Patterns of adaptation to Parkinson's disease.

Interviewed 44 50–80 yr-old Parkinson's disease patients about the effects of the disease on their lives; in addition, the revised SCL 90 and Mini-Mental State, and physician ratings of disease severity, were obtained. Four clusters of patients were identified. Cluster I Ss were sanguine and engaged; Cluster II Ss were depressed and apprehensive about the future; Cluster III Ss felt depressed, ashamed, and misunderstood; and Cluster IV Ss were passive and resigned. Disease severity, but not demographic or other health variables, discriminated the groups. Findings suggest that the degree to which personal attitudes can influence adaptation to somatic disease is limited by specific realities of the disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verb learning in Parkinson's disease.

The relative roles of grammatical processing and memory in the language comprehension difficulties of patients with Parkinson's disease (PD) were evaluated. 20 PD patients who did not have dementia were exposed to a new verb in a naturalistic setting. After 10 min, the semantic and grammatical information that they learned about the new verb was probed. Significant impairments in recalling some aspect of the new verb were seen in 55% of PD patients. Most of these patients demonstrated a language-sensitive deficit in appreciating grammatical information represented in the new verb. A small number of PD patients responded randomly to probes of all information about the new word, which suggests a memory impairment. It is concluded that difficulty in appreciating grammatical information contributes to the language impairments of PD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intellectual and cognitive functions in Parkinson's disease.

Compared the performance of 25 parkinson's disease patients and 25 normals matched for age, race, sex, and education on 32 behavioral variables including the wechsler-bellevue intelligence scale (form i), halstead neuropsychological battery, and R. Reitan's trail making test. Ss with parkinson's disease had lower mean scores than controls on all 32 measures. Statistical comparisons indicated these differences were significant beyond the .001 level for 25 tests, and on only 1 measure was the probability level greater than .05. Results indicate that parkinson's disease patients have suffered marked deterioration not only in motor abilities but also in problem-solving, sensory, memory, general cognitive, and abstracting and organizing abilities. (23 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Plasma dehydroepiandrosterone sulfate in unipolar major depression. Short communication

We investigated plasma dehydroepiandrosterone sulfate (DHEAS) and cortisol levels in 12 patients with unipolar depression and 11 matched normal controls. The depressed patients showed significantly higher values of plasma DHEAS and cortisol than the controls. After 4 weeks of treatment with antidepressants (mainly clomiplamine), the high plasma DHEAS levels recovered. This finding showed the possible relationship between plasma DHEAS levels and depression, as well as cortisol levels.     

Enhanced negative priming in Parkinson's disease.

In the ignored repetition paradigm, negative priming (NP) is defined as the increase in response time that occurs when the current target stimulus served as a distractor stimulus in the previous trial. In this study, 25 Parkinson's disease (PD) participants and 17 age-matched healthy controls (HCs) were tested using a touchscreen version of the ignored repetition task that allowed response time to be partitioned into response initiation and response execution segments. In both groups, NP effects were stronger in the response execution than in the response initiation segments. The most striking result was that the PD group showed larger NP effects overall than the HC group. In PD, clinical ratings of bradykinesia, but not tremor, were related to larger NP effects. Results indicate that in PD, disruption of dopamine neuromodulation diminishes response efficiency when action must be directed toward previously ignored information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual construction impairments in Parkinson's disease.

24 nondemented Parkinson's disease (PD) patients were asked to copy and then recall the Rey-Osterrieth Complex Figure, dividing the units of the figure into "main structural" and "detail" components. PD patients consistently omitted some main structural units from recall of the figure. When main structures were produced, PD patients were impaired at drawing these features in an organized fashion, and they produced these main units late in the course of their drawings. PD patients differed from control Ss in their recall of the figure's details, but there were no qualitatively unique features in their omission of details. Correlation and regression analyses suggest that compromised executive functioning contributed to the PD patients' constructional difficulties and that visual perception and motor functioning also played a modest role. It is concluded that visual construction impairments in PD are multifactorial in nature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Category learning deficits in Parkinson's disease.

Sixteen patients with Parkinson's disease (PD), 15 older controls (OCs), and 109 younger controls (YCs) were compared in 2 category-learning tasks. Participants attempted to assign colored geometric figures to 1 of 2 categories. In rule-based tasks, category membership was defined by an explicit rule that was easy to verbalize, whereas in information-integration tasks, there was no salient verbal rule and accuracy was maximized only if information from 3 stimulus components was integrated at some predecisional stage. The YCs performed the best on both tasks. The PD patients were highly impaired compared with the OCs, in the rule-based categorization task but were not different from the OCs in the information-integration task. These results support the hypothesis that learning in these 2 tasks is mediated by functionally separate systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal learning strategies in Parkinson's disease.

Word-list learning was studied in patients with Parkinson's disease (PD) and normal control (NC) participants by means of the selective-reminding procedure of H. Buschke and P. A. Fuld (1974) in 3 learning conditions using semantically unrelated items; semantically related items, whose implicit categorical structure had to be spontaneously guessed; and semantically related items, whose explicit categorical structure was known in advance. The PD patients displayed poor learning in all 3 conditions. To identify the functional locus of the PD patients' deficits, the authors performed a stochastic Markov chain analysis, which allowed individual measurements of encoding, retrieval, and category clustering abilities. PD patients were never significantly impaired in encoding word engrams; their impairment was confined to automatic and intentional retrieval and to the ability to benefit from explicit semantic clues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal fluency deficits in Parkinson's disease.

