Effect of clinical autonomic dysfunction on cognitive functions in Parkinson’s disease

• Main Authors: Dursun Aygun, Cetin Kursad Akpinar, Serpil Yon, Musa Kazım Ona
• Format: Article
• Language: English
• Published: Dicle University Medical School 2017-09-01
• Series: Dicle Medical Journal
• Subjects: Blessed score; Clinical autonomic dysfunction; Cognitive test; Parkinson’s disease
• Online Access: http://diclemedj.org/upload/sayi/65/Dicle%20Med%20J-03121.PDF

Objective: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, and postural instability. PD also involves nonmotor manifestations such as autonomic failure, cognitive disorders, and sleep disorders. These clinical characteristics are not identical in severity, frequency, and onset time in all PD patients. We assessed whether there is a negative effect on cognition of clinical autonomic dysfunction in PD patients. Methods: This prospective study includes 37 PD patients with autonomic failure. From each patient, a questionnaire (SCOPA-AUT) including symptoms associated with clinical autonomic dysfunction such as constipation, urinary incontinence, orthostatic hypotension, and hyperhydrosis was obtained and the patient’s clinical condition was rated on the Hoehn and Yahr (H-Y) scale in the ON-medication state. The patients’ cognitive function was assessed by the Mini-Mental State Examination (MMSE), Blessed score, Frontal Assessment Battery (FAB), and Digid Span Test (DST) (forward, reverse). Cognitive test scores were compared with SCOPA-OUT scores. Results: Mean age was 66,5±11.2 years. There was no correlation between cognitive test scores and SCOPA -OUT scores (p>0.05). However, H-Y scores were negatively correlated with the DSTf, DSTr, FAB, and MMSE scores (p50.005, r:-0.451; p50.025, r: -0.367; p50.040, r: -0.340; p50.044, r5-0.333, respectively). Conclusions: According to our results, clinical autonomic dysfunction did not seem to ha ve an effect on cognition. In addition, severity of cognitive dysfunction showed a strong negative correlation with the stage of disease.