Dexterity, attention and working memory in patients with Parkinson's disease

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Disturbed manual dexterity is common among patients with Parkinson's Disease(PD), even in early stages of the disease and may be less responsive to pharmacological treatment. Cognitive impairments are associated with old age and severe motor symptoms and occur mostly in the later stages. The aim of this study is to investigate hand dexterity, attention and working memory and their association in patients with PD. PD patients were grouped according to Hoehn and Yahr staging as early-stage (1–2, Group1; n = 16) and mid-stage (3–4, Group2; n = 16) Hand dexterity, attention and working memory were assessed with Nine Hole Peg Test(NHPT), Stroop Color-Word Test (SCWT) and subtests of Wechsler Memory Scale-Revised(WMS-R), respectively. The mid-stagers' NHPT, Logical Memory-II subtest of WMS-R and SCWT scores were worse than early-stagers'(p < .05). However, it was seen that the groups had similar properties in terms of WMS-Digit Span (p > 0.05). The relation between left hand dexterity (NHPT), attention and memory were significant (p < .05). While the stage of PD was correlated with NHPT, SCWT and WMS-Logical Memory I (p < .05), we could not find a significant relationship with the rest of WMS-R subtests(p > .05). Dexterous impairment leads to difficulties in activities of daily living (ADL) that require fine motor skills, especially with the progression of the PD's stage. These could be in association with the deficient cognitive performance, which could be appear in early-stage PD patients. Cognitive assessment and dexterity could be in the context of assessment and treatment of PD patients from the early terms with multidisciplinary approach.