Objective: The objective of this study was to explore the pattern of cognitive dysfunction in the patient’s with Parkinson’s disease and psychosis (PD-P) by comparing the cognitive characteristics of PD-P with those without psychosis (PD-NP) and healthy controls (HC).

Background: Psychosis is one of the debilitating non-motor symptoms of PD which commonly manifests through minor hallucinations (such as passage hallucinations, presence hallucinations, and illusions) and well-formed visual hallucinations. Several studies have suggested a strong association of cognitive impairment with psychosis in PD. In fact, cognitive impairment is considered as a risk factor for the emergence of psychosis in PD.

Method: This study recruited a total of 150 subjects (PD-P: 50, PD-NP: 50, HC: 50).  The three groups were matched for age, gender, and education. Assessment of the global cognitive function was done by the Montreal cognitive assessment scale (MoCA). A set of neuropsychological tests assessed several cognitive domains that include executive functions [frontal assessment battery (FAB) and Stroop test], attention (Color trail and digit span), visuo-spatial functions [Rey’s complex figure test (CFT), memory and learning [Rey’s auditory and verbal learning test (RAVLT)], language (animal naming test) of all the subjects.

Results: The three groups were matched for age, gender, and years of education. HC had better performance in the tests assessing the global cognitive function (MMSE and MoCA) compared to both the patient groups. However, both PD-P and PD-NP had similar MoCA scores. In all the tests, PD-P group had poor performance compared to PD-NP; however, the differences were significant in FAB, RAVLT trial-5, RAVLT-total learning, RAVLT (IR and DR), and CFT (copy, immediate and delayed recall).

Conclusion: Patient with PD-P have significantly poor cognitive function compared to PD-NP. The cognitive domains that were significantly affected in the PD-P were executive functions, memory and learning, and visuo-spatial functions. Although this study reinforces the association of PD-P with cognitive impairment, additional longitudinal studies are warranted to understand the natural course of these two NMS and relationship.

References: 1) Pattern of cognitive impairment in patients with Parkinson’s disease and psychosis: A critical review.; Lenka A, Hegde S, Arumugham SS, Pal PKParkinsonism Relat Disord. 2017 Apr;37:11-18. doi: 10.1016/j.parkreldis.2016.12.025. Epub 2016 Dec 29.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-dysfunction-in-patients-with-parkinsons-disease-and-psychosis/