E-ISSN : 2733-4538
A number of previous studies reported that patients with Parkinson’s disease (PD) perform poorly on executive function tests. However, due to the low specificity of most executive function tests, it is uncertain whether these results reflect deficits in the executive function or some other cognitive functions. Accordingly, the aim of this study was to distinguish between two hypotheses: (1) low performance of PD patients on executive function tests reflects deficits in the executive function and (2) low performance of PD patients on executive function tests is due to impairment in some other cognitive functions. To this end, Cognition Scale for Older Adults was administered to patients with PD (n=30) and matched controls (n=26). They were compared on six sets of paired tasks, in which one strongly demanded the executive function while the other did not. The major findings were as follows. First, relative to the matched controls, PD patients showed significantly greater impairment in word fluency than in information fluency, Rey copy than picture naming, delayed recall than delayed recognition, and Executive Function Index than Basic Function Index, indicating that low performance on word fluency, Rey copy, Delayed recall, and Executive Function Index is associated with impairment in executive function. Second, PD patients showed a large impairment in both the Stroop simple and interference trials, indicating prominent deficit in the psychomotor speed. Third, PD patients and controls were not significantly different with respect to Digit span forward and backward, indicating relative preservation of working memory capacity. Taken together, these results indicate that PD is associated with relatively greater cognitive impairment in the domains of the executive function and psychomotor speed.
Aarsland, D., Andersen, K., Larsen, J. P., & Lolk, A. (2003). Prevalence and characteristics of dementia in Parkinson disease: An 8-year prospective study. Archives of Neurology, 60, 387-392.
Aarsland, D., Brønnick, K., Larsen, J., Tysnes, O., Alves, G., & Group, N. P. S. (2009). Cognitive impairment in incident, untreated Parkinson disease: The Norwegian Park West Study. Neurology, 72, 1121-1126.
Alvarez, J. A., & Emory, E, (2006). Executive function and the frontal lobes: A meta-analytic review. Neuropsychology Review, 16, 17-42.
Bradley, V. A., Welch, J. L., & Dick, D. J. (1989). Visuospatial working memory in Parkinson’s disease. Journal of Neurology, Neurosurgery and Psychiatry, 52, 1228-1235.
Chu, E. J., & Kim, H. (2009). Differential deficits in executive function in elderly stroke patients. Korean Journal of Psychology: General, 28, 29-48.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
De Rijk, M. (2000). Prevalence of Parkinson’s disease in Europe: A collaborative study of population-based cohorts. Neurology, 54(Suppl 5), s21-s23.
Dirnberger, G., & Jahanshahi, M. (2013). Executive dysfunction in Parkinson’s disease: A review. Journal of Neuropsychology, 7, 193-224.
Elgh, E., Domellöf, M., Linder, J., Edström, M., Stenlund, H., & Forsgren, L. (2009). Cognitive function in early Parkinson’s disease:A population based study. European Journal of Neurology, 16, 1278-1284.
Eslinger, P. J. (1996). Conceptualizing, describing, and measuring components of executive function: A summary. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp. 367-395). Baltimore, MD: Brookes.
Filley, C. M. (2011). Neurobehavioral Anatomy (3rd ed.). Boulder, CO: University Press of Colorado.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.
Goetz, C. G., Poewe, W., Rascol, O., Sampaio, C., Stebbins, G. T., Counsell, C., Seidl, L. (2004). Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations. Movement Disorders, 19, 1020-1028.
Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez-Martin, P., LaPelle, N. (2008). Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Movement Disorders, 23, 2129-2170.
Hausdorff, J. M., Doniger, G. M., Springer, S., Yogev, G., Simon, E. S., & Giladi, N. (2006). A common cognitive profile in elderly fallers and in patients with Parkinson’s disease: The prominence of impaired executive function and attention. Experimental Aging Research, 32, 411-429.
Hughes, A. J., Daniel, S. E., Kilford, L., & Lees, A. J. (1992). Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases. Journal of Neurology, Neurosurgery and Psychiatry, 55, 181-184.
Jung, J. H., & Kim, H. (2014). Differential deficits of executive function in traumatic brain injury patients. Journal of Special Education and Rehabilitation Science, 53, 211-230.
Jung, I. K., Kwak, D. I., Joe, S. H., & Lee, H. S. (1997). A study of standardization of Korean Form of Geriatric Depression Scale (KGDS). Journal of Korean Geriatric Psychiatry, 1, 61-72.
Kang, M. J., & Kim, H. (2012). Executive function deficits in Asperger disorder: Evidence from a paired task method. Korean Journal of Psychology: General, 31, 581-598.
Kehagia, A. A., Barker, R. A., & Robbins, T. W. (2010). Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson’s disease. The Lancet Neurology, 9, 1200-1213.
