Global cognitive performance is associated with sleep efficiency measured by polysomnography in patients with Parkinson's disease.

AIM: Sleep disorders can be associated with an increased risk for cognitive decline in patients with Parkinson's disease (PD). The aim of this study was to examine the association between cognitive status and presence of sleep symptoms and sleep disorders in PD patients. METHODS: We evaluated excessive sleepiness, other sleep symptoms, and performed polysomnography and neuropsychological evaluation in 79 patients. They were classified as having normal cognition (PDNC), mild cognitive impairment (PDMCI), or dementia (PDD). RESULTS: There were 29 PDNC, 39 PDMCI, and 11 PDD patients. PDD patients were older, had higher scores on the Unified Parkinson's Disease Rating Scale, and lower Schwab and England Activities of Daily Living scores than PDNC patients. After analysis of the polysomnographic variables, it was also found that PDD patients had a lower sleep efficiency, lower total sleep time, and lower number of sleep state changes than PDNC patients. In a stepwise analysis, defining Mattis Dementia Rating Scale scores as the dependent variable, the results were a model that selected three variables that accounted for 59% of the variation in the Mattis Dementia Rating Scale score: wake time after sleep onset, number of state changes, and schooling. CONCLUSION: We found a significant association between global cognitive performance and wake time after sleep onset and the number of state changes during sleep measured in the polysomnography of PD patients. However, we did not find any other association between sleep disorders or symptoms and cognitive status or cognitive performance of PD patients.

Neuroimaging of major depression in Parkinson's disease: Cortical thickness, cortical and subcortical volume, and spectroscopy findings.

Depression is the most common psychiatric disorder in Parkinson's disease (PD). The aim of this study was to compare PD patients with current Major Depressive Disorder (MDD), lifetime MDD, and no MDD using three neuroimaging techniques. A total of 43 PD patients were selected and divided into three groups: (i) current MDD (n = 15), (ii) previous MDD without current MDD (n = 10); and (iii) control group (no current or lifetime MDD; n = 18). All participants underwent magnetic resonance imaging to evaluate cortical thickness, cortical and subcortical volume, and spectroscopy in the bilateral putamen and cingulate cortex. Volumetric analysis showed volume decreases in frontal and temporal areas, bilateral amygdala, and left cerebellar white matter in the lifetime MDD group compared to the control group. Furthermore, the volumes of the anterior cingulate cortex, right amygdala, and left cerebellar white matter were smaller in the group with current MDD compared to the control group. Regarding cortical thickness, the left rostral anterior cingulate gyrus of the group with previous MDD was thinner compared to the control group. There was a weak negative correlation between the NAA/Cre ratio in the right putamen and depressive symptoms. The results suggested current and lifetime MDD have a negative impact on the neurodegenerative process of PD, with decreased volume and/or reduction of cortical thickness in temporal and frontal areas, anterior cingulate cortex, amygdala, and cerebellar white matter.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised / Rastreio de comprometimento cognitivo em pacientes com doença de Parkinson: validade diagnóstica das versões brasileiras da Montreal Cognitive Assessment e do Addenbrooke's Cognitive Examination-Revised

ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

RESUMOObjetivo O objetivo do estudo foi avaliar a acurácia das versões Brasileiras das escalas: Montreal Cognitive Assessment (MoCA) e Addenbrooke's Cognitive Examination-Revised (ACE-R), no rastreamento de comprometimento cognitivo leve (CCL) e demência em pacientes com doença de Parkinson (DP).Método As duas escalas foram aplicadas a uma amostra de conveniência de 79 pacientes com DP. Os pacientes foram avaliados por um neurologista, um psiquiatra e uma neuropsicóloga que utilizaram a UPDRS, a escala de Hoehn e Yahr, a escala de Schwab e England, a escala de deterioração global, uma entrevista psiquiátrica estruturada, a escala de demência de Mattis e outros testes cognitivos.Resultados 32 pacientes foram diagnosticados com CCL e 17 com demência. A MoCA e o ACE-R foram capazes de discriminar pacientes com demência dos demais.Conclusão As duas escalas se mostraram úteis para rastrear demência, mas não CCL, em pacientes com DP.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised.

OBJECTIVE: The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD). METHOD: Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests. RESULTS: There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others. CONCLUSION: Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.