf)

 

Contacts

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Materials  

 

 

For citation: Mikhailov V.A., Lukina L.V., Radnaeva S.M., Fadeev A.I. Features of cognitive impairment in Parkinson's disease (review). Sibirskii Vestnik Psikhiatrii i Narkologii.2025; 2 (127): 119-130. https://doi.org/10.26617/1810-3111-2025-2(127)-119-130

 

REFERENCES

 

  1. Weintraub D, Chahine LM, Hawkins KA, Siderowf A, Eberly S, Oakes D, Seibyl J, Stern MB, Marek K, Jennings D; PARS Investigators. Cognition and the course of prodromal Parkinson's disease. Mov Disord. 2017 Nov;32(11):1640-1645. https://doi.org/10.1002/mds.27189. Epub 2017 Oct 24. PMID: 29063713; PMCID: PMC5722226.
  2. Flores-Torres MH, Bjornevik K, Hung AY, Healy BC, Schwarzschild MA, Blacker D, Ascherio A. Subjective cognitive decline in women with features suggestive of prodromal Parkinson’s disease. Mov. Disord. 2023;38:1473-1482. https://doi.org/10.1002/mds.29503. Epub 2023 Jun 14. PMID: 37315105; PMCID: PMC10524634.
  3. Bock MA, Tanner CM. The epidemiology of cognitive function in Parkinson’s disease. Prog. Brain Res. 2022;269:3-37. https://doi.org/10.1016/bs.pbr.2022.01.004. Epub 2022 Feb 4. PMID: 35248199.
  4. Aarsland D, Kurz MW. The epidemiology of dementia associated with Parkinson disease. J Neurol Sci. 2010 Feb 15;289(1-2):18-22. https://doi.org/10.1016/j.jns.2009.08.034. Epub 2009 Sep 4. PMID: 19733364.
  5. Chandler JM, Nair R, Biglan K, Ferries EA, Munsie LM, Changamire T, Patel N. Characteristics of Parkinson's disease in patients with and without cognitive impairment. J Parkinsons Dis. 2021;11(3):1381-1392. https://doi.org/10.3233/JPD-202190. PMID: 33720850; PMCID: PMC8461668.
  6. Stulov IK, Ananyeva NI, Lukina LV, Zalutskaya NM. The role of MR morphometry of hippocampal subfields in the diagnosis of moderate cognitive disorders of various origins. Russian Neurosurgical Journal named after professor A.L. Polenov. 2022;14(2):153-159 (in Russian).
  7. Kurbanova MM, Galaeva AA, Stefanovskaya EV, Suvorkina AA, Alikhanov NM. Modern methods for diagnosing cognitive impairment. Russian Family Doctor. 2020;24(1):35-44 (in Russian).
  8. Yakhno NN. Cognitive disorders in a neurological clinic. Neurological Journal. 2006;11(suppl 1):4-12 (Russian).
  9. Litvan I, Goldman JG, Tröster AI, Schmand BA, Weintraub D, Petersen RC, Mollenhauer B, Adler CH, Marder K, Williams-Gray CH, Aarsland D, Kulisevsky J, Rodriguez-Oroz MC, Burn DJ, Barker RA, Emre M. Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Mov Disord. 2012 Mar;27(3):349-56. https://doi.org/10.1002/mds.24893. Epub 2012 Jan 24. PMID: 22275317; PMCID: PMC3641655.
  10. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126-35. https://doi.org/10.1212/WNL.0000000000004826. Epub 2017 Dec 27. PMID: 29282327; PMCID: PMC5772157.
  11. Levin OS. Moderate cognitive impairment: diagnostics and treatment. Effective Pharmacotherapy. 2012;5:14-21 (Russian).
  12. Wen MC, Chan LL, Tan LCS, Tan EK. Mild cognitive impairment in Parkinson's disease: a distinct clinical entity? Transl Neurodegener. 2017 Sep 13;6:24. https://doi.org/10.1186/s40035-017-0094-4. PMID: 28919975; PMCID: PMC5596909.
  13. Monastero R, Cicero CE, Baschi R, Davì M, Luca A, Restivo V, Zangara C, Fierro B, Zappia M, Nicoletti A. Mild cognitive impairment in Parkinson's disease: the Parkinson's disease cognitive study (PACOS). J Neurol. 2018 May;265(5):1050-1058. https://doi.org/10.1007/s00415-018-8800-4. Epub 2018 Feb 24. PMID: 29478221.
