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Review
. 2024 Sep 2:18:e20230102.
doi: 10.1590/1980-5764-DN-2023-0102. eCollection 2024.

Associations between cognitive screening performance and motor symptoms in Parkinson's disease:a systematic review and meta-analysis

Karlee Patrick  1 , Elizabeth Cousins  1 , Mary Beth Spitznagel  1
Affiliations
Review

Associations between cognitive screening performance and motor symptoms in Parkinson's disease:a systematic review and meta-analysis

Karlee Patrick et al. Dement Neuropsychol. .

Abstract
in English, Portuguese

Although the most prominent symptoms of Parkinson's disease (PD) are those impacting movement, cognitive dysfunction is prevalent and often presents early in the disease process. Individuals with cognitive symptoms of PD often complete cognitive screening, making it important to identify factors associated with cognitive screening performance to ensure prompt and accurate detection of cognitive impairments.

Objective: Despite a body of research examining relationships between motor symptoms and cognitive dysfunction in PD, no prior study has undertaken a systematic review of the magnitude of the relationship between motor symptoms and cognitive screening performance in PD.

Methods: This study was a systematic review and meta-analysis of the relationship between cognitive screening performance, as assessed by the Montreal Cognitive Assessment (MoCA), and motor symptoms of PD. After the systematic screening, 20 studies were included, and meta-regressions using mixed-effects models were conducted.

Results: Motor symptoms across included studies were relatively mild, but average MoCA scores were at the established cutoff for risk of dementia in PD. The average disease duration was 5 years. Consistent with hypotheses, more severe motor symptoms were associated with lower MoCA scores (r=-0.22 (95%CI -0.29 to -0.16), p<0.001), indicating worse cognitive functioning.

Conclusion: The results indicate a significant negative correlation between MoCA performance and motor symptoms of PD. Average MoCA scores captured early disease-stage cognitive impairment when motor symptoms remained relatively mild. Serial screening for cognitive impairment beginning early in the disease course may be of benefit to ensure that cognitive dysfunction is detected as it arises.

Embora os sintomas mais proeminentes da doença de Parkinson (DP) sejam aqueles que afetam o movimento, a disfunção cognitiva é prevalente e muitas vezes se apresenta no início do processo da doença. Indivíduos com sintomas cognitivos de DP frequentemente realizam triagem cognitiva, tornando importante identificar os fatores associados ao desempenho da triagem cognitiva para garantir a detecção rápida e precisa de deficiências cognitivas.

Objetivo: Apesar de um conjunto de pesquisas examinar as relações entre sintomas motores e disfunção cognitiva na DP, nenhum trabalho anterior realizou uma revisão sistemática da magnitude da relação entre sintomas motores e desempenho na triagem cognitiva na DP.

Métodos: O presente estudo foi uma revisão sistemática e meta-análise da relação entre o desempenho da triagem cognitiva, avaliada pela Avaliação Cognitiva de Montreal (Montreal Cognitive Assessment – MoCA), e os sintomas motores da DP. Após triagem sistemática, 20 estudos foram incluídos e foram realizadas meta-regressões utilizando modelos de efeitos mistos.

Resultados: Os sintomas motores nos estudos incluídos foram relativamente leves, mas as pontuações médias do MoCA estavam no ponto de corte estabelecido para o risco de demência na DP. A duração média da doença foi de 5 anos. Consistente com as hipóteses, sintomas motores mais graves foram associados a pontuações mais baixas no MoCA, r=-0,22 (IC95% -0,29 to -0,16), p<0,001), indicando pior funcionamento cognitivo.

Conclusão: Os resultados indicam uma correlação negativa significativa entre o desempenho no MoCA e os sintomas motores da DP. As pontuações médias do MoCA capturaram o comprometimento cognitivo em estágio inicial da doença, quando os sintomas motores permaneceram relativamente leves. O rastreio em série do comprometimento cognitivo que começa no início do curso da doença pode ser benéfico para garantir que a disfunção cognitiva seja detectada à medida que surge.

Keywords: Mental Status and Dementia Tests; Movement Disorders; Parkinson’s Disease.

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Conflict of interest statement

Conflict of interest: The authors no conflicts of interest.

Figures

Figure 1
Figure 1. PRISMA flow diagram.
Figure 2
Figure 2. Forest plot of included studies.
Figure 3
Figure 3. Funnel plot of included studies.
See this image and copyright information in PMC

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