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. 2025 Jul 4:13:100365.
doi: 10.1016/j.prdoa.2025.100365. eCollection 2025.

Distinctive cognitive phenotypes in Parkinson's disease patients with GBA mutations and without dementia: a multicentre cross-sectional retrospective study

Chiara Longo  1   2 , Marco Liccari  3   4 , Ruggero Bacchin  1 , Costanza Papagno  5 , Donatella Ottaviani  1 , Raffaella Di Giacopo  1 , Mauro Catalan  3 , Alina Menichelli  3 , Massimo Marano  6   7 , Alessio Di Fonzo  8   9 , Giovanni Duro  10 , Carmela Zizzo  10 , Paolo Manganotti  3   11 , Bruno Giometto  1   5 , Maria Chiara Malaguti  1
Affiliations

Distinctive cognitive phenotypes in Parkinson's disease patients with GBA mutations and without dementia: a multicentre cross-sectional retrospective study

Chiara Longo et al. Clin Park Relat Disord. .

Abstract

Background: Cognitive impairment is a major non-motor complication of Parkinson's disease (PD). GBA mutations are associated with an increased risk, with PD-GBA+ patients typically showing earlier disease onset and faster cognitive decline. However, the specific cognitive phenotype of these patients remains unclear.

Aim: To provide a detailed neuropsychological profile of PD-GBA+ patients compared to PD-GBA- patients.

Methods: Data from 18 PD-GBA+ and 68 PD-GBA- patients were retrospectively analyzed. All participants underwent comprehensive neurological evaluations of motor and non-motor symptoms, along with a Level II neuropsychological assessment based on the MDS criteria for mild cognitive impairment (MCI). Patients with dementia were excluded.

Results: PD-GBA+ patients showed significantly lower cognitive performance, particularly on the RAVLT immediate recall (RAVLT-IR, p < 0.001) and delayed recall (RAVLT-DR, p = 0.002). All PD-GBA+ patients exhibited an amnestic multi-domain MCI phenotype. In contrast, the PD-GBA- group predominantly showed a non-amnestic single-domain MCI, characterized by a dysexecutive profile. Additionally, PD-GBA+ patients had a higher prevalence of freezing of gait (p < 0.001), right-sided motor symptom lateralization (p = 0.011), and REM sleep behavior disorder (p = 0.006).

Conclusions: PD-GBA+ patients exhibit a distinctive cognitive phenotype, already evident in the early stages of the disease. These results highlight the added value of Level II neuropsychological assessment in accurately characterizing the clinical phenotype and identifying patients at higher risk of developing dementia. Early cognitive profiling may thus contribute to more targeted monitoring and personalized therapeutic strategies.

Keywords: Cognition; GBA mutation; Memory; Mild Cognitive Impairment; Parkinson’s Disease.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Radar graph of motor and non-motor symptoms in PD-GBA+ and PD-GBA-. The radar amplitude corresponds to the frequency of the disturbance. FOG = Freezing of gait; ICD = Impulsive control disorder; Motor fluct. = Motor fluctuations; RA motor phenotype = Rigid-akinetic motor phenotype; RBD = REM sleep Behavior Disorder; Right motor lateral. = Right motor lateralization.
Fig. 2
Fig. 2
A) Types of MCI in the two groups. MCI a-sd = Mild Cognitive Impairment amnesic-single domain; MCI a-md = Mild Cognitive Impairment amnesic-multiple domain; MCI na-sd = Mild Cognitive Impairment non-amnesic-single domain; MCI na-md = Mild Cognitive Impairment non-amnesic-multiple domain. B) Radar graph of the frequency of cognitive domain compromised in each group.
See this image and copyright information in PMC

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