Metamemory and prospective memory in Parkinson's disease.

Objective: Metamemory is integral for strategizing about memory intentions. This study investigated the prospective memory (PM) deficit in Parkinson's disease (PD) from a metamemory viewpoint, with the aim of examining whether metamemory deficits might contribute to PM deficits in PD. Method: Sixteen patients with PD and 16 healthy older adult controls completed a time-based PM task (initiating a key press at two specified times during an ongoing task), and an event-based PM task (initiating a key press in response to animal words during an ongoing task). To measure metamemory participants were asked to predict and postdict their memory performance before and after completing the tasks, as well as complete a self-report questionnaire regarding their everyday memory function. Results: The PD group had no impairment, relative to controls, on the event-based task, but had prospective (initiating the key press) and retrospective (recalling the instructions) impairments on the time-based task. The PD group also had metamemory impairments on the time-based task; they were inaccurate at predicting their performance before doing the task but, became accurate when making postdictions. This suggests impaired metamemory knowledge but preserved metamemory monitoring. There were no group differences regarding PD patients' self-reported PM performance on the questionnaire. Conclusions: These results reinforce previous findings that PM impairments in PD are dependent on task type. Several accounts of PM failures in time-based tasks are presented, in particular, ways in which mnemonic and metacognitive deficits may contribute to the difficulties observed on the time-based task. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Working memory in mild Alzheimer's disease and early Parkinson's disease.

Alzheimer's disease (AD) and Parkinson's disease (PD) impair working memory (WM). It is unclear, however, whether the deficits seen early in the course of these diseases are similar. To address this issue, the authors compared the performance of 22 patients with mild AD, 20 patients with early PD and without dementia, and 112 control participants on tests of inhibition, short-term memory, and 2 commonly administered tests of WM. The results suggest that although mild AD and early PD both impair WM, the deficits may be related to the interruption of different processes that contribute to WM performance. Early PD disrupted inhibitory processes, whereas mild AD did not. The WM deficits seen in patients with AD may be secondary to deficits in other cognitive capacities, including semantic memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective memory impairment in individuals with Parkinson's disease.

This study investigated prospective memory and its relationship to executive and memory functions in persons with Parkinson's disease (PD). Twenty-three individuals with PD and 25 healthy comparison participants participated in the study. In the prospective memory tasks, participants were asked to execute 3 actions after 20 min (time-based condition) or after a timer ring (event-based condition). A score was computed for the correct recall of the intention to perform the actions (prospective component) and for the correct execution of the actions (retrospective component). Participants with PD also received an extensive neuropsychological test battery. PD participants were less accurate than comparison participants in the prospective component of the time-based but not the event-based task. Individuals with PD were also impaired on the retrospective component of both tasks. In the PD group, a general trend toward significant correlations was found between performance level on the prospective memory component of the time-based task and scores on executive and working memory measures. These results document that prospective memory is impaired in PD possibly in relation to a dysregulation of cognitive functions associated with frontal systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition memory impairment in Parkinson's disease: Power and meta-analyses.

Contrary findings notwithstanding, the prevailing notion is that recognition memory is little affected by Parkinson's disease (PD). Both a power analysis and a meta-analysis were conducted to help clarify the degree of recognition memory deficit associated with PD. The power analysis confirmed that, in general, memory studies of PD participants have been underpowered. This analysis indicated the need to pool study results in a subsequent meta-analysis, the main finding of which was that recognition memory deficits do occur with PD. The largest deficit occurs in PD participants with dementia. Nevertheless, deficits also occur in PD participants without dementia on medication, but nondopaminergic central nervous system abnormalities are more likely to underlie this deficit than PD medication itself. Future development of a theory of cognitive dysfunction in PD should take into account these recognition memory deficits, which may increase with disease progression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal and nonverbal short-term memory impairment in untreated Parkinson's disease.

Extended previous research (J. A. Cooper et al, 1991) and examined whether the impairment in verbal and nonverbal short-term memory (STM) documented in chronically treated patients with Parkinson's disease (PD) is attributable to the pathology of the disease or to antiparkinsonian drug therapy. Verbal recall by a group of 58 never-treated PD patients was virtually perfect when the retention intervals were distractor free but was impaired, as compared with a matched group of 34 healthy control Ss, following distractor-filled intervals. Nonverbal recall by the PD group showed significant forgetting after distractor-free but not distractor-filled intervals. Recall was not related to depressive symptoms, motor disability, or distractor task performance. Thus, STM impairment in PD occurs for both verbal and nonverbal material and arises directly from the disease pathology rather than from antiparkinsonian medication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A differential deficit in time- versus event-based prospective memory in Parkinson's disease.