Kim, B. N., & Kim, H. (2011). Alcohol dependence patients show differential deficits in frontal-executive function. Korean Journal of Psychology: General, 30, 443-459.
Kim, H. (2001). Kims Frontal-Executive Neuropsychological Test: Manual. Daegu: Neuropsychology Press.
Kim, H., Choi, Y. J., Yi, M. Y., & Seo, S. G. (2009). Schizophrenia is associated with differential deficit in executive function: Integrated analyses of 3 studies. Korean Journal of Psychology: General, 28, 319-342.
Kim, H., & Kim, T. Y. (2007). Cognition Scale for Older Adults: Manual. Daegu: Neuropsychology Press.
Kim, S. C., & Kim, H. (2014). Cognitive deficits in depressed patients:Evidence from a paired task analysis. Journal of Rehabilitation Psychology, 21, 151-169.
Ko, S. H., & Kim, H. (2013). Executive function deficits in pathological gambling: Evidence from a paired task method. Korean Journal of Clinical Psychology, 32, 481-498.
Kudlicka, A., Clare, L., & Hindle, J. V. (2011). Executive functions in Parkinson’s disease: Systematic review and meta-analysis. Movement Disorders, 26, 2305-2315.
Lewis, S. J., Dove, A., Robbins, T. W., Barker, R. A., & Owen, A. M. (2003). Cognitive impairments in early Parkinson’s disease are accompanied by reductions in activity in frontostriatal neural circuitry. The Journal of Neuroscience, 23, 6351-6356.
Litvan, I., Mohr, E., Williams, J., Gomez, C., & Chase, T. N. (1991). Differential memory and executive functions in demented patients with Parkinson’s and Alzheimer’s disease. Journal of Neurology, Neurosurgery and Psychiatry, 54, 25-29.
Muslimović, D., Post, B., Speelman, J. D., & Schmand, B. (2005). Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology, 65, 1239-1245.
Nagano-Saito, A., Washimi, Y., Arahata, Y., Kachi, T., Lerch, J., Evans, A., Ito, K. (2005). Cerebral atrophy and its relation to cognitive impairment in Parkinson disease. Neurology, 64, 224-229.
Owen, A. M. (2004). Cognitive dysfunction in Parkinson’s disease: The role of frontostriatal circuitry. The Neuroscientist, 10, 525-537.
Phillips, L. H. (1997). Do “frontal tests” measure executive function? Issues of assessment and evidence from fluency tests. In P. Rabbitt (Ed.), Methodology of frontal and executive function (pp. 191-123). East Sussex, UK: Psychology Press.
Rinne, J. O., Portin, R., Ruottinen, H., Nurmi, E., Bergman, J., Haaparanta, M., & Solin, O. (2000). Cognitive impairment and the brain dopaminergic system in Parkinson disease: [18F] fluorodopa positron emission tomographic study. Archives of Neurology, 57, 470-475.
Shin, H. Y., Lee W. Y., & Park, K. W. (2008). The characteristics of cognitive impairment in Parkinson’s disease and recognition of cognitive symptom by questionnaire. Journal of Movement Disorders, 1, 38-46.
Snyder, H. R. (2013). Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: A meta-analysis and review. Psychological Bulletin, 139, 81-132.
Svenningsson, P., Westman, E., Ballard, C., & Aarsland, D. (2012). Cognitive impairment in patients with Parkinson's disease: Diagnosis, biomarkers, and treatment. The Lancet Neurology, 11, 697-707.
Taylor, A. E., Saint-Cyr, J., & Lang, A. (1986). Frontal lobe dysfunction in Parkinson’s disease. Brain, 109, 845-883.
Tremblay, C., Achim, A. M., Macoir, J., & Monetta, L. (2013). The heterogeneity of cognitive symptoms in Parkinson’s disease: A meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry, 84, 1265-1272.
Verbaan, D., Marinus, J., Visser, M., Van Rooden, S., Stiggelbout, A., Middelkoop, H., & Van Hilten, J. (2007). Cognitive impairment in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 78, 1182-1187.
Williams-Gray, C., Foltynie, T., Brayne, C., Robbins, T., & Barker, R. (2007). Evolution of cognitive dysfunction in an incident Parkinson's disease cohort. Brain, 130, 1787-1798.
Won, C. W., Yang, K. Y., Rho, Y. G., Kim, S. Y., Lee, E., Yoon, J. L., & Lee, Y. S. (2002). The development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) Scale. Journal of the Korean Geriatrics Society, 6, 107-120.
Yesavage, J. A., Brink, T., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
Zgaljardic, D. J., Borod, J. C., Foldi, N. S., & Mattis, P. (2003). A review of the cognitive and behavioral sequelae of Parkinson’s disease:Relationship to frontostriatal circuitry. Cognitive and Behavioral Neurology, 16, 193-210.