In Parkinson’s, There’s Growing Recognition of Cognitive Problems

When most people think about Parkinson’s disease (PD), they focus on movement problems almost exclusively. But mild cognitive impairment is among other potential disease symptoms, although medical professionals and researchers currently disagree on the extent and exact nature of this problem in Parkinson’s patients.

Progressive tremors and rigidity occur in PD largely due to the degeneration of the substantia nigra dopamine-producing neurons, and loss of dopamine. For this reason, most treatments for PD focus on restoring lost dopamine and helping with impaired movement. Recognition of cognitive impairment in PD is increasing, though, with a recent article in the journal Neurodegenerative Disease Management devoted to exploring controversies in mild cognitive impairment in Parkinson’s disease (PD-MCI).

Mild cognitive impairment is a risk factor for dementia in PD, one that needs to be better recognized and understood, the researchers explain. The article explores signs of PD-MCI, as well as biomarkers, disease progression, and how PD-MCI factors into clinical trial design.

Jennifer Goldman, MD, MS, article co-authored with Neelum T. Aggarwal, MD, and Cynthia D. Schroeder, MHScolleagues from Rush University Medical Center Department of Neurological Sciences. In a press release, Dr. Goldman noted, “Recent research on mild cognitive impairment in Parkinson’s disease (PD-MCI) has sought to define its characteristics and risk factors as well as possible precursors of Parkinson’s dementia.”

“Precursors under investigation include serum, cerebrospinal fluid, and neuroimaging biomarkers, some of which may be similar in concept or in scientific findings to those found in Alzheimer’s disease,” she added. “Lessons learned from the Alzheimer’s disease field may help Parkinson’s disease clinicians and researchers further the development of good screening and accurate diagnostic algorithms, which may predict future cognitive decline, and ultimately assist in making treatment decisions.”

Goldman and colleagues explored how PD-MCI definitions have evolved over the years, and how prevention may be incorporated into PD treatment. In addition, monitoring PD-MCI is now being incorporated as a measurement for PD clinical trials. The group reviews the most effective biomarkers and other assessments for PD-MCI and discusses how the field of Alzheimer’s disease research has informed studies of PD-MCI.

“The authors elegantly synthesize advances and challenges in PD-MCI, a complex field which currently lacks consensus, and make comparisons with the more advanced field of AD-MCI,” stated Daphne Boulicault, commissioning editor. “We are pleased to offer this thoughtful review in both our MEDLINE-indexed journal, and free of charge on our industry portal, Neurology Central.”