Abstract
In Parkinson’s disease (PD), internal cueing mechanisms are impaired leading to symptoms like hypokinesia. However, external cues can improve movement execution by using cortical resources. These cortical processes can be affected by cognitive decline in dementia. It is still unclear how dementia in PD influences external cueing. We investigated a group of 25 PD patients with dementia (PDD) and 25 non-demented PD patients (PDnD) matched by age, sex, and disease duration in a simple reaction time task using an additional acoustic cue. PDD patients benefited from the additional cue in similar magnitude as did PDnD patients. However, withdrawal of the cue led to a significantly increased reaction time in the PDD group compared to the PDnD patients. Our results indicate that even PDD patients can benefit from strategies using external cue presentation but the process of cognitive worsening can reduce the effect when cues are withdrawn.
Highlights
Parkinson’s disease (PD) is defined as a neurodegenerative disorder affecting nigrostriatal neurons in the basal ganglia (BG) circuit
Purpose of the study was to investigate the effect of global cognitive deterioration as seen in dementia on the usage of an acoustic cue in a simple reaction time (SRT) paradigm in PD
There is increasing evidence that such cueing strategies can improve motor performance in particular in everyday life situations [25]. This cannot be generalized since cuing can lead to attention shift, distraction, and additional stress because of the introduction of an additional task [14, 15]. These aspects have not been well investigated in Parkinson’s disease dementia (PDD)
Summary
Parkinson’s disease (PD) is defined as a neurodegenerative disorder affecting nigrostriatal neurons in the basal ganglia (BG) circuit. A study with PD patients revealed that damaged BG can be bypassed by visual input through neuronal circuits involving cerebro– cerebellar–cerebral pathways resulting in improved movement abilities in response to the stimulus [9]. The fact that external cues help to suppress and/or bypass the BG implies that in addition to the participation of motor areas, sensory and higher cortical areas are involved in movement initiation. This may even include prefrontal regions [12] known for their involvement in higher cognitive functions, such as executive functions and attention, which are known to be vulnerable in the dementing process in PD [13]
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