Objective: To analyze the relationship between subjectively reported sleep alterations and cognitive functions in a large series of advanced Parkinson Disease (PD) patients evaluated with an extensive neuropsychological test battery.

Background: PD is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including cognitive and sleep disturbances. Cognitive alterations encompass mainly executive dysfunction, though visuospatial functions and memory may also be compromised. Sleep disturbances are extremely frequent in PD affecting up to 90% of patients. There are some preliminary evidences of a relationship between neuropsychological functions and self-reported nocturnal sleep disturbances. Excessive daytime sleepiness was found to be a significant predictor of slowed processing speed whereas RBD predicted working memory and verbal fluency performances.

Methods: We enrolled 122 PD patients who completed two self-administered sleep measures: the modified version of Parkinson’s Disease Sleep Scale (PDSS2) and the Epworth Sleepiness Scale (ESS). Neuropsychological assessment encompassed five cognitive domains: reasoning [Raven Coloured Matrices Test (CPM47)]; memory [Corsi’s Block Tapping Test (CBT), Paired Associate Learning (PAL)]; attention [Digit Cancellation Test (DCT), Trail Making Test A (TMTA)]; frontal executive functions [Trail Making Test B (TMTB), Frontal Assessment Battery (FAB)] and phonemic and category verbal fluency to evaluate language skills (PVF, CVF).

Results: Mean neuropsychological scores were within normal ranges (CPM47 28.2±6.1; DCT 46.5±9.9; TMTA 58.3±48.9; TMTB 174.4±148.9; FAB 15.4±2.7). Patients showed only low levels of sleep disturbances (PDSS2 23.3±11.3) and daytime sleepiness (ESS 8.8±5.1). A significant correlation was found between PDSS2 scores and non verbal reasoning (CPM 47 p=-0.0297), as well as attentive skills (DCT p=-0.295; TMTA p=-0.111), executive functions (TMTB p=0.285; FAB p=-0.330) and language abilities (PVF p=-0.201; CVF p=-0.255).

Conclusions: This study show that in advanced PD patients sleep disturbances are selectively related to sub-cortical neuropsychological functions and not to short term memory and consolidation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-neuropsychological-functioning-and-subjective-measures-of-sleep-quality-in-parkinson-disease/