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Background <p>Parkinson’s Disease (PD)-associated subjective cognitive decline (PDSCD) is defined as cognitive complaints without objective cognitive impairment. Based on most studies, it is associated with a greater risk of cognitive decline and may represent a prodromal stage of cognitive impairment.</p> Methods <p>The main objectives are to identify cognitive progression patterns and clinical predictors of worse cognitive decline within a large PD-SCD cohort with a 4-year followup. All patients belong to the prospective observational multicenter study COPPADIS.</p> Results <p>A total of 198 PD-SCD subjects were analyzed. Mean age was 60.9, mean disease duration 5.2, and mean PD-Cognitive Rating Scale (PD-CRS) 97.6. Subjects were classified as Progressors if their Reliable Change Index was ≤ − 1.64 at year 4, and as non-Progressors if it was &gt; − 1.64 (− 1.64 corresponded to − 16 on the PD-CRS). Progressors had significantly higher age, Movement Disorders Society-Unified PD Rating Scale (MDS-UPDRS) III, levodopa equivalent daily-dose, Non-Motor Symptom Scale total score, memory-related cognitive complaints, and prevalence of REM-sleep behavior disorder (RBD) at baseline. A linear mixed-effects model showed divergent cognitive trajectories between Progressors and non-Progressors (estimate = − 26.8; p &lt; 0.001), with no differences in motor trajectories. In the binary regression model, age (OR = 1.09; p = 0.001), MDS-UPDRS III (OR = 1.05, p = 0.008), and RBD (OR = 2.55, p = 0.010) at baseline were independent predictors of cognitive progression.</p> Conclusions <p>Subjects with PD-SCD do not consistently show cognitive decline, but rather exhibit a heterogeneous progression. Age, MDS-UPDRS III and RBD significantly increase the risk of a more aggressive cognitive phenotype. Future research on biomarkers will help explore additional cognitive predictors in PD-SCD.</p>

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Heterogeneity of cognitive progression and clinical predictors in Parkinson’s disease–subjective cognitive decline

