EditorialCognitive Changes and Promotion in Parkinson’s Disease

XiaoPing Wang ,1 XiJin Wang,2 HaiBo Chen ,3 Sarah Duff Canning,4

and Xingguang Luo5

1Tongren Hospital, Shanghai Jiao Tong University Medical School, Shanghai 200336, China2Shanghai Jiao Tong University Medical School, Shanghai 200092, China3National Center of Gerontology, Beijing Hospital, Beijing 100730, China4University of Toronto, Toronto, ON, Canada M5W 1G35Yale University School of Medicine, New Haven, CT 20802, USA

Correspondence should be addressed to XiaoPing Wang; x_p_wang@sjtu.edu.cn

Received 9 July 2018; Accepted 10 July 2018; Published 1 August 2018

Copyright © 2018 XiaoPing Wang et al. 'is is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work isproperly cited.

Parkinson’s disease (PD) has been recognized as a multi-systemic neurodegenerative disorder with typical motorsymptoms, including static tremor, bradykinesia, rigidity,postural instability, and gait difficulty. In addition to thedefining dopamine-related motor symptoms, however, in-creasing evidence has shown that PD patients often expe-rience a series of nonmotor symptoms, including mood andbehavior disorders, cognitive impairment, brain-gut-axisdisorders, autonomic system failure, sensory symptoms,and sleep disturbances.

Cognitive impairment is one of the most devastating andcommon nonmotor symptoms of PD. People with PD exhibitmore rapid decline in a number of cognitive domains, inparticular, executive, attentional, and visuospatial domains,but also memory especially skill/implicit learning. As we allknow, the underlyingmechanism ofmotor symptoms of PD isdepleted dopaminergic cells in the substantia nigra. In con-trast, the pathophysiological basis of cognitive impairments inPD remains uncertain. Disrupted frontal-subcortical circuitsdue to dopaminergic neuron damage and wide deposition ofα-synuclein, β-amyloid, and tau proteins might play a role. InK. Li et al.’s paper, they summarized rs-fMRI studies oncognitive function in PD and discuss the strong potential of rs-fMRI in this area. rs-fMRI can help reveal the pathophysiologyof cognitive symptoms in PD, facilitate early identification ofPD patients with cognitive impairment, distinguish PD de-mentia from dementia with Lewy bodies, and monitor andguide treatment for cognitive impairment in PD. In particular,

ongoing and future longitudinal studies would enhance theability of rs-fMRI in predicting PD dementia. In combinationwith other modalities such as positron emission tomography,rs-fMRI could give us more information on the underlyingmechanism of cognitive deficits in PD.

Progressive supranuclear palsy (PSP) was first describedas a progressive neurological disorder with motor, ocular, andcognitive features. Both PSP and PD are characterised byextrapyramidal syndromes, each of which can comprisesymptoms of bradykinesia, rigidity, and/or postural in-stability. Clinically, it remains difficult to distinguish fromParkinson’s disease (PD). In J. A. Foley et al.’s paper, theyinvestigated whether the newly developed ECAS, designed tobe used with people with even severe motor disability, wassensitive to the cognitive impairment seen in PD and PSP andable to distinguish between these two disorders. It is de-veloped to be used with patients with even severe physicaldisability and thus may be suitable for detecting cognitiveimpairment in all motor disorders. Many of the subtests canbe performed either orally or manually, with some measurescorrected for motor speed, reducing the impact that physicaldisability may have performance on cognitive tests. It alsoallows the clinician to track cognitive impairment throughoutthe disease course, crucial for any longitudinal studies. ECASis a quick, simple, and inexpensive test that can be used tosupport the differential diagnosis of PSP.

How to get cognitive training? 'ere are two frequentlyused methods: standard or tailored. Standard cognitive

HindawiParkinson’s DiseaseVolume 2018, Article ID 9872183, 2 pageshttps://doi.org/10.1155/2018/9872183

training involves cognitive tasks that are not customised tothe individual’s cognitive deficits, whereas tailored cognitivetraining is deficit specific. In B. J. Lawrence et al.’s paper,they examined whether standard cognitive training, tailoredcognitive training, transcranial direct current stimulation(tDCS), standard cognitive training + tDCS, or tailoredcognitive training + tDCS improved cognitive function andfunctional outcomes in participants with PD and mildcognitive impairment (PD-MCI). And the outcomes im-proved for the groups that received standard or tailoredcognitive training combined with tDCS. Participants withPD-MCI receiving cognitive training (standard or tailored)or tDCS demonstrated significant improvements on cog-nitive and functional outcomes, and combining these in-terventions provided greater therapeutic effects.

Another method, bilateral deep brain stimulation ofsubthalamic nucleus (STN-DBS), has been proven to beeffective in improving motor symptoms in Parkinson’sdisease (PD) patients. However, psychiatric changes aftersurgery are controversial. So in Y. Wang et al.’s paper, theyspecifically analyzed apathy following bilateral STN-DBS inPD patients using a meta-analysis. 'ey found a significantdifference between the presurgery stage and the postsurgerystage scores. STN-DBS seems to relatively worsen thecondition of apathy, which may result from both the surgerytarget (subthalamic nucleus) and the reduction of dopa-minergic medication. 'us, in J. A. Foley et al.’s paper, theyexamined the use of standardised neuropsychological as-sessment for the evaluation of surgical candidates and toidentify risk factors for subsequent decline in cognition andmood. 'ey concluded that neuropsychological assessmentin a sample of patients undergoing DBS for PD is suitable forthe screening of candidates and can identify baseline riskfactors, which requires careful consideration before and aftersurgery.

'is issue assembles exciting, distinguished observationsinto the state of the art and science, as well as emergingfuture topics, in this important interdisciplinary field. Wehope that this special issue would attract a major attention ofthe peers. We would like to express our appreciation heartand soul to all of the authors and reviewers.

XiaoPing WangXiJin WangHaiBo Chen

Sarah Duff CanningXingguang Luo

2 Parkinson’s Disease

Stem Cells International

Hindawiwww.hindawi.com Volume 2018

Hindawiwww.hindawi.com Volume 2018

MEDIATORSINFLAMMATION

of

EndocrinologyInternational Journal of

Hindawiwww.hindawi.com Volume 2018

Hindawiwww.hindawi.com Volume 2018

Disease Markers

Hindawiwww.hindawi.com Volume 2018

BioMed Research International

OncologyJournal of

Hindawiwww.hindawi.com Volume 2013

Hindawiwww.hindawi.com Volume 2018

Oxidative Medicine and Cellular Longevity

Hindawiwww.hindawi.com Volume 2018

PPAR Research

Hindawi Publishing Corporation http://www.hindawi.com Volume 2013Hindawiwww.hindawi.com

The Scientific World Journal

Volume 2018

Immunology ResearchHindawiwww.hindawi.com Volume 2018

Journal of

ObesityJournal of

Hindawiwww.hindawi.com Volume 2018

Hindawiwww.hindawi.com Volume 2018

Computational and Mathematical Methods in Medicine

Hindawiwww.hindawi.com Volume 2018

Behavioural Neurology

OphthalmologyJournal of

Hindawiwww.hindawi.com Volume 2018

Diabetes ResearchJournal of

Hindawiwww.hindawi.com Volume 2018

Hindawiwww.hindawi.com Volume 2018

Research and TreatmentAIDS

Hindawiwww.hindawi.com Volume 2018

Gastroenterology Research and Practