The applause sign in Parkinson’s disease patients is related to dysexecutive syndrome

• Published in: Journal of clinical neuroscience 2013-12, Vol.20 (12), p.1734-1736
• Main Authors: Tomic, Svetlana, Vladetic, Mirjana, Solic, Kresimir, Misevic, Sanja, Soldo, Silva Butkovic
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Applause sign; Cognition; Cognition Disorders - complications; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Dysexecutive syndrome; Executive Function - physiology; Female; Humans; Male; Middle Aged; Neurodegenerative disease; Neurology; Neuropsychological Tests; Parkinson Disease - complications; Parkinson Disease - diagnosis; Parkinson Disease - psychology; Parkinson plus syndrome; Parkinson’s disease
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2013.02.024

Abstract Recent publications report that a positive applause sign is not only present in patients with neurodegenerative diseases where the subcortical structures are affected but also in patients with cortical dementia. The nature of this sign remains unknown. This study aimed to determine the frequency of the applause sign and its correlation with cognitive impairment in patients with idiopathic Parkinson’s disease. The study included 30 non-depressed patients diagnosed with idiopathic Parkinson’s disease. Study patients underwent the Unified Parkinson Disease Rating Scale part III, Dementia Rating Scale (DRS), Raven’s Colored Progressive Matrices, and Mill Hill Vocabulary tests. Statistical analysis was performed by use of the parametric Student’s t -test, nonparametric Mann–Whitney U test and Fisher’s exact test, with the level of significance set at p < 0.05. Negative applause sign was recorded in 66.7% and positive applause sign in 33.3% of patients. There were no between-group differences according to age, disease duration, or severity of motor symptoms. The positive applause sign group had significantly lower scores on the initiation/perseveration subscale of the DRS and a significantly higher frequency of scores below the cut-off score on the conceptualization and construction subscales of the DRS. The applause sign appears to be part of a broader dysexecutive syndrome in idiopathic Parkinson’s disease.