Objective: To analyze the cognitive profile of patients with degenerative parkinsonian syndromes in the French West Indies and explore the correlations between cognitive deficits and eye movements recordings.

Background: In the French West Indies, atypical parkinsonism (AP) and idiopathic Parkinson disease (iPD) represent respectively, 70% and 30% of degenerative parkinsonian syndromes. Cognitive assessment and eye-movement recordings might help to differentiate atypical from idiopathic parkinsonism and represent a marker of disease progression.

Method: From 2012 to 2016, 180 patients were prospectively recruited in Guadeloupe and Martinique. All patients had a cognitive evaluation including the assessment of cognitive efficiency, memory, executive functions, visuospatial abilities, language, praxis and mood. For each cognitive test the percentage of patients having an abnormal score was compared between groups using Chi-2 analysis, after adjustment for age, socio-cultural level and disease duration. Among these patients 117 had an eye-tracking recording (iPD n=42, AP n=75).

Results: 63 patients had the MDS diagnostic criteria for iPD and 117 had AP. AP patients were significantly more impaired than iPD patients for MATTIS Dementia Rating Scal -2 (MDRS2, 82.1% vs. 65.6%, p = 0.032), praxis (58.0% vs. 35.7%, p = 0.026), visuospatial abilities (31.6% vs.7.3%; p = 0.02), executive functions (81.0% vs. 59.3%, p = 0.002) but not memory (63.5% vs. 66.7%, n.s.). The cortical cognitive deficit was more severe in patients with impaired vertical gaze. The latencies of horizontal and vertical oculomotor saccades and the percentage of errors in antisaccades of all patients were correlated with: MDRS2 scores (rho ranging from -0.32 to -0.48, p < 0.001), executive functions (rho ranging from -0.30 to -0.48, p < 0.05 to p < 0.001), praxis (rho ranging from -0.31 to -0.45, p < 0.01) and visual perception (rho ranging from -0.42 to -0.43, p < 0.01).

Conclusion: Patients with atypical parkinsonism have more severe cognitive deficits including cortical dysfunction involving frontal and parietal regions. Oculomotor abnormalities are highly correlated with several cognitive scores suggesting that eye tracking and cognitive testing could lead to the development of diagnostic and monitoring tools in Caribbean parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-profile-of-degenerative-parkinsonian-syndromes-in-the-french-west-indies-and-relationship-with-eye-movements-recordings/