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Abstract
BackgroundSubjective cognitive decline (SCD) may occur very early in the course of Parkinson’s disease (PD) before the onset of objective cognitive decline. Data on neural correlates and determinants of SCD in PD are rare.ObjectiveThe aim of the present study was to identify neural correlates as well as sociodemographic, clinical, and neuropsychological predictors of SCD in patients with PD.MethodsWe retrospectively analyzed 30 patients with PD without cognitive impairment (23% female, 66.90 ± 7.20 years, UPDRS-III: 19.83 ± 9.29), of which n = 12 patients were classified as having no SCD (control group, PD-CG) and n = 18 as having SCD (PD-SCD). Neuropsychological testing and 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) were conducted. SCD was assessed using a questionnaire covering multiple cognitive domains.ResultsSCD subscores differed significantly between PD-CG and PD-SCD and correlated significantly with other scales measuring related concepts. FDG-PET whole-brain voxel-wise regression analysis revealed hypometabolism in middle frontal, middle temporal, and occipital areas, and the angular gyrus as neural correlates of SCD in PD. Next to this hypometabolism, depressive symptoms were an independent significant determinant of SCD in a stepwise regression analysis (adjusted R2 = 50.3%).ConclusionThis study strengthens the hypothesis of SCD being an early manifestation of future cognitive decline in PD and, more generally, early pathological changes in PD. The early identification of the vulnerability for future cognitive decline constitutes the basis for successful prevention and delay of this non-motor symptom.
Highlights
Subjective cognitive decline (SCD) describes a self-perceived, subjective deterioration in potentially different cognitive domains in the absence of objective cognitive impairment [1]
The objective of the current study was to identify sociodemographic, clinical, and neuropsychological determinants as well as functional neural correlates of SCD in patients with Parkinson’s disease (PD) assessed with 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) which have, to the authors’ best knowledge, not been investigated in combination so far
Inclusion criteria were (i) the diagnosis of PD according to UK brain bank criteria; (ii) the availability of FDG-PET imaging data; (iii) the availability of neuropsychological data including the modified and extended version of the Subjective Memory Impairment Questionnaire, the SCD-Q [29, 30]; (iv) the exclusion of PD-mild cognitive impairment (MCI) or PD dementia according to level-II diagnostic criteria;, and (v) the exclusion of other diseases affecting brain functions, e.g., operationalized by the intake of any centrally active medication such as antidepressant/ anxiolytics beyond the antiparkinsonian dopaminergic medication
Summary
Subjective cognitive decline (SCD) describes a self-perceived, subjective deterioration in potentially different cognitive domains in the absence of objective cognitive impairment [1]. Subjective cognitive decline (SCD) may occur very early in the course of Parkinson’s disease (PD) before the onset of objective cognitive decline. Objective The aim of the present study was to identify neural correlates as well as sociodemographic, clinical, and neuropsychological predictors of SCD in patients with PD. FDG-PET whole-brain voxel-wise regression analysis revealed hypometabolism in middle frontal, middle temporal, and occipital areas, and the angular gyrus as neural correlates of SCD in PD. To this hypometabolism, depressive symptoms were an independent significant determinant of SCD in a stepwise regression analysis (adjusted R2 = 50.3%). The early identification of the vulnerability for future cognitive decline constitutes the basis for successful prevention and delay of this non-motor symptom
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