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Javier Pagonabarraga

Cognitive deterioration and impulse control disorders in Parkinson’s disease : neuropsychological evaluation and imaging markers

Movement Disorders Unit, Hospital Sant Pau, Barcelona

Parkinson’s disease (PD) is a neurodegenerative disease which involves social, emotional, cognitive and motor circuits. PD deficits have to be understood along with motor, psychiatric and cognitive phenomena that are best described by the widespread neurodegenerative processes involving many cortical areas, the cingulate cortex, and progressive denervation of the basal ganglia.

Cognitive impairment such as dementia and impulse control disorders have been described in up to 15-25% of PD patients, causally related to the use of dopamine agonists. This family of drugs is used in PD in order to delay and diminish the clinical impact of debilitating motor complications. In order to detect PD before patients develop cognitive symptoms, and to broaden options to prevent cognitive deterioration, new criteria for the diagnosis of mild cognitive impairment in PD have been designed. The use of neuropsychological and imaging techniques appears essential to better define which patients will develop these complications, helping to minimize the tragic adverse events and to utilize more personalized medicines.