Frontal dysfunction as a cognitive biomarker in prodromal Parkinson’s disease [Póster]

Results: 1Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain; 2Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain; 3Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain, 4. Departamento de Psicología Experimental. Facultad de Psicología, Universidad de Sevilla. Jesús S. 1,2; Muñoz-Delgado L.1,2; Castellano-Guerrero AM.1,2; San Eufrasio M.1,2; Adarmes-Gómez, A.D. 1,2; Macías-García D. 1,2; Franco-Rosado P. 1,2; Villarreal B1; Benitez B. 1; Pérez-Calvo C.1; Carrillo F. 1,2,3; Martín-Rodríguez JF1,2,4; Mir P. 1,2,3 Objective: To assess specific cognitive biomarkers to increase the sensibility for the diagnosis of Prodromal Parkinson’s disease (pPD) that could help to identify these patient. Background:pPD criteria feature a high specificity up to 98.3%, but a lack of sensitivity ranged from 4.5-27.3%. Global cognitive decline is a prodromal marker for pPD but with low positive likelihood ratio (1.8). More specifically, frontal cognitive dysfunction has been shown to be a common cognitive feature of prodromal stages of PD. Thus, searching for new biomakers with a higher impact to optimize the identification of the prodromal phase of Parkinson’s disease (PD) is crucial. a.Clinical and demographc features b. Neuropsychological assessment: Methods: We evaluated a cohort of patients with pPD, PD at their early stage (less than five years of disease evolution and a Modified Hoehn&Yahr scale <2.5) and healthy controls (HC). They were enrolled during the years 2018 to 2023 to prospective observational research study of individuals at risk of PD conducted in the “Movement Disorders Unit at the University Hospital “Virgen del Rocio” in Seville (Spain). A detail clinical evaluation and a large neuropsychological battery were performed. The neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Parkinson`s Disease Cognitive Rating Scale (PD-CRS) and Frontal Lobe Assessment Battery (FAB). ANCOVA tests was applied to assess differences among groups adjusted by age, sex and years of education. Post-hoc T- tests were applied to determine differences among groups. Conclusions: In addition to global cognitive deficits, pPD patients could present with selective frontal dysfunction. Thus, frontal functioning should be deeply assessed as a putative biomarker with a higher sensitivity in prodromal phases of PD. Frontal dysfunction as a cognitive biomarker in prodromal Parkinson’s disease 0 1 2 3 4 5 6 Visuospatial/execu tive (mean) Naming (mean) Attention (mean) Language (mean)Abstraction (mean) Delayed recall (mean) Orientation (mean) HC PD pPD 0 2 4 6 8 10 12 14 16 18 20 Immediate verbal memory (mean) Naming (mean) Attention (mean) Working memory (mean) Clock drawing (mean) Copy of a clock (mean) Delayed verbal memory (mean) Alternative fluency (mean) HC PD pPD 0 0,5 1 1,5 2 2,5 3 Conceptualization (mean) Mental flexibility (mean) Programming (mean) Sensitivity to interference (mean) Inhibitory control (mean) Environmental autonomy (mean) HC PD pPD Figure 1. MoCA test subdomains Figure 2. PD-CRS subdomains Figure 3. FAB test subdomains Regarding cognitive performance, ANCOVA showed main effects of group for MoCA (p<0.001), PD-CRS (p<0.001), and FAB (p<0.001)). Pair-wise tests between groups showed significantly lower performance in pPD compared to HC (MoCA p=0.002, PD-CRS p=0.001 and FAB p=0.01). Mainly, differences in the cognitive performance regarding frontal tasks were observed between pPD and HC (Table 2, 3 and 4; Figures 1, 2, 3) We included individuals with pPD (n=40), patients with a clinical diagnosis of PD (n=50), and HC (n=36). Demographic features are included in Table 1. a: p value<0.05 of post-hoc T-tests between HC and pPD; b: p value<0.05 of post-hoc T-tests between HC and PD; c: p value<0.05 of post-hoc T-tests between pPD and PD. Table 1. Demographhic features Table 2, 3 and 4. Cognitive characteristics of the study sample