  • 期刊论文

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  • 发表日期：

    2025年3月5日

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  • Jon Rodríguez-Antigüedad,
  • Saül Martínez-Horta,
  • Arnau Puig-Davi,
  • Andrea Horta-Barba,
  • Javier Pagonabarraga,
  • Teresa de Deus Fonticoba,
  • Silvia Jesús,
  • Marina Cosgaya,
  • Juan García Caldentey,
  • María Asunción Ávila-Rivera,
  • Nuria Caballol,
  • Inés Legarda,
  • Jorge Hernández Vara,
  • Iria Cabo,
  • Lydia López Manzanares,
  • Isabel González Aramburu,
  • Víctor Gómez Mayordomo,
  • Jessica González Ardura,
  • Julio Dotor García-Soto,
  • Carmen Borrué,
  • Berta Solano Vila,
  • María Álvarez Sauco,
  • Lydia Vela,
  • Sonia Escalante,
  • Esther Cubo,
  • Zebenzui Mendoza,
  • Isabel Pareés,
  • Pilar Sánchez Alonso,
  • María G. Alonso Losada,
  • Nuria López Ariztegui,
  • Itziar Gastón,
  • Javier Ruíz Martínez,
  • María Teresa Buongiorno,
  • Carlos Ordás,
  • Caridad Valero,
  • Víctor Puente,
  • Mónica Kurtis,
  • Marta Blázquez Estrada,
  • Pablo Martínez-Martín,
  • Pablo Mir,
  • Diego Santos-García,
  • A. D. Adarmes,
  • M. Almeria,
  • M. G. Alonso Losada,
  • A. Alonso Cánovas,
  • F. Alonso Frech,
  • R. Alonso Redondo,
  • I. Álvarez,
  • M. Álvarez Sauco,
  • A. Aneiros Díaz,
  • S. Arnáiz,
  • S. Arribas,
  • A. Ascunce Vidondo,
  • M. Aguilar,
  • M. A. Ávila,
  • N. Bernardo Lambrich,
  • H. Bejr-Kasem,
  • M. Blázquez Estrada,
  • M. Botí,
  • C. Borrue,
  • M. T. Buongiorno,
  • C. Cabello González,
  • I. Cabo López,
  • N. Caballol,
  • A. Cámara Lorenzo,
  • H. Canfield Medina,
  • E. Carabajal Pendón,
  • F. Carrillo,
  • F. J. Carrillo Padilla,
  • E. Casas,
  • M. J. Catalán,
  • P. Clavero,
  • A. Cortina Fernández,
  • M. Cosgaya,
  • A. Cots Foraster,
  • A. Crespo Cuevas,
  • E. Cubo,
  • T. de Deus Fonticoba,
  • O. de Fábregues-Boixar,
  • M. Díez-Fairen,
  • J. Dotor García-Soto,
  • E. Erro,
  • S. Escalante,
  • E. Estelrich Peyret,
  • N. Fernández Guillán,
  • P. Gámez,
  • M. Gallego,
  • J. García Caldentey,
  • C. García Campos,
  • C. García Díez,
  • J. M. García Moreno,
  • I. Gastón,
  • M. P. Gómez Garre,
  • V. Gómez Mayordomo,
  • J. González Aloy,
  • I. González-Aramburu,
  • J. González Ardura,
  • B. González García,
  • M. J. González Palmás,
  • G. R. González Toledo,
  • A. Golpe Díaz,
  • M. Grau Solá,
  • G. Guardia,
  • J. Hernández Vara,
  • A. Horta-Barba,
  • D. Idoate Calderón,
  • J. Infante,
  • S. Jesús,
  • J. Kulisevsky,
  • M. Kurtis,
  • C. Labandeira,
  • M. A. Labrador,
  • F. Lacruz,
  • M. Lage Castro,
  • S. Lastres Gómez,
  • I. Legarda,
  • N. López Ariztegui,
  • L. M. López Díaz,
  • D. López Domínguez,
  • L. López Manzanares,
  • B. López Seoane,
  • S. Lucas del Pozo,
  • Y. Macías,
  • M. Mata,
  • G. Martí Andres,
  • M. J. Martí,
  • J. C. Martínez Castrillo,
  • P. Martinez-Martin,
  • D. McAfee,
  • M. T. Meitín,
  • Z. Mendoza Plasencia,
  • M. Menéndez González,
  • C. Méndez del Barrio,
  • P. Mir,
  • J. Miranda Santiago,
  • M. I. Morales Casado,
  • A. Moreno Diéguez,
  • I. Muro García,
  • V. Nogueira,
  • A. Novo Amado,
  • S. Novo Ponte,
  • C. Ordás,
  • J. Pagonabarraga,
  • I. Pareés,
  • B. Pascual-Sedano,
  • P. Pastor,
  • A. Pérez Fuertes,
  • R. Pérez Noguera,
  • A. Planas-Ballvé,
  • L. Planellas,
  • M. A. Prats,
  • C. Prieto Jurczynska,
  • V. Puente,
  • M. Pueyo Morlans,
  • A. Puig Daví,
  • N. Redondo Rafales,
  • L. Rodríguez Méndez,
  • A. B. Rodríguez Pérez,
  • F. Roldán,
  • M. Ruíz De Arcos,
  • J. Ruíz Martínez,
  • P. Sánchez Alonso,
  • M. Sánchez-Carpintero,
  • G. Sánchez Díez,
  • A. Sánchez Rodríguez,
  • P. Santacruz,
  • D. Santos García,
  • J. C. Segundo Rodríguez,
  • M. Seijo,
  • M. Sierra Peña,
  • B. Solano Vila,
  • E. Suárez Castro,
  • J. P. Tartari,
  • C. Valero,
  • L. Vargas,
  • L. Vela,
  • C. Villanueva,
  • B. Vives,
  • Jaime Kulisevsky

摘要

Background

Parkinson’s Disease (PD)-associated subjective cognitive decline (PDSCD) is defined as cognitive complaints without objective cognitive impairment. Based on most studies, it is associated with a greater risk of cognitive decline and may represent a prodromal stage of cognitive impairment.

Methods

The main objectives are to identify cognitive progression patterns and clinical predictors of worse cognitive decline within a large PD-SCD cohort with a 4-year followup. All patients belong to the prospective observational multicenter study COPPADIS.

Results

A total of 198 PD-SCD subjects were analyzed. Mean age was 60.9, mean disease duration 5.2, and mean PD-Cognitive Rating Scale (PD-CRS) 97.6. Subjects were classified as Progressors if their Reliable Change Index was ≤ − 1.64 at year 4, and as non-Progressors if it was > − 1.64 (− 1.64 corresponded to − 16 on the PD-CRS). Progressors had significantly higher age, Movement Disorders Society-Unified PD Rating Scale (MDS-UPDRS) III, levodopa equivalent daily-dose, Non-Motor Symptom Scale total score, memory-related cognitive complaints, and prevalence of REM-sleep behavior disorder (RBD) at baseline. A linear mixed-effects model showed divergent cognitive trajectories between Progressors and non-Progressors (estimate = − 26.8; p < 0.001), with no differences in motor trajectories. In the binary regression model, age (OR = 1.09; p = 0.001), MDS-UPDRS III (OR = 1.05, p = 0.008), and RBD (OR = 2.55, p = 0.010) at baseline were independent predictors of cognitive progression.

Conclusions

Subjects with PD-SCD do not consistently show cognitive decline, but rather exhibit a heterogeneous progression. Age, MDS-UPDRS III and RBD significantly increase the risk of a more aggressive cognitive phenotype. Future research on biomarkers will help explore additional cognitive predictors in PD-SCD.