Cognitive and Motoric Sequelae of Dopaminergic Intervention in Parkinson's Disease [microform]
- ISBN-10
- 0612680479
- ISBN-13
- 9780612680470
- Category
- Parkinson's disease
- Pages
- 290
- Language
- English
- Published
- 2001
- Publisher
- National Library of Canada = Bibliothèque nationale du Canada
- Author
- Andrew Malcolm Johnson
Description
Despite the fact that recent research has begun to apply expensive and technologically advanced imaging techniques to the study of Parkinsonian reaction time deficits, few studies have employed appropriate methodological techniques in controlling for aspects of PD relevant to its clinical management--particularly with regards to the effects of medication. Furthermore, although PD is considered to be a movement disorder, the tendency of impairment to co-vary with the cognitive complexity of the task suggests some higher-level cognitive involvement. In the present study, 40 PD patients, and 40 matched controls were tested on a battery of visuospatial processing, verbal memory, and short-term memory scanning tasks. Both patients and controls were tested twice, with a two-hour delay--patients were tested both off and on their medications. Results suggest that the mean scores for all components of movement are impaired in a PD population, with "motor-dominant" tasks showing greater impairment than "cognition-dominant" tasks. Despite the fact that reaction time was successful in discriminating between PD patients and controls, none of the tasks demonstrated a significant medication effect for their RT component. This suggests that bradyphrenia (slowness of thought) is not reduced by current dopaminergic intervention. Furthermore, manipulation of stimulus degradation within a Sternberg paradigm demonstrated the presence of a significant visuospatial learning deficit in PD patients. Although the results of cognitive tasks in this study are generally supportive of current findings in the literature, the non-cognitive tasks suggest a novel motor programming model--a "motor packaging" model of motor learning, in which the required number of motor subcomponents is reduced through practice. Unmedicated PD patients demonstrate significantly impaired use of "packaged motor solutions", and their use of motor solutions improves significantly following dopaminergic medication. These discrepancies support the hypothesis that the basal ganglia are centrally involved in the production of these motor packages. Finally, when used to classify patients and controls, the information processing speed battery was able to correctly classify 93.6% of unmedicated patients, and 80.8% of the medicated patients. This suggests that batteries of information processing speed may be useful adjuncts to traditional qualitative assessments of neurological impairment.
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