Attentional dysfunction and the punding spectrum in Parkinson's disease.
Parkinsonism Relat Disord
; 84: 23-28, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-33545553
ABSTRACT
BACKGROUND:
Punding is a complication of Parkinson's disease (PD) treatment and stimulant abuse that features excessive preoccupation with repetitive and/or aimless behaviors. We hypothesized that cognitive impairment and functional limitations influence how punding behaviors manifest in PD.METHODS:
We extracted data on punding, hobbyism, and cognition from the Parkinson's Progression Marker Initiative (PPMI). Punding and hobbyism were measured with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) scale. We determined how cognition predicted punding and hobbyism behaviors-adjusting for levodopa dose, Hoehn & Yahr stage, disease duration, and age-using generalized estimating equation (GEE) logistic regression. Activities of daily living (ADL) and motor impairment were measured with the MDS-UPDRS scale.RESULTS:
In GEE logistic regression models, punding was selectively associated with lower scores on the Letter Number Sequencing test (LNS), the primary attention test in PPMI (Odds ratio 0.87 (95% CI 0.79-0.96); p = 0.022). This was corroborated by a subscale-analysis of Montreal Cognitive Assessment (MoCA) scores, as only the attention subscale was significantly associated with punding (OR 0.59 (0.45-0.77); p < 0.001). Baseline impairment in LNS (Hazard ratio 2.52 (1.22-5.20); p = 0.012) and MoCA attention (HR 2.68 (1.32-5.42); p = 0.006) predicted earlier punding in Cox regression. In turn, ADL dysfunction predicted punding (OR 1.55 (1.20-2.00); p < 0.001), but not hobbyism.CONCLUSION:
Attentional dysfunction is a domain-specific cognitive biomarker of punding risk in PD. Further, attentional capacity and functional impairment may determine the complexity of perseverative behaviors on the continuum from rudimentary punding to semi-purposeful hobbyism.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
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Atenção
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Disfunção Cognitiva
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Transtornos Disruptivos, de Controle do Impulso e da Conduta
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article