The concept of Mild Cognitive Impairment (MCI) in Parkinson’s disease (PD) has shown the potential for identifying at-risk dementia patients. Identifying subtypes of MCI is likely to assist therapeutic discoveries and better clinical management of patients with PD (PWP). Recent cluster-based approaches have demonstrated dominance in memory and executive impairment in PD. The present study will further explore the role of memory and executive impairment and associated clinical features in non-demented PWP.
A K-means cluster analysis was performed on ten “frontal” and “posterior” cognitive variables derived from a dataset of 85 non-demented PWP. The resulting cluster structure was chosen based on quantitative, qualitative, theoretical, and clinical validity. Cluster profiles were then created through statistical analysis of cognitive and clinical/demographic variables. A descriptive analysis of each cluster’s performance on a comprehensive PD-MCI diagnostic battery was also explored.
The resulting cluster structure revealed four distinct cognitive phenotypes: (1) frontal-dominant impairment; (2) posterior-cortical-dominant impairment; (3) global impairment, and (4) cognitively intact. Demographic profiling revealed significant differences in the age, gender split, global cognitive ability, and motor symptoms between these clusters. However, there were no significant differences between the clusters on measures of depression, apathy, and anxiety.
These results validate the existence of distinct cognitive phenotypes within PD-MCI and encourage future research into their clinical trajectory and neuroimaging correlates.
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We thank the Royal Brisbane and Woman’s Foundation for Grant funding, and all participants of the study. Dr. Nadeeka is supported by the Lions Medical Research Foundation Fellowship and National Health and Medical Research Boosting Dementia Research Leadership Fellowship (APP1137339).
This work was supported by the Royal Brisbane and Woman’s Hospital Foundation and Lions Medical Research Foundation.
Conflicts of interest
The authors declare that there was no potential conflict of interest.
Ethical standard statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Pourzinal, D., Yang, J.H.J., Byrne, G.J. et al. Identifying subtypes of mild cognitive impairment in Parkinson’s disease using cluster analysis. J Neurol (2020). https://doi.org/10.1007/s00415-020-09977-z
- Parkinson’s disease
- Mild cognitive impairment
- Cluster analysis