The aim of the study was to improve the assessment of the dynamics of motor and cognitive deficits in patients with Parkinson's syndrome within 6 months on a background of an optimal antiparkinsonian therapy. We employed such methods as clinical neurological examination with a quantitative assessment of motor, cognitive, affective and psychotic disorders; analysis of medical records, and statistical analysis. The optimal antiparkinsonian therapy showed variation in the rate of disease progression, while about a quarter of the patients manifested rapid rate of progression of motor disorders. The deterioration of cognitive function was observed in 25 % of patients and in 12 % of patients with mild cognitive impairment during 6 months of developing dementia. Neurodynamic, regulatory and visual-spatial cognitive functions were affected most by negative dynamic in patients with Parkinson's syndrome. The antiparkinsonian therapy in 29.4 % of patients provoked psychotic violations, more often in patients with more severe visual-spatial and regulatory cognitive disabilities. We recommend using the test that had been involved in our work in order to improve the assessment of the dynamics in patients with Parkinson's syndrome. The highest rate of progression of motor function was marked in patients with mild cognitive impairment due to the relationship between cognitive and mental disorders. The qualitative feature of patients with severe cognitive impairment was predominant growth of motor disorders in axial sections.
Key words: cognitive impairment, Parkinson's disease, cyclodol, dementia, mental disorders.
The full text
- Lutskii IS, Evtushenko SK, Simonian VA. Bolezn Parkinsona (klinika, diagnostika, pritsipy terapii) [Parkinson’s disease (symptoms, diagnosis and therapy)]. Donetsk, 2011, 174 p.
- del Dotto P, Pavese N, Gambaccini G. Intravenous amantadine improves levodopa-disease: a double-blind рlacebo-controlled study. New York, 2000, pp.82–85.
- Rabey JM, Sagi I, Huberman M, Melamed E, Korczyn A, Giladi N, Inzelberg R, et al. Rasagiline mesylate, a new MAO-B inhibitor for the treatment of Parkinson’s disease: a double-blindstudy as unjunctive therapy to levodopa. Clinical Neuropharmacology. 2000;23(6):324–330.
- Tarsy D, Baldessarini RJ, Tarazi FI. Effects of newer antipsychotics on extrapyramidal function. CNS Drugs. 2002;16(1):23–45.
- Shtok VN, Ivanova-Smolenskaia IA, Levin OS. Ekstrapiramidnye rasstroistva: rykovodstvo po diagnostike i lecheniiu [Extrapyramidal disorders: guidelines for diagnosting and treatment]. Moscow: MEDpress-inform Publ., 2002, 608 p.
- Khoffman F. Bolezn Parkinsona i ee lechenie [Parkinson’s disease and its treatment]. Moscow, 2000, 389 p.
- Brocks DR. Anticholinergic drugs used in Parkinson’s disease: an overlooked class of drugs from a pharmacokinetic perspective. Journal of Pharmacy and Pharmaceutical Sciences. 1999;2(2):39–46.
- Litvinenko IV. Bolezn Parkinsona i sindromy parkinsonizma [Parkinson’s disease and its symptoms]. Saint Petersburg, 2012, 102 p.
- Triumfov AV. Parkinsonizm. Topicheskaia diagnostika zabolevanii nervnoi sistemy [Parkinsonism. Localization diagnosis of the nervous system diseases]. Moscow: MEDpress Publ., 1998, 304 p.
- Oldfield V, Keating GM, Perry CM. Rasagiline: a review of its use in the management of Parkinson’s disease. Drugs. 2007;67(12):1725–47.
- Golubev VL, Levin YaI, Vein AM. Bolezn Parkinsona i sindrom parkinsonizma [Parkinson’s disease and syndrome]. Moscow: MEDpress Publ., 2000, 53 p.
- Rogovina EG, Manevich TM, Nechkina PN, Yakhno NN. Yuvenilnyi parkinsoniz – distoniia [Juvenile Parkinsonism – dystonia]. Moscow, 2001, 24 p.
- Higginson CI, King DS, Levine D, Wheelock VL, Khamphay NO, Sigvardt KA. The relationship between executive function and verbal memory in Parkinson’s disease. Brain and Cognition. 2003;52(3):343–52.
- Illarioshkin SN, Yakhno NN. Bolezn Parkinsona i rasstroistva dvizhenii: rukovodstvo dlia vrachei [Parkinson’s disease and motor disorders: manual for doctors]. Moscow, 2008, 405 p.
- Brooks DJ. Morphological and functional imaging studies on the diagnosis and progression of Parkinson’s disease. Journal of Neurology. 2000;247 Suppl 2:II11–8.
- Khykina TA. Sovremennye predstavleniia o neiropsikhologicheskikh narysheniiakh pri bolezni Parkinsona [Modern views on neuropsychological disorders during Parkinson’s disease]. Mezhd. nevrol. zhurnal. 2011;6(44):114–119.
- Shin J. Subcortical white matter hyperintensities within the cholinergic pathways of Parkinson’s disease patients according to cognitive status. Journal of Neurology, Neurosurgery, and Psychiatry. 2012;83(3):315–321.
- Chouinard G, Margolese HC. Manual for the Extrapyramidal Symptom Rating Scale. Schizophrenia Research. 2005;76(2–3):247–65.
- Belova AN. Shkaly i oprosniki v nevrologii i neirokhirurgii [Scales and questionnaires for neurology and neurosurgery]. Moscow, 2004, 432 p.
- Benamer HT, Grosset DG. Vascular parkinsonism: a clinical review. European Neurology. 2009;61(1):11–5. doi: 10.1159/000165343