The Cognitive Profile of Atypical Parkinsonism: A Meta-Analysis.

Atypical Parkinsonism (AP) syndromes are characterized by a wide spectrum of non-motor symptoms including prominent attentional and executive deficits. However, the cognitive profile of AP and its differences and similarities with that of Parkinson's Disease (PD) are still a matter of debate. The present meta-analysis aimed at identifying patterns of cognitive impairment in AP by comparing global cognitive functioning, memory, executive functions, visuospatial abilities, language, non-verbal reasoning, and processing speed test performances of patients with AP relative to healthy controls and patients with PD. All investigated cognitive domains showed a substantial impairment in patients with AP compared to healthy controls. When AP syndromes were considered separately, their cognitive functioning was distributed along a continuum from Multiple Systemic Atrophy at one extreme, with the least impaired cognitive profile (similar to that observed in PD) to Progressive Supranuclear Palsy, with the greatest decline in global cognitive and executive functioning (similar to Corticobasal Syndrome). These findings indicate that widespread cognitive impairment could represent an important clinical indicator to distinguish AP from other movement disorders.

Personality traits associated with blepharospasm: A comparison with healthy subjects, patients with facial hemispasm and patients with hyperhidrosis.

The aim of this study is to explore the existence of specific personality traits related to patients with blepharospasm (BSP), treated with injections of botulinum neurotoxin (BTX). Sixteen patients with BSP, 22 with facial hemispasm (HFS), 20 with essential hyperhidrosis (EH) and 20 healthy controls (HCs) completed the Temperament and Character Inventory-Revised to explore personality traits based on Cloninger's Psychobiological Model. The results revealed that the four groups differed on the Harm Avoidance (HA) scale and fear of uncertainty subscale, as well as on Persistence (PS). On HA, BSP group did not differ from HCs, but had higher scores than HFS and EH groups. On PS scales, BSP and HFS patients did not differ between them but showed higher score than HCs and EH patients. Our findings suggested that a high level of Harm Avoidance and Persistence seem to be associated with BSP, when compared with any disorders treated with BTX. An evaluation of the personality traits might help the clinicians to early identify BSP patients at greater risk of developing psychopathological disturbances.

Cognitive correlates of prospective memory in dystonia.

INTRODUCTION: Executive dysfunctions are observed in focal dystonia (i.e., blepharospasm and cervical dystonia). Prospective memory (PM) is the ability to remember to carry out intended actions in the future and plays a relevant role in everyday living and quality of life. Although alterations of prefrontal cortex occur in focal dystonia, until now, no study has yet investigated the occurrence of deficit of PM in focal dystonia. Therefore, the aim of the study was to explore PM and its cognitive correlates in cervical dystonia and blepharospasm. METHODS: Twenty-seven patients with blepharospasm, 26 patients with cervical dystonia and 30 healthy subjects, matched for demographic features, underwent neuropsychological tests assessing PM, verbal memory, executive functions, and questionnaires assessing subjective prospective and retrospective memory failures, and apathy. RESULTS: The three groups did not differ on tests assessing verbal memory, executive functions, but they significantly differed on PM tests. In detail, patients with blepharospasm and cervical dystonia performed worse on time-based and recognition tasks than healthy subjects, while no difference on event-based task was found. Regression analysis showed a relationship between a lower score on Modified Card Sorting Test and a reduced performance on time-based, event-based and recognition tasks within focal dystonia group. CONCLUSION: The results indicated a selective deficit of time-based PM in focal dystonia, supporting previous evidence of cognitive dysfunctions in dystonic patients. The relationship between impaired time-based PM and poor performance on cognitive flexibility tests might suggest that difficulty in managing two concurrent cognitive demands contributes to impaired time-based PM.