Clinical & Neuropsychological profile in patients with Parkinson’s disease and Parkinson’s Plus syndromes: study from a tertiary care referral centre in a developing country

Abu Zafar Ansari,¹ Deepika Joshi,¹ Vijay Nath Mishra,¹ Rameshwar Nath Chaurasia,¹ Shailesh Gupta,² Baidanath Kumar,¹ Vijay Nandmer,¹ Arun Kumar<sup>1

1</sup>Dept. of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India; ²Dept. of Cl. Neurophysiology, Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India

Background: Cognitive dysfunction is an important cause of disability in Parkinson’s disease (PD) and Parkinson’s Plus syndrome (PD Plus). The development of dementia in PD has significant impact on the natural history of disease with rapid progression of disability and increased mortality. The present study aimed to evaluate the clinical and neuropsychological profile in patients with PD and PD Plus syndromes.
Methods: Forty-one patients with a diagnosis of probable PD, and Parkinson’s Plus syndromes with minimum of fifth standard education were enrolled. They were evaluated with the UPDRS, Hoehn & Yahr staging, MMSE and AIIMS comprehensive neuropsychological battery in Hindi (adult form) using the eight lobar scales for the right and left hemisphere. Patients were then compared with age and gender matched controls.
Results: Parkinson’s disease (85.4%) comprised the majority of cases followed by PSP (12.2%) and CBGD (2.4%). The MMSE scores were significantly reduced in the patients as compared to controls. Neuropsychological testing revealed that the mean T scores of the lobar scales (both right and left hemispheres) in patient group (LF – 77.33; LSM 76.57; LPO – 79.26; LT- 82.74; RF – 95.14; RSM – 92.05; RPO – 73.86; RT- 74.45) were higher & remarkably significant as compared to the controls (p<0.0005) particularly stage II and above.
Conclusion: Our study revealed neuropsych-ological dysfunction involving right hemisphere more than the left. The AIIMS test battery was more sensitive for cognitive evaluation in this study, as about 70% patients who had impaired cognitive function with this battery had scored normal on MMSE.