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Attentional Set-Shifting in Parkinson’s Disease Patients with Freezing of Gait-Acquisition and Discrimination Set Learning Deficits at the Background?

Published online by Cambridge University Press:  13 October 2014

Elka Stefanova ,
Milica Ječmenica Lukić ,
Ljubomir Žiropadja ,
Vladana Marković ,
Tanja Stojković ,
Aleksandra Tomić ,
Nataša Dragašević Mišković  and
Vladimir Kostić
Elka Stefanova*
Affiliation:
Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Neurology, CCS, Belgrade, Serbia
Milica Ječmenica Lukić
Affiliation:
Clinic of Neurology, CCS, Belgrade, Serbia
Ljubomir Žiropadja
Affiliation:
Faculty of Philology, University of Belgrade, Belgrade, Serbia
Vladana Marković
Affiliation:
Clinic of Neurology, CCS, Belgrade, Serbia
Tanja Stojković
Affiliation:
Clinic of Neurology, CCS, Belgrade, Serbia
Aleksandra Tomić
Affiliation:
Clinic of Neurology, CCS, Belgrade, Serbia
Nataša Dragašević Mišković
Affiliation:
Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Neurology, CCS, Belgrade, Serbia
Vladimir Kostić
Affiliation:
Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Neurology, CCS, Belgrade, Serbia
*
Correspondence and reprint requests to: Elka Stefanova, Faculty of Medicine University of Belgrade, Clinic of Neurology, CCS, 11000 Belgrade, Serbia. E-mail: steela21@gmail.com
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Abstract

Cognitive loading aggravates the freezing of gait (FoG), which is observed in approximately 50% of patients with Parkinson’s disease (PD) in the advanced stages. To investigate whether a specific pattern of executive deficits, that is, attentional set-shifting and/or inhibitory control, are associated with FoG in PD, 30 PD patients with FoG (PD-FoG+) and 36 PD patients without FoG (PD-FoG−) and 22 control healthy subjects were examined with a comprehensive neuropsychological battery. Intra-Extra Dimensional Set shifting Test (IED) and Stop Signal Task (SST), selected from the Cambridge Automated Neuropsychological Battery (CANTAB battery), were administered to analyze set-shifting and motor inhibition, respectively. The IED task was significantly sensitive for differentiating between PD-FoG+ and PD-FoG− groups (p<.01), as well Adenbrook’s clock drawing task (p=.033). By contrast, no differences emerged on any aspect of the SST task and other cognitive tasks. The attrition rate during the IED task showed that the problem in the PD-FoG+ group appeared at the pre-ID level, on the discrimination-learning set; the 32% PD-FoG+ subjects did not achieve the ID level of the task in comparison to negligible 4% of the PD-FoG− patients (p=.011). The logistic regression analysis, indicated the higher the IED stage successfully completed, the less likely presence of FoG in PD subjects. These results demonstrate that the complex cognitive–motor interplay might be responsible for FoG in PD and have had real life implication for the patients. (JINS, 2014, 20, 1–8)

Keywords

CognitionDiscrimination learningAttentionMovement disorderhumansFreezing
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 9 , October 2014 , pp. 929 - 936
Copyright
Copyright © The International Neuropsychological Society 2014 

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