Abstract
Parkinson’s disease is a progressive neurodegenerative disorder associated with reduced spatial and verbal working memory ability. There are two established motor subtypes of PD, tremor dominant (TD) and postural instability and gait difficulty (PIGD). This study used structural equation modelling to explore the longitudinal relationship between the two subtypes and working memory assessed at a 2-year follow-up. The study comprised 84 males and 30 females (N = 114), aged between 39 and 85 (M = 64.82, SD = 9.23) with confirmed PD. There was no significant relationship between motor subtype at Time 1 and working memory at Time 2. Postural symptom severity at Time 1 predicted Time 2 spatial working memory for the PIGD subtype (p = .011) but not the TD subtype. Tremor symptoms were not associated with Time 2 working memory in either subtype. Predictive significance of Time 1 postural symptoms only in the PIGD subtype suggests an interaction between symptom dominance (subtype) and symptom severity that future subtyping should consider. This study demonstrates a predictive relationship between postural difficulties and working memory performance assessed at a 2-year follow-up. Establishing physical symptoms as predictors of cognitive change could have significant clinical importance.
Highlights
Two primary subtypes of motor symptoms in Parkinson’s disease (PD) are recognised: ‘tremor dominant’ (TD), and ‘postural instability and gait difficulty’ (PIGD)[1]
This study examined whether motor subtype (TD/PIGD) at baseline predicted verbal working memory (Aim 1) and/or spatial working memory (Aim 2) performance at a 2-year follow-up
The present study examined whether motor subtype at baseline (TD or PIGD) predicted working memory performance two years later in individuals with PD
Summary
Two primary subtypes of motor symptoms in Parkinson’s disease (PD) are recognised: ‘tremor dominant’ (TD), and ‘postural instability and gait difficulty’ (PIGD)[1]. These represent the ratio of tremor to postural/gait or akinetic-rigid symptoms exhibited on the Unified Parkinson’s Disease Rating Scale (UPDRS), the clinimetric standard for motor symptom assessment in PD[2]. Individuals who present with comparable levels of tremor and postural difficulty are identified as ‘indeterminate’[2]. The classification criteria for each subtype were recently updated following Goetz et al.’s[3] revision of the UPDRS[4]. Stebbins et al.[4] used Jankovic.
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