Dynamics of Cognitive Impairments in Patients with Parkinson’s Disease Receiving L-DOPA Treatment

• Published in: Neuroscience and behavioral physiology Vol. 52; no. 3; pp. 368 - 372
• Main Authors: Ismailova, S. B., Prokopenko, S. V., Pokhabov, D. V., Mosaleva, E. I., Alekseenko, P. V., Zhumzhanov, I. M.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2022; Springer Nature B.V
• Subjects: Behavioral Sciences; Biomedical and Life Sciences; Biomedicine; Cognitive ability; Levodopa; Movement disorders; Neurobiology; Neurodegenerative diseases; Neurosciences; Parkinson's disease; Patients; Scopa; Statistical analysis; MoCA; neuropsychological investigations; levodopa; FAB; SCOPA-Cog; nonmotor manifestations; L-DOPA therapy; Parkinson’s disease
• DOI: 10.1007/s11055-022-01250-2
• EISSN: 1573-899X
• ISSN: 0097-0549

Objectives.
To assess the dynamics of cognitive impairment (CI) in patients with Parkinson’s disease (PD) during L-DOPA treatment.
Materials and methods.
A randomized clinical trial included 41 patients with confirmed diagnoses of PD at stage 2.5–3.5 on the Hoehn and Yahr scale, mainly of the akinetic-rigid and mixed forms, who were taking levodopa and had PD-associated CI syndrome. Mean duration of illness was five years. The design included randomization of study participants to two groups. The dynamics of CI were assessed using neuropsychological investigations on two occasions separated by six months: group 1 in the on and off phases of L-DOPA therapy and group 2 in the off and on phases of levodopa therapy, respectively. The state of CI was assessed on the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Scales for Outcomes in Parkinson’s Disease – Cognition (SCOPA-Cog), and the Geriatric Depression Scale (GDS).
Results.
A statistically significant improvement in cognitive status was seen at the on phase of levodopa action, along with degradation in the off phase of L-DOPA therapy in the form of increased cognitive deficit (
p
< 0.05).
Conclusions.
CI in PD may to some extent be dependent on L-DOPA therapy, as well as on motor signs. The most dynamic functions on the background of L-DOPA therapy were attention, language, and executive and visuospatial functions.