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[Dynamics of cognitive impairments during L-dopa therapy in Parkinson's disease].

  • 2021
  • Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova 121(7)
    • S B Ismailova
    • S V Prokopenko
    • D V Pokhabov
    • E I Mosaleva
    • P V Alekseenko
    • I M Zhumzhanov

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 41
Population
41 patients with Parkinson's disease (PD) stages 2.5-3.5 by Hoehn-Yahr scale
Methods
Randomized clinical study, two groups assessed at peak and outcome of L-DOPA therapy with 6-month interval
Duration
6 months

Objective

To assess the dynamics of cognitive impairments (CI) in patients with Parkinson's disease (PD) during L-dopa therapy.

Material and methods

The randomized clinical study included 41 patients with a refined diagnosis of PD 2.5-3.5 stages by Hoehn-Yahr scale, mainly with akinetic-rigid and mixed forms, and with CI associated with PD. All patients were on levodopa therapy. The average duration of the disease was 5 years. The study participants were randomized into two groups according to the design. To assess the dynamics of CI, a neuropsychological study was carried out twice with an interval of 6 months: in group I - at the «peak and outcome» of L-DOPA therapy, and in group II - at the «outcome and peak» of levodopa therapy, respectively. Assessment of cognitive functions (CF) was carried out using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog), Geriatric Depression Scale (GDS).

Results

The statistically significant improvement of CF at the «peak» of levodopa drugs and the deterioration at the «outcome» of L-DOPA therapy in the form of an increase in CI (p<0.05) was revealed.

Conclusion

CI in PD, in a certain extent, may be dependent on L-DOPA therapy as well as motor manifestations. The most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.

Research Insights

  • L-DOPA→Improved Attention Span

    The statistically significant improvement of CF at the «peak» of levodopa drugs ... the most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.

    Effect
    Beneficial
    Effect size
    Small
  • L-DOPA→Improved Cognitive Function

    The statistically significant improvement of CF at the «peak» of levodopa drugs ... the most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.

    Effect
    Beneficial
    Effect size
    Small
  • L-DOPA→Improved Speech Function

    The statistically significant improvement of CF at the «peak» of levodopa drugs ... the most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.

    Effect
    Beneficial
    Effect size
    Small
  • L-DOPA→Improved Visual-Spatial Function

    The statistically significant improvement of CF at the «peak» of levodopa drugs ... the most dependent on L-DOPA therapy CF were attention, speech, executive and visual-spatial functions.

    Effect
    Beneficial
    Effect size
    Small
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