Objective: The aim of the current study was to clarify the nature and extent of impairment in time- versus event-based prospective memory in Parkinson's disease (PD). Prospective memory is thought to involve cognitive processes that are mediated by prefrontal systems and are executive in nature. Given that individuals with PD frequently show executive dysfunction, it is important to determine whether these individuals may have deficits in prospective memory that could impact daily functions, such as taking medications. Although it has been reported that individuals with PD evidence impairment in prospective memory, it is still unclear whether they show a greater deficit for time- versus event-based cues. Method: Fifty-four individuals with PD and 34 demographically similar healthy adults were administered a standardized measure of prospective memory that allows for a direct comparison of time-based and event-based cues. In addition, participants were administered a series of standardized measures of retrospective memory and executive functions. Results: Individuals with PD demonstrated impaired prospective memory performance compared to the healthy adults, with a greater impairment demonstrated for the time-based tasks. Time-based prospective memory performance was moderately correlated with measures of executive functioning, but only the Stroop Neuropsychological Screening Test emerged as a unique predictor in a linear regression. Conclusions: Findings are interpreted within the context of McDaniel and Einstein's (2000) multiprocess theory to suggest that individuals with PD experience particular difficulty executing a future intention when the cue to execute the prescribed intention requires higher levels of executive control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Manipulation of working memory information is impaired in Parkinson's disease and related to working memory capacity.

It has been suggested that in patients with Parkinson's disease (PD), difficulties in the manipulation of information, which result in problems in executive tasks, are related to a reduction of working memory capacity (J. D. E. Gabrieli, J. Singh, G. T. Stebbins, & C. G. Goetz, 1996). The present study selectively varied the manipulation demand irrespective of the maintenance requirement. In a group of 14 PD patients, performance declined overproportionally with the increasing task demand and was significantly correlated with a measure of working memory capacity. These results suggest that the complexity of working memory processing may decisively contribute to the exhaustion of resources in PD patients. Increasing complexity may either affect their manipulation ability directly or impede the management of inhibitory control requirements inherent to the task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extent, pattern, and correlates of remote memory impairment in Alzheimer's disease and Parkinson's disease.

Content and contextual memory for remote public figures and events was assessed with a modified version of the Presidents Test in patients with Alzheimer's disease (AD) or Parkinson's disease (PD). Contributions of executive functioning, semantic memory, and explicit anterograde memory to remote memory abilities were also examined. The AD group had temporally extensive deficits in content and contextual remote memory not accountable for by dementia severity. The PD group did not differ from the control group in remote memory, despite anterograde memory impairment. These results support the position that different component processes characterize remote memory, various mnemonic and nonmnemonic cognitive processes contribute to remote memory performance, and anterograde and remote memory processes are dissociable and differentially disrupted by neurodegenerative disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contributions of frontal system dysfunction to memory and perceptual abilities in Parkinson's disease.

Tested (1) the hypothesis that Parkinson's disease (PD), thought to result in disturbed neuronal outflow from the striatum, leads to circumscribed deficits in cognitive functions presumed to be dependent on the functional integrity of the frontal lobes and (2) whether such deficits could account for previously reported memory and visuoperceptual difficulties in PD. 19 nondemented PD patients were demographically matched to 19 normal elderly control Ss. Three categories of tests were given: (1) tests sensitive to frontal system dysfunction, (2) tests of learning and memory, and (3) tests of visuoperceptual and visuoconstructive skills. Nondemented PD patients demonstrated selective deficits on frontal system tasks; tests of learning and memory and of visuoperceptual and visuoconstructive skill were not significantly impaired once performance on the frontal related tasks was statistically covaried. Results are consistent with the striatofrontal outflow model of neuropsychological impairment in nondemented PD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

S-methylation in Parkinson's disease

We report thiolmethyltransferase (TMT) activity in RBC membrane preparations from patients with Parkinson's disease (PD), normal controls, and patients with symptomatic parkinsonism. Unlike previous reports, our report found no significant decrease in TMT activity in PD patients compared with normal controls. Low S-methylation capacity does not appear to be a risk factor for PD in Japanese patients.     

Reduced working memory span in Parkinson's disease: Evidence for the role of frontostriatal system in working and strategic memory.

