• Jennifer Wojtala, Ines Ann Heber, Petra Neuser, Julia Heller, Elke Kalbe, Sarah P Rehberg, Alexander Storch, Katharina Linse, Christine Schneider, Susanne Gräber, Daniela Berg, Judith Dams, Monika Balzer-Geldsetzer, Rüdiger Hilker-Roggendorf, Carola Oberschmidt, Simon Baudrexel, Karsten Witt, Nele Schmidt, Günther Deuschl, Brit Mollenhauer, Claudia Trenkwalder, Inga Liepelt-Scarfone, Annika Spottke, Sandra Roeske, Ullrich Wüllner, Hans-Ulrich Wittchen, Oliver Riedel, Richard Dodel, Jörg B Schulz, and Kathrin Reetz.
• Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany.
• J. Neurol. Neurosurg. Psychiatr. 2019 Feb 1; 90 (2): 171-179.

ObjectivesParkinson's disease (PD) is the second most common neurodegenerative disorder and is further associated with progressive cognitive decline. In respect to motor phenotype, there is some evidence that akinetic-rigid PD is associated with a faster rate of cognitive decline in general and a greater risk of developing dementia.The objective of this study was to examine cognitive profiles among patients with PD by motor phenotypes and its relation to cognitive function.MethodsDemographic, clinical and neuropsychological cross-sectional baseline data of the DEMPARK/LANDSCAPE study, a multicentre longitudinal cohort study of 538 patients with PD were analysed, stratified by motor phenotype and cognitive syndrome. Analyses were performed for all patients and for each diagnostic group separately, controlling for age, gender, education and disease duration.ResultsCompared with the tremor-dominant phenotype, akinetic-rigid patients performed worse in executive functions such as working memory (Wechsler Memory Scale-Revised backward; p=0.012), formal-lexical word fluency (p=0.043), card sorting (p=0.006), attention (Trail Making Test version A; p=0.024) and visuospatial abilities (Leistungsprüfungssystem test 9; p=0.006). Akinetic-rigid neuropsychological test scores for the executive and attentive domain correlated negatively with non-tremor motor scores. Covariate-adjusted binary logistic regression analyses showed significant odds for PD-mild cognitive impairment for not-determined as compared with tremor-dominant (OR=3.198) and akinetic-rigid PD (OR=2.059). The odds for PD-dementia were significant for akinetic-rigid as compared with tremor-dominant phenotype (OR=8.314).ConclusionThe three motor phenotypes of PD differ in cognitive performance, showing that cognitive deficits seem to be less severe in tremor-dominant PD. While these data are cross-sectional, longitudinal data are needed to shed more light on these differential findings.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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