  14. Siciliano M, De Micco R, Russo AG, Esposito F, Sant'Elia V, Ricciardi L, Morgante F, Russo A, Goldman JG, Chiorri C, Tedeschi G, Trojano L, Tessitore A. Memory phenotypes in early, de novo parkinson's disease patients with mild cognitive impairment. Mov Disord. 2023 Aug;38(8):1461-1472. https://doi.org/10.1002/mds.29502. Epub 2023 Jun 15. PMID: 37319041.
  15. Mack J, Marsh L. Parkinson's disease: Cognitive impairment. Focus (Am Psychiatr Publ). 2017 Jan;15(1):42-54. https://doi.org/10.1176/appi.focus.20160043. Epub 2017 Jan 11. PMID: 31975839; PMCID: PMC6519621.
  16. Pedersen KF, Larsen JP, Tysnes OB, Alves G. Natural course of mild cognitive impairment in Parkinson disease: A 5-year population-based study. Neurology. 2017 Feb 21;88(8):767-774. https://doi.org/10.1212/WNL.0000000000003634. Epub2017 Jan 20. PMID: 28108638.
  17. Jones JD, Kuhn TP, Szymkowicz SM. Reverters from PD-MCI to cognitively intact are at risk for future cognitive impairment: Analysis of the PPMI cohort. Parkinsonism Relat Disord. 2018 Feb;47:3-7. https://doi.org/10.1016/j.parkreldis.2017.12.006. Epub 2017 Dec 9. PMID: 29233608; PMCID: PMC5803409.
  18. Lawson RA, Yarnall AJ, Duncan GW, Breen DP, Khoo TK, Williams-Gray CH, Barker RA, Burn DJ; ICICLE-PD study group. Stability of mild cognitive impairment in newly diagnosed Parkinson's disease. J Neurol Neurosurg Psychiatry. 2017 Aug;88(8):648-652. https://doi.org/10.1136/jnnp-2016-315099. Epub 2017 Mar 1. PMID: 28250029; PMCID: PMC5537517.
  19. Akhmadeeva GN, Magzhanov RV, Tayupova GN, Baytimerov AR. Clinical features, diagnosis and treatment of cognitive disorders in Parkinson's disease. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(1):101-105. https://doi.org/10.14412/2074-2711-1-101-105 (Russian).
  20. Forbes E, Tropea TF, Mantri S, Xie SX, Morley JF. Modifiable comorbidities associated with cognitive decline in Parkinson's disease. Mov Disord Clin Pract. 2021 Jan 20;8(2):254-263. https://doi.org/10.1002/mdc3.13143. PMID: 33553496; PMCID: PMC7853194.
  21. Flanigan JL, Harrison MB, Patrie JT, Shah BB, Sperling SA, Wyman-Chick KA, Dalrymple WA, Barrett MJ. Clinical and cognitive features associated with psychosis in Parkinson's disease: a longitudinal study. Front Aging Neurosci. 2024 Nov 6;16:1463426. https://doi.org/10.3389/fnagi.2024.1463426. PMID: 39574488; PMCID: PMC11579864.
  22. Santos-García D, de Deus Fonticoba T, Cores Bartolomé C et al. Risk of cognitive impairment in patients with Parkinson's disease with visual hallucinations and subjective cognitive complaints. J Clin Neurol. 2023 Jul;19(4):344-357.https://doi.org/10.3988/jcn.2022.0186. Epub 2023 Jan 2. PMID: 36647231; PMCID: PMC10329922.
  23. Longardner K, Bayram E, Litvan I. Orthostatic hypotension is associated with cognitive decline in Parkinson disease. Front Neurol. 2020 Sep 2;11:897. https://doi.org/10.3389/fneur.2020.00897. PMID: 32982926; PMCID: PMC7492200.
  24. Cholerton B, Johnson CO, Fish B et al. Sex differences in progression to mild cognitive impairment and dementia in Parkinson’s disease. Park. Relat. Disord. 2018;50:29-36. https://doi.org/10.1016/j.parkreldis.2018.02.007.Epub 2018 Feb 9. PMID: 29478836; PMCID: PMC5943177.
  25. Gonzalez-Latapi P, Bayram E, Litvan I, Marras C. Cognitive impairment in Parkinson’s disease: Epidemiology, clinical profile, protective and risk factors. Behav Sci (Basel). 2021 May 13;11(5):74. https://doi.org/10.3390/bs11050074. PMID: 34068064; PMCID: PMC8152515.
  26. Wan H, Wang G, Liu Q, Wang Y. Effect of cerebral small vessel disease on cognitive impairment in Parkinson's disease: a systematic review and meta-analysis. Ann Transl Med. 2022 Mar;10(6):288. https://doi.org/10.21037/atm-22-276. PMID: 35433969; PMCID: PMC9011212.
  27. Lucero C, Campbell MC, Flores H, Maiti B, Perlmutter JS, Foster ER. Cognitive reserve and β-amyloid pathology in Parkinson disease. Parkinsonism Relat Disord. 2015 Aug;21(8):899-904. https://doi.org/10.1016/j.parkreldis.2015.05.020. Epub 2015 May 27. PMID: 26037458; PMCID: PMC4509801.
  28. JellingerKA. Pathobiology of cognitive impairment in Parkinson disease: Challenges and outlooks. Int J Mol Sci. 2023 Dec 29;25(1):498. https://doi.org/10.3390/ijms25010498. PMID: 38203667; PMCID: PMC10778722.
  29. Picelli A, Varalta V, Melotti C, Zatezalo V, Fonte C, Amato S, Saltuari L, Santamato A, Fiore P, Smania N. Effects of treadmill training on cognitive and motor features of patients with mild to moderate Parkinson's disease: a pilot, single-blind, randomized controlled trial. Funct Neurol. 2016 Jan-Mar;31(1):25-31. https://doi.org/10.11138/fneur/2016.31.1.025. PMID: 27027891; PMCID: PMC4819815.
  30. Paknahad Z, Sheklabadi E, Derakhshan Y, Bagherniya M, Chitsaz A. The effect of the Mediterranean diet on cognitive function in patients with Parkinson's disease: A randomized clinical controlled trial. Complement Ther Med. 2020 May;50:102366.https://doi.org/10.1016/j.ctim.2020.102366. Epub 2020 Mar 4. PMID: 32444045.
  31. Cho BH, Choi SM, Kim JT, Kim BC. Association of coffee consumption and non-motor symptoms in drug-naïve, early-stage Parkinson's disease. Parkinsonism Relat Disord. 2018 May;50:42-47. https://doi.org/10.1016/j.parkreldis.2018.02.016. Epub 2018 Feb 9. PMID: 29449185.
  32. Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging. 2003 Mar-Apr;24(2):197-211. https://doi.org/10.1016/s0197-4580(02)00065-9. PMID: 12498954.
  33. Senkevich KA, Miliukhina IV, Pchelina SN. The genetic predictors of cognitive impairment in Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(8):109‑117.https://doi.org/10.17116/jnevro2018118081109(in Russian).
  34. Aarsland D, Creese B, Politis M, Chaudhuri KR, Ffytche DH, Weintraub D, Ballard C. Cognitive decline in Parkinson disease. Nat Rev Neurol. 2017 Apr;13(4):217-231. https://doi.org/10.1038/nrneurol.2017.27. Epub 2017 Mar 3. PMID: 28257128; PMCID: PMC5643027.
  35. Carceles-Cordon M, Weintraub D, Chen-Plotkin AS. Cognitive heterogeneity in Parkinson's disease: A mechanistic view. Neuron. 2023 May 17;111(10):1531-1546.https://doi.org/10.1016/j.neuron.2023.03.021. Epub 2023 Apr 6. PMID: 37028431; PMCID: PMC10198897.
  36. Liu JY, Ma LZ, Wang J, Cui XJ, Sheng ZH, Fu Y, Li M, Ou YN, Yu JT, Tan L, Lian Y. Age-related association between apoe ɛ4 and cognitive progression in de novo Parkinson's disease. J Alzheimers Dis. 2023;91(3):1121-1132.https://doi.org/10.3233/JAD-220976. PMID: 36565124.
  37. Szwedo AA, Dalen I, Pedersen KF et al. GBA and APOE impact cognitive decline in Parkinson’s disease: A 10-year population-based study. Mov Disord. 2022 May;37(5):1016-1027. https://doi.org/10.1002/mds.28932. Epub 2022 Feb 2. PMID: 35106798; PMCID: PMC9362732.
  38. Hussein A, Guevara CA, Del Valle P, Gupta S, Benson DL, Huntley GW. Non-motor symptoms of Parkinson's disease: The neurobiology of early psychiatric and cognitive dysfunction. Neuroscientist. 2023 Feb;29(1):97-116. doi: 10.1177/10738584211011979. Epub 2021 May 8. PMID: 33966533; PMCID: PMC9338765.
  39. Zaman V, Shields DC, Shams R, Drasites KP, Matzelle D, Haque A, Banik NL. Cellular and molecular pathophysiology in the progression of Parkinson's disease. Metab Brain Dis. 2021 Jun;36(5):815-827. https://doi.org/10.1007/s11011-021-00689-5. Epub 2021 Feb 18. PMID: 33599945; PMCID: PMC8170715.
  40. Kehagia AA, Barker RA, Robbins TW. Cognitive impairment in Parkinson's disease: the dual syndrome hypothesis. Neurodegener Dis. 2013;11(2):79-92. https://doi.org/10.1159/000341998. Epub 2012 Oct 3. PMID: 23038420; PMCID: PMC5079071.
