Relation of Parkinson's Disease Subtypes to Visual Activities of Daily Living

Department of Psychology, Boston University, Boston, MA02215, USA.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 08/2011; 17(5):841-52. DOI: 10.1017/S1355617711000853
Source: PubMed


Visual perceptual problems are common in Parkinson's disease (PD) and often affect activities of daily living (ADLs). PD patients with non-tremor symptoms at disease onset (i.e., rigidity, bradykinesia, gait disturbance or postural instability) have more diffuse neurobiological abnormalities and report worse non-motor symptoms and functional changes than patients whose initial symptom is tremor, but the relation of motor symptom subtype to perceptual deficits remains unstudied. We assessed visual ADLs with the Visual Activities Questionnaire in 25 non-demented patients with PD, 13 with tremor as the initial symptom and 12 with an initial symptom other than tremor, as well as in 23 healthy control participants (NC). As expected, the non-tremor patients, but not the tremor patients, reported more impairment in visual ADLs than the NC group, including in light/dark adaptation, acuity/spatial vision, depth perception, peripheral vision and visual processing speed. Non-tremor patients were significantly worse than tremor patients overall and on light/dark adaptation and depth perception. Environmental enhancements especially targeted to patients with the non-tremor PD subtype may help to ameliorate their functional disability.

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    • "For example, Vakil and Herishanu- Naaman (1998) found that tremor-dominant patients are less impaired at procedural learning tasks than akinesia-dominant patients. Studies also showed that PD patients with tremor are less impaired than PD patients with other motor subtypes on perceptual tasks, including peripheral vision and visual processing speed (Seichepine et al., 2011). Interestingly, we also found that akinesia-dominant patients were more impaired than tremordominant patients at various working memory (Moustafa et al., 2013a) and learning (Moustafa et al., 2013b) measures. "
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    ABSTRACT: Parkinson's disease (PD) is a neurological disorder, associated with rigidity, bradykinesia, and resting tremor, among other motor symptoms. In addition, patients with PD also show cognitive and psychiatric dysfunction, including dementia, mild cognitive impairment (MCI), depression, hallucinations, among others. Interestingly, the occurrence of these symptoms-motor, cognitive, and psychiatric-vary among individuals, such that a subgroup of PD patients might show some of the symptoms, but another subgroup does not. This has prompted neurologists and scientists to subtype PD patients depending on the severity of symptoms they show. Neural studies have also mapped different motor, cognitive, and psychiatric symptoms in PD to different brain networks. In this review, we discuss the neural and behavioral substrates of most common subtypes of PD patients, that are related to the occurrence of: (a) resting tremor (vs. nontremor-dominant); (b) MCI; (c) dementia; (d) impulse control disorders (ICD); (e) depression; and/or (f) hallucinations. We end by discussing the relationship among subtypes of PD subgroups, and the relationship among motor, cognitive, psychiatric factors in PD.
    Frontiers in Systems Neuroscience 12/2013; 7:117. DOI:10.3389/fnsys.2013.00117
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    • "Larger samples would enable analysis by subgroups, which may be informative. For example, we recently reported that self-identified impairments in visual ADLs were more extensive in PD patients whose initial motor symptom was not tremor than in those whose initial symptom was tremor [33]. In particular, future work should focus on expanding the range of PD severity to include participants with milder and more severe motor impairment than were assessed here. "
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    ABSTRACT: Visual and visuospatial dysfunction is prevalent in Parkinson's disease (PD). To promote assessment of these often overlooked symptoms, we adapted the PD Vision Questionnaire for Internet administration. The questionnaire evaluates visual and visuospatial symptoms, impairments in activities of daily living (ADLs), and motor symptoms. PD participants of mild to moderate motor severity (n = 24) and healthy control participants (HC, n = 23) completed the questionnaire in paper and web-based formats. Reliability was assessed by comparing responses across formats. Construct validity was evaluated by reference to performance on measures of vision, visuospatial cognition, ADLs, and motor symptoms. The web-based format showed excellent reliability with respect to the paper format for both groups (all P's < 0.001; HC completing the visual and visuospatial section only). Demonstrating the construct validity of the web-based questionnaire, self-rated ADL and visual and visuospatial functioning were significantly associated with performance on objective measures of these abilities (all P's < 0.01). The findings indicate that web-based administration may be a reliable and valid method of assessing visual and visuospatial and ADL functioning in PD.
    03/2012; 2012(1):564812. DOI:10.1155/2012/564812
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    • "In PD, abnormalities are found on measures of contrast sensitivity (e.g., Amick et al., 2003; Davidsdottir, Wagenaar, Young, & Cronin-Golomb, 2008; Seichepine et al., 2011; Uc et al., 2005), with sensitivity to middle and high spatial and temporal frequencies reduced in patients on dopamine precursor therapy (Bodis-Wollner et al., 1987). For PD, it has been suggested that 'real world' functioning could be impacted under low-contrast conditions, such as driving in fog. "
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    ABSTRACT: External support may improve task performance regardless of an individual's ability to compensate for cognitive deficits through internally generated mechanisms. We investigated if performance of a complex, familiar visual search task (the game of bingo) could be enhanced in groups with suboptimal vision by providing external support through manipulation of task stimuli. Participants were 19 younger adults, 14 individuals with probable Alzheimer's disease (AD), 13 AD-matched healthy adults, 17 non-demented individuals with Parkinson's disease (PD), and 20 PD-matched healthy adults. We varied stimulus contrast, size, and visual complexity during game play. The externally supported performance interventions of increased stimulus size and decreased complexity resulted in improvements in performance by all groups. AD also obtained benefit from increasing contrast, presumably by compensating for their contrast sensitivity deficit. The general finding of improved performance across healthy and afflicted groups suggests the value of visual support as an easy-to-apply intervention to enhance cognitive performance.
    Aging Neuropsychology and Cognition 11/2011; 19(1-2):102-21. DOI:10.1080/13825585.2011.621930 · 1.07 Impact Factor
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