Administered verbal (category naming, letter fluency) and nonverbal (category drawing, design fluency) tasks to patients with Parkinson's disease (PD). PD patients were significantly impaired only in their category naming for a semantic target like fruit. The hypothesis that compromised lexical retrieval contributed to PD patients' impaired category naming by examining free recall and recognition on a supraspan learning task was tested. PD patients were significantly impaired in free recall but not recognition. Category naming fluency correlated with free recall but not recognition on the supraspan learning task. It is argued that the verbal fluency deficit in PD is due to a lexical retrieval impairment and that the difference between category naming and letter fluency is due to the nature of the prompts for lexical retrieval that patients can derive from these tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visuospatial dysfunction and problem solving in Parkinson's disease.

Individuals with Parkinson's disease (PD) perform deficiently on Raven's Coloured Progressive Matrices (RCPM), in contrast to their relatively good performance on many other problem-solving tasks. The question is raised as to whether a visuospatial deficit may account for poor RCPM performance in PD. The authors analyzed RCPM results in 50 nondemented participants with PD and 39 age-matched healthy control participants. The PD group made significantly more errors than the control group on all RCPM subtests, including the subtest that mainly assessed visuospatial function (RCPM-A). For the PD group, the composite score of other visuospatial tests, but not the composite scores of tests of executive function or verbal memory, significantly predicted performance on the RCPM-A. Visuospatial impairment in PD may arise from dysfunction of the basal ganglia-thalamocortical circuit that also includes the dorsolateral prefrontal cortex and, importantly, the posterior parietal lobes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of the Short Parkinson's Evaluation Scale: a new friendly scale for the evaluation of Parkinson's disease in clinical drug trials

The extensive use of the Unified Parkinson's Disease Rating Scale (UPDRS) has revealed low interrater reliability in some items and redundancy in others. In view of these shortcomings, we have structured a new scale that includes a zero-to three-point scale for each item in the evaluation of PD. The mental axis includes memory, thought disorders, and depression. Activities of daily living (ADL) includes eight items: speech, eating, feeding, dressing, hygiene, handwriting, walking, and turning in bed. The motor examination includes eight items: speech, tremor, rest and posture, rigidity, finger tapping, arising from chair, gait, and postural stability. Complications of therapy were also included: dyskinesias, dystonia, motor fluctuations, and freezing episodes, collected by history. In addition, a global scoring for motor fluctuations that should complement the Hoehn and Yahr Scale was incorporated. In this report, we present a statistical analysis of the ADL, motor evaluation, and complications of therapy sections. Concerning the interrater reliability mean, Kendall's W values were >0.9 for most of the items in the Short Parkinson's Evaluation Scale (SPES). Kendall's W <0.8 (motor evaluation) was found for two items of the SPES and nine items of the UPDRS. The mean interrater reliability for both scales across all seven centers (seven Kendall's W for seven centers) (Mann-Whitney test) showed no statistical differences between the scales. Spearman's correlations between items of both scales were significant. Factor analysis of the SPES and UPDRS data revealed a four-factor solution that explained approximately 60% of the data. All participating centers found the SPES easier to apply and quicker to complete, when compared with the UPDRS. The results obtained strongly favor the introduction of SPES for clinical practice.     

Interference from retrieval cues in Parkinson's disease.

Objective: Existing studies on memory interference in Parkinson's disease (PD) patients have provided mixed results and it is unknown whether PD patients have problems in overcoming interference from retrieval cues. We investigated this issue by using a part-list cuing paradigm. In this paradigm, after the study of a list of items, the presentation of some of these items as retrieval cues hinders the recall of the remaining ones. Method: We tested PD patients' (n = 19) and control participants' (n = 16) episodic memory in the presence and absence of part-list cues, using initial-letter probes, and following either weak or strong serial associative encoding of list items. Results: Both PD patients and control participants showed a comparable and significant part-list cuing effect after weak associative encoding (13% vs. 12% decrease in retrieval in part-list cuing vs. no part-list cuing -control- conditions in PD patients and control participants, respectively), denoting a similar effect of cue-driven interference in the two populations when a serial retrieval strategy is hard to develop. However, only PD patients showed a significant part-list cuing effect after strong associative encoding (20% vs. 5% decrease in retrieval in patients and controls, respectively). Conclusions: When encoding promotes the development of an effective serial retrieval strategy, the presentation of part-list cues has a specifically disruptive effect in PD patients. This indicates problems in strategic retrieval, probably related to PD patients' increased tendency to rely on external cues. Findings in control conditions suggest that less effective encoding may have contributed to PD patients' memory performance. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Adjustments of conflict monitoring in Parkinson's disease.

Objective: In Stroop-like tasks, the detection of conflict triggers adjustments of cognitive control to reduce conflict in subsequent trials. The present study tested the hypothesis of an impaired modulation of conflict monitoring in Parkinson's disease (PD). Method: 18 PD patients and 18 healthy control (HC) participants performed a Stroop-like task in 2 conditions differing in terms of incongruent/congruent stimuli ratio. Results: HC participants demonstrated a sustained modulation of interference effect, the interference effect being decreased when the proportion of incongruent stimuli was high. A trial-by-trial analysis also showed that in the HC group, processing an incongruent stimulus reduced interference in the subsequent trial. Unlike controls, PD patients did not demonstrate any transient or sustained reduction of the interference effect. Conclusion: Within the framework of recent models, these results can be interpreted as an impairment of a proactive mode of cognitive control in patients with PD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)