Neuropsychologic assessment in collaborative Parkinson's disease research: a proposal from the National Institute of Neurological Disorders and Stroke Morris K. Udall Centers of Excellence for Parkinson's Disease Research at the University of Pennsylvania and the University of Washington

Abstract

Cognitive impairment (CI) and behavioral disturbances can be the earliest symptoms of Parkinson's disease (PD), ultimately afflict the vast majority of PD patients, and increase caregiver burden. Our two Morris K. Udall Centers of Excellence for Parkinson's Disease Research were supported by the National Institute of Neurological Disorders and Stroke (NINDS) in an effort to recommend a comprehensive yet practical approach to cognitive and behavioral assessment to further collaborative research. We recommend a stepwise approach with two levels of standardized evaluation to establish a common battery, as well as an alternative testing recommendation for severely impaired subjects, and review supplemental tests that may be useful in specific research settings. Our flexible approach may be applied to studies with varying emphasis on cognition and behavior, does not place undue burden on participants or resources, and has a high degree of compatibility with existing test batteries to promote collaboration.

Figure. Penn-UW recommendations for cognitive and behavioral testing of PD subjects

Our recommended strategy for assessing cognition and behavior are shown. Refer to Table 2 for the test battery recommended for Level II and for examples of additional tests to consider for Supplemental Testing. Abbreviations. MoCA: Montréal Cognitive Assessment. NPI: Neuropsychiatric Inventory. DRS-2: Mattis Dementia Rating Scale-2. ^†Meet United Kingdom Parkinson’s Disease Society Brain Bank (UKPDSBB) clinical diagnostic criteria [30]. *While patients may not be able to complete the DRS-2, there is the capacity to examine subscale performances in the sections that they are able to complete.