Cognitive Impairments in Early Parkinson's Disease Are Accompanied by Reductions in Activity in Frontostriatal Neural Circuitry

Studies in patients with Parkinson's disease (PD) suggest that the characteristic motor symptoms of the disorder are frequently accompanied by impairments in cognition that are most profound in tasks of executive function. Neuropsychological deficits are not an inevitable consequence of the dis...

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Bibliographic Details
Published in:The Journal of neuroscience 2003-07, Vol.23 (15), p.6351-6356
Main Authors: Lewis, Simon J. G, Dove, Anja, Robbins, Trevor W, Barker, Roger A, Owen, Adrian M
Format: Article
Language:English
Subjects:
Adult
Aged
Behavioral/Systems/Cognitive
Brain Mapping
Cognition Disorders - complications
Cognition Disorders - diagnosis
Cognition Disorders - physiopathology
Corpus Striatum - physiopathology
Female
Frontal Lobe - physiopathology
Humans
Magnetic Resonance Imaging
Male
Memory, Short-Term - physiology
Middle Aged
Neural Pathways - physiopathology
Neuropsychological Tests
Parkinson Disease - complications
Parkinson Disease - physiopathology
Photic Stimulation
Reference Values
Verbal Behavior
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Summary:Studies in patients with Parkinson's disease (PD) suggest that the characteristic motor symptoms of the disorder are frequently accompanied by impairments in cognition that are most profound in tasks of executive function. Neuropsychological deficits are not an inevitable consequence of the disease, yet the reasons underlying cognitive heterogeneity in PD are not well understood. To determine the underlying neural correlate of these cognitive deficits, we used event-related functional magnetic resonance imaging (fMRI) to compare groups of cognitively impaired and unimpaired patients, matched on all other clinical measures. fMRI revealed significant signal intensity reductions during a working-memory paradigm in specific striatal and frontal lobe sites in patients with cognitive impairment compared with those patients who were not cognitively unimpaired. These results demonstrate that cognitive deficits in PD are accompanied by neural changes that are related to, but distinct from, those changes that underlie motoric deficits in these patients. Furthermore, they suggest that fMRI may provide a valuable tool for identifying patients who may benefit from targeted therapeutic strategies.
ISSN:0270-6474
1529-2401
DOI:10.1523/jneurosci.23-15-06351.2003