Abstract
Non-motor symptoms such as neuropsychiatric and cognitive dysfunction have been found to be common in Parkinson’s disease (PD) but the relation between such symptoms is poorly understood. We focused on alexithymia, an impairment of affective and cognitive emotional processing, as there is evidence for its interaction with cognition in other disorders. Twenty-two non-demented PD patients and 22 matched normal control adults (NC) were administered rating scales assessing neuropsychiatric status, including alexithymia, apathy, and depression, and a series of neuropsychological tests. As expected, PD patients showed more alexithymia than NC, and there was a significant association between alexithymia and disease stage. Alexithymia was associated with performance on non-verbally mediated measures of executive and visuospatial function, but not on verbally mediated tasks. By contrast, there was no correlation between cognition and ratings of either depression or apathy. Our findings demonstrate a distinct association of alexithymia with non-verbal cognition in PD, implicating right hemisphere processes, and differentiate between alexithymia and other neuropsychiatric symptoms in regard to PD cognition.
Highlights
Parkinson’s disease (PD) is traditionally characterized as a motor disorder, but the existence of non-motor symptoms is attracting increasing attention from clinicians and researchers because of their impact on patients’ quality of life
We found that apathy and alexithymia differentially correlated with performance on neuropsychological measures
Whereas alexithymia was significantly associated with performance on non-verbal measures of executive function and visuospatial ability, apathy was not associated with performance on any of the tasks
Summary
Parkinson’s disease (PD) is traditionally characterized as a motor disorder, but the existence of non-motor symptoms is attracting increasing attention from clinicians and researchers because of their impact on patients’ quality of life. According to a current model, alexithymia derives from dysfunction of frontal areas [36,37], the ACC and prefrontal cortex [38] Support for this model comes from neuroimaging studies [39,40,41,42,43], which have related alexithymia to predominantly right hemisphere dysfunction. To address an ongoing debate in the literature regarding lateralized (left vs right hemisphere) expression of alexithymia and follow the lead of one neuropsychological study of PD that suggested an association between alexithymia and cognitive abilities mediated by the right hemisphere (i.e., visuospatial function) [47], in the present study we related alexithymia to material-specific cognitive. We explored the relation between cognitive performance and various aspects (factors) of alexithymia in PD, as neuroimaging studies have suggested differentiation between neural systems associated with specific aspects of alexithymia.
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