Working and strategic memory were examined in unmedicated patients with Parkinson's disease who had neither depression nor dementia. The patients, relative to control participants, had reduced working memory spans for verbal and arithmetic materials. They also had impairment on strategic memory tests of fee recall, temporal ordering, and self-ordered pointing, but no impairment on tests of recognition memory and semantic memory. Impairments in working memory capacity correlated with impairments in strategic memory and with a measure of perceptual-motor speed, but not with motor speed. It is hypothesized that a frontostriatal memory system, in which dopamine plays a critical role, mediates perceptual-motor processing speed that contributes to working memory capacity, which in turn, contributes to strategic memory performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dementia in Parkinson's disease

The occurrence of dementia in patients with Parkinson's disease was studied in a Parkinsonian population consisting of all traceable patients residing in a defined area. The prevalence of dementia was found to be 29 per cent in 444 patients studied. The frequency of dementia increased with advancing age and the patients showing signs of clinical arteriosclerosis were more often demented than the patients without arteriosclerosis. There was, however, an evident association between the stage of the disease and the frequency of dementia. The most severely disabled patients displayed dementia more often than the mildly affected, both among the patients with and without arteriosclerosis. The demented patients showed significantly more severe rigidity and hypokinesia when compared with the non-demented. Increasing severity of rigidity and hypolinesia, in particular was found to have a positive correlation with the degree of dementia. The association between dementia and the degree of motor involvement is considered to suggest the role of subcortical structures in the patholophysiology of dementia in Parkinson's disease.     

Verbal memory in drug-naive, newly diagnosed Parkinson's disease. The retrieval deficit hypothesis revisited.

Objective: The retrieval deficit hypothesis on memory impairment in patients with Parkinson's disease (PD) implies a selective impairment in recall of learned material with normal encoding, retention, and recognition. This hypothesis has been challenged by new data. We have therefore investigated verbal memory and learning in a large sample of newly diagnosed, drug na?ve, non-demented patients with PD. Method: From a sample of patients with PD from the Norwegian ParkWest study, 133 PD patients and 133 controls matched on sex, age, and education were included. The California Verbal Learning Test-2 (CVLT-2) was used to assess verbal memory. Results: Patients performed significantly worse than controls on free and cued recall as well as on recognition memory. Patients used the semantic clustering learning strategy significantly less extensively than the controls and the learning slope of the PD patients was significantly less steep. There was no difference in retention when controlling for encoding. Patients did not perform better on the recognition measure or on cued recall (d-prime), as compared to free recall. Executive functions explained a substantial part of the memory deficits. Conclusions: This study suggests that memory impairment in drug na?ve early PD to a large degree is a deficit of learning/ encoding and not of retention or retrieval. An implication is that the retrieval deficit hypothesis should be moderated in its general form. Executive deficits and less extensive use of the efficient semantic clustering learning strategy had a strong impact on learning and memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of task complexity on reaction times in memory scanning and visual discrimination in Parkinson's disease

Within the context of the bradyphrenia debate, two experiments designed to measure the cognitive speed of Parkinson patients (PD) were conducted with 58 subjects. The experiments took the form of a high-speed memory scanning task using memory sets consisting of one-six words or one-six abstract figures. In a visual discrimination task, two simultaneously presented abstract images had to be compared, the complexity of the images being varied through four stages. Motor response was constant, reaction time was the dependent variable. PD differed from matched controls in the level (significant only in scanning) but in neither experiment in the slope of reaction time curves. Interaction group x complexity (MANOVA) was not significant. Correlations between disease parameters and a 'complexity effect' measure were low throughout. However, the link to general intelligence was significant. The findings contradict the conventional bradyphrenia hypothesis.     

Sleep benefit in Parkinson's disease

Sleep benefit (SB) In Parkinson's disease (PD) is not well characterized. To determine SB frequency, as well as to characterize and correlate it with other disease variables, we evaluated prospectively a consecutive series of 312 PD patients by means of a structured questionnaire: 55% reported having SB and 35% reported that awakening was their best time of the day. Because of SB, 21% of the entire population were able to skip or delay medication. The mean duration of the phenomenon was 85.4 +/- 67 min. Patients with SB were significantly older (p < 0.0002), had disease longer (p < 0.05), and were often men (chi 2 = 3.5, df 1, p = 0.05). Patients with SB took sleep medication with similar frequency as those without SB. There were no differences in hours of sleep or sleep latency. Sleep problems such as nightmares or somnambulism, but not the number of sleep awakenings, were similar in both groups. In conclusion, SB is a frequent phenomenon, especially in men, elderly patients, and patients with longer disease duration. SB enables the morning L-dopa dose to be postponed in approximately 50% of patients.