Objective: To compare the cognitive function between unilateral and bilateral PD to identify whether worse cognitive impairment underlies in the bilateral group who had greater burden of dopaminergic degeneration.

Background: Progressive degenerative changes in nigral dopamine neuron is a pathologic hallmark of PD. Converging evidence has described that the level of dopaminergic neurodegeneration is closely associated with the severity of nonmotor manifestations as well as motor dysfunction. Cognitive dysfunction is a type of very well-known non-motor dysfunction in PD.

Method: This retrospective study included 15 unilateral and 16 bilateral PD, respectively. All the subjects underwent [¹⁸F] N-(3-Fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane positron emission tomography, the Korean version of Mini-Mental Status Exam (K-MMSE), and Montreal Cognitive Assessment (K-MoCA) at their initial diagnosis.

Results: The scores of K-MMSE (25.6 ± 4.1 vs 21.2 ± 5.5, p = 0.017) and K-MoCA (19.7 ± 5.2 vs 14.3 ± 7.2, p = 0.023) were significantly lower in the bilateral group than those in the unilateral group, respectively. The bilateral PD group was strongly associated with a lower K-MMSE score (regression coefficient (standard error), -2.99 (1.27), p = 0.03) and showed trend without significance with lower K-MoCA score (-3.23 (1.73), p = 0.07). The cognitive status between different lateral group was not found.

Conclusion: Our data demonstrated a worse cognitive decline in the bilateral PD group compared to the unilateral group. This result is in accordant with antecedent results of the close quantitative association between dopaminergic degeneration and cognitive dysfunction. We may need to more carefully pay attention to cognitive function in bilaterally presented PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparative-analysis-of-cognitive-function-between-unilaterally-and-bilaterally-affected-parkinsons-disease/