Objective: To assess cortical and subcortical dysfunction in several stages of Parkinson’s disease (PD) using the Parkinson’s disease-cognitive rating scale (PD-CRS).

Background: Cognitive impairment in PD is mainly associated to dopamine depletion in the fronto-striatal circuits (subcortical alterations), however cognitive impairment related to cortical areas and different neurotransmitters may be considered as a marker for risk of dementia. The Parkinson’s disease Cognitive Rating Scale (PD-CRS) provides information of cognitive deficits regarding to subcortical and cortical dysfunction. Cognitive impairment usually appears on early stages as a no-motor symptom and the severity can be explained by spatiotemporal progression of Lewy bodies inclusions, resulting in cognitive dysfunction decline and higher risk of dementia.

Methods: Forty four Parkinson’s disease patients and twelve healthy participants (CG) accomplished cognitive evaluation for cognitive impairment and dementia risk using PD-CRS.

Results: CG (n= 12; Mean age=59.5, SD 12.29; 8 women), PD patients (n=44 mean age 61, SD= 9.14, 20 women, 27 Hoehn & Yahr 1-2) one patient was discarded for incomplete data. No statistical differences were found in CG vs EP HY 1-2, differences were found regarding higher severity of PD HY 3-4 in total [F (2,52)=8.036, p=0.001], subcortical [F (2,52)=6.734, p=0.003], and cortical scores [F (2,52)=4.060, p=0.023]. Risk of dementia is associated to cortical subtest naming and copy of a clock. When comparing severity of PD HY1-2 vs HY3-4, lower scores were found only for naming subtest (p= 0.021). Cognitive decline appeared in total (p=0.003), subcortical (p=0.001), and cortical scores (p=0.012). Subcortical differences were found in attention (p=0.001), delayed verbal memory (p=0.014), and alternating fluency (p= 0.005).

Conclusions: Association of PD and cognitive impairment is easy identifiable in late stages of PD. Decline in specific areas may occur with progression of disease. In HY 3-4 stages, cortical and subcortical functioning account for cognitive impairment. For dementia risk only naming test appear to contribute for cortical impairment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-of-parkinsons-disease-severity-and-cortical-and-subcortical-cognitive-markers/