The Epidemiology and Clinical Manifestations of Dysexecutive Syndrome in Parkinson’s Disease

Roberto Ceravolo,Gloria Tognoni,Cristina Pagni,Ubaldo Bonuccelli

doi:10.3389/fneur.2012.00159

Abstract

This mini-review summarizes the evidence of the cognitive and behavioral features of dysexecutive syndrome in Parkinson’s disease (PD). Deficits in response inhibition, set-shifting, mental flexibility, and strategy have been frequently described from the earliest stages of PD, although there are inconsistencies in study findings due to the complexity of the executive function (EF) construct and methodological limitations. Behavioral disorders of PD, e.g., apathy, distractibility, perseverative behavior, and impulse-control disorders, may be viewed as the other side of dysexecutive syndrome. Despite the interrelationship between the cognitive and behavioral domains, some reports reveal that the two syndromes may be dissociated, suggesting that both aspects must be clinically assessed. EFs are widely associated with the prefrontal areas, although dysexecutive syndrome may be observed in patients with damage to other brain regions. EFs drive numerous abilities essential to daily life, such as prospective remembering and language comprehension, which may be impaired in PD subjects. Considering the impact of dysexecutive syndrome on independence and quality of life, early detection of executive impairment is crucial in the management of PD.

Highlights

A growing body of recent studies on cognition in Parkinson’s disease (PD) have indicated that different cognitive domains may be affected from the early stages of PD (Dujardin et al, 2004; Foltynie et al, 2004; Muslimovic et al, 2005; Aarsland et al, 2009a; Elgh et al, 2009; Martin et al, 2009)
NEUROBIOLOGICAL BASIS OF EXECUTIVE DEFICITS IN NON-DEMENTED PD SUBJECTS A number of relevant studies have demonstrated that executive function (EF) are widely associated with the prefrontal areas
These findings indicate that Prospective memory (ProM) deficits seen in PD could be due to executive impairment

Summary

Introduction

A growing body of recent studies on cognition in Parkinson’s disease (PD) have indicated that different cognitive domains may be affected from the early stages of PD (Dujardin et al, 2004; Foltynie et al, 2004; Muslimovic et al, 2005; Aarsland et al, 2009a; Elgh et al, 2009; Martin et al, 2009). These include memory, language, attention, visuospatial and visuoconstructive abilities, and executive functions (EFs). According to diagnostic criteria proposed by Godefroy et al (2010), dysexecutive syndrome includes cognitive (e.g., deficits in response inhibition, set-shifting, and information generation) and/or behavioral (e.g., apathy, distractibility, perseverative behavior) alterations.

Results

Conclusion