Abstract
Working memory (WM) represents a core cognitive function with a major striatal contribution, and thus WM deficits, commonly observed in Parkinson’s disease (PD), could also relate to many other problems in PD patients. Our online study aimed to determine the subdomains of WM that are particularly affected in PD and to clarify the links between WM and everyday cognitive deficits, other executive functions, psychiatric and PD symptoms, as well as early cognitive impairment. Fifty-two mild-to-moderate PD patients and 54 healthy controls performed seven WM tasks tapping selective updating, continuous monitoring, or maintenance of currently active information. Self-ratings of everyday cognition, depression, and apathy symptoms, as well as screenings of global cognitive impairment, were also collected. The data were analyzed using structural equation modeling. Of the three WM domains, only selective updating was directly predictive of PD group membership. More widespread WM deficits were observed only in relation to global cognitive impairment in PD patients. Self-rated everyday cognition or psychiatric symptoms were not linked to WM performance but correlated with each other. Our findings suggest that WM has a rather limited role in the clinical manifestation of PD. Nevertheless, due to its elementary link to striatal function, the updating component of WM could be a candidate for a cognitive marker of PD also in patients who are otherwise cognitively well-preserved.
Highlights
Parkinson’s disease (PD) is characterized by complex symptomatology including motor symptoms and a decline of cognitive function and psychiatric well-being (Kalia and Lang, 2015)
For the rest of the working memory (WM) tasks (i.e., Running Memory Task (RM), and Alphabet Working Memory Task (AWM)) that were excluded from the final model and those cognitive tasks not taxing WM, we report independentsamples t-tests in which the outcome variable of interest served as the dependent variable and group (PD vs. controls) as the independent variable
The results indicate that WM deficits in PD involve mainly the subdomain of updating, possibly resulting from the underlying dysregulation of the frontostriatal networks
Summary
Parkinson’s disease (PD) is characterized by complex symptomatology including motor symptoms and a decline of cognitive function and psychiatric well-being (Kalia and Lang, 2015). Later neurobiological and brain imaging studies in healthy adults have concluded that WM typically engages widespread frontoparietal networks (Rottschy et al, 2012; Eriksson et al, 2015), some evidence indicates that especially the cortico-striatal loops are linked to updating of information in WM (Frank et al, 2001; O’Reilly and Frank, 2006). This raises the question of whether WM deficits in PD concern this subdomain. A link between WM and psychiatric symptoms could be expected because of the overlapping neuropathology (Joutsa et al, 2013)
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