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Obsessive compulsive symptoms and cognitive performance in PD patients

Background: A dysfunction in the frontobasal ganglia circuitry has been implicated in the pathophysiology of obsessive-compulsive (OC) disorders and Parkinson&#8217; s disease (PD). There are studies demonstrating higher incidence of OC symptoms in PD patients, a fact that was explained by involvement of a shared circuitry in their pathogenesis. The intact activity of frontobasal ganglia circuitry has been found important for cognitive performance, especially on executive tasks. Impaired cognitive performance has been found in OC patients and it could be speculated that PD patients with OC symptoms are additionally cognitively impaired. Objective: To assess association between OC symptoms and cognitive performance in non-demented PD patients. Patients and Methods: 30 non-demented PD patients with OC symptoms and 40 PD patients without OC symptoms were included in the study. Diagnosis of PD was based according to the UK PD Society Brain Bank criteria. The two groups did not differ for age, education and disease severity according to Hoehn &Yahr stage. To enlist OC symptoms checklist of symptoms was used. To assess severity of OC symptoms Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was administered. A clinical diagnosis of presence of OC symptoms was made if the total Y-BOCS score was greater than 8. Severity of depression was assessed in all patients using the Beck Depression Inventory. Neuropsychological testing included Digit Span test, letter and category fluency, Trail Making test A and B, Hooper Visual Organization Test and Stroop Colour Word Naming test. Results: According to scores obtained on BDI, PD patients with OC symptoms tended to be more depressed, but this difference was not statistically significant (p>0.05). Patients with OC symptoms has significantly worse performance on Stroop Interference test than patients without OC symptoms (ANOVA p<0.05). No significant difference was found between groups regarding cognitive performance on other tasks assessing attention, executive functions, semantic memory and visuospacial abilities. Discussion: PD patients with OC symptoms performed worse on tests of response inhibition, measuring mainly executive functions. This could be due to higher co occurrence of depression with OC symptoms, but it could not be ruled out that OC symptoms in PD patients additionally contribute to specific cognitive dysfunction, mainly in domain of executive functions.

cognition; Parkinson's disease; obsessive-compulsive symptoms

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