  41. McGaughy J, Ross RS, Eichenbaum H. Noradrenergic, but not cholinergic, deafferentation of prefrontal cortex impairs attentional set-shifting. Neuroscience. 2008;153:63-71.https://doi.org/10.1016/j.neuroscience.2008.01.064. Epub 2008 Feb 19. PMID: 18355972; PMCID: PMC2615225.
  42. Rowe JB, Hughes L, Ghosh BC, Eckstein D, Williams-Gray CH, Fallon S, Barker RA, Owen AM. Parkinson's disease and dopaminergic therapy ‒ differential effects on movement, reward and cognition. Brain. 2008 Aug;131(Pt 8):2094-105. https://doi.org/10.1093/brain/awn112. Epub 2008 Jun 24. PMID: 18577547; PMCID: PMC2494617.
  43. Lawson RA, Yarnall AJ, Duncan GW, Breen DP, Khoo TK, Williams-Gray CH, Barker RA, Burn DJ; ICICLE-PD study group. Stability of mild cognitive impairment in newly diagnosed Parkinson's disease. J Neurol Neurosurg Psychiatry. 2017 Aug;88(8):648-652. https://doi.org/10.1136/jnnp-2016-315099. Epub 2017 Mar 1. PMID: 28250029; PMCID: PMC5537517.
  44. Flores-Torres M.H., Bjornevik K., Hung A.Y., Healy B.C., Schwarzschild M.A., Blacker D., Ascherio A. Subjective cognitive decline in women with features suggestive of prodromal Parkinson’s disease. Mov. Disord. 2023;38:1473–1482.https://doi.org/10.1002/mds.29503. Epub 2023 Jun 14. PMID: 37315105; PMCID: PMC10524634.
  45. Levin OS. Diagnosis and treatment of cognitive impairment and dementia in clinical practice. 3rd ed. Moscow: MEDpress-inform, 2023:448(in Russian).
  46. Mazurenko EV, Ponomarev VV, Sakovich RA. Cognitive impairment in Parkinson's disease. Medical News. 2014;1(232):6-11 (in Russian).
  47. Mazurenko EV. Neuroimaging diagnostic criteria and clinical features of cognitive impairment in patients with Parkinson's disease. Medical News. 2016;4(259):73-76 (in Russian).
  48. Hong JY, Lee PH. Subjective cognitive complaints in cognitively normal patients with Parkinson's disease: A systematic review. J Mov Disord. 2023 Jan;16(1):1-12. https://doi.org/10.14802/jmd.22059. Epub 2022 Nov 10. PMID: 36353806; PMCID: PMC9978265.
  49. Barbosa RP, Mendonça MD, Caetano AP, Lampreia TM, Miguel R, Bugalho PM. Cognitive complaints in Parkinson's disease patients: from subjective cognitive complaints to dementia and affective disorders. J Neural Transm (Vienna). 2019 Oct;126(10):1329-1335. https://doi.org/10.1007/s00702-019-02042-8. Epub 2019 Jul 5. PMID: 31278557.
  50. Purri R, Brennan L, Rick J, Xie SX, Deck BL, Chahine LM, Dahodwala N, Chen-Plotkin A, Duda JE, Morley JF, Akhtar RS, Trojanowski JQ, Siderowf A, Weintraub D. Subjective cognitive complaint in Parkinson's disease patients with normal cognition: Canary in the coal mine? Mov Disord. 2020 Sep;35(9):1618-1625. https://doi.org/10.1002/mds.28115. Epub 2020 Jun 10. PMID: 32520435; PMCID: PMC7722141.
  51. Wallace ER, Segerstrom SC, van Horne CG, Schmitt FA, Koehl LM. Meta-analysis of cognition in Parkinson's disease mild cognitive impairment and dementia progression. Neuropsychol Rev. 2022 Mar;32(1):149-160. https://doi.org/10.1007/s11065-021-09502-7. Epub 2021 Apr 16. PMID: 33860906.
  52. Weil RS, Costantini AA, Schrag AE. Mild cognitive impairment in Parkinson's disease ‒ what is it? Curr Neurol Neurosci Rep. 2018 Mar 10;18(4):17. https://doi.org/10.1007/s11910-018-0823-9. PMID: 29525906; PMCID: PMC5845587.
  53. Galtier I., Nieto A., Mata M., Lorenzo J.N., Barroso J. Specific pattern of linguistic impairment in Parkinson’s disease patients with subjective cognitive decline and mild cognitive impairment predicts dementia. J. Int. Neuropsychol. Soc. 2023;29:632–640. https://doi.org/10.1017/S1355617722000571. Epub 2022 Oct 13. PMID: 36226685.