Abstract
Objective
To compare participants with Parkinson disease (PD) motor subtypes, postural instability
and gait difficulty (PIGD) (n=46) and tremor dominant (TD) (n=28), in cognitive and
motor-cognitive assessments with the purpose of identifying associations between subtype
and visuospatial, whole-body spatial, inhibition and/or switching, and planning and/or
organizational aspects of cognitive and motor-cognitive function.
Design
Retrospective cohort study. Fisher exact test was used for categorical variables,
while 2-sample independent t tests were used to analyze continuous variables.
Setting
Assessments took place at Emory University.
Participants
Participants (N=72) were 40 years and older, had a clinical diagnosis of PD, exhibited
3 of the 4 cardinal signs of PD, had shown benefit from antiparkinsonian medications,
and were in Hoehn and Yahr stages I-IV. Participants could walk 3 m or more with or
without assistance.
Interventions
Not applicable.
Main Outcome Measures
Balance and mobility tests included Fullerton Advanced Balance Scale and the time
needed to turn 360 degrees. Cognitive assessments included Montreal Cognitive Assessment,
Brooks Spatial Memory Task, Color-Word Interference Test, Tower of London, Trail Making
Test, Corsi Blocks, Serial 3s Subtraction, and Body Position Spatial Task. Motor-cognitive
function measures included Four Square Step Test and Timed Up and Go.
Results
Participants with PIGD performed lower than those with TD symptoms on mental status
(P=.005), spatial memory (P=.027), executive function (P=.0001-.034), and visuospatial ability (P=.048).
Conclusions
Findings suggest that PIGD subtype is linked to greater deficits in spatial cognition,
attentional flexibility and organizational planning, and whole-body spatial memory
domains. These findings support the need for more personalized approaches to clinically
managing PD.
Keywords
List of abbreviations:
ADL (activities of daily living), BPST (Body Position Spatial Task), CPF (Composite Physical Function), CWIT (Color-Word Interference Test), FAB (Fullerton Advanced Balance Scale), FSST (Four Square Step Test), MDS-UPDRS (Movement Disorders Society Unified Parkinson’s Disease Rating Scale), MoCA (Montreal Cognitive Assessment), PD (Parkinson disease), PIGD (postural instability and gait difficulty), TD (tremor dominant), TOL (Tower of London), TUG (Timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 12, 2020
Footnotes
Supported by a Department of Veterans Affairs Career Development Award N0870W (5IK2RX000870-06) to M.E. Hackney and by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award no. UL1TR002378. The study was also supported by the Emory Center for Health in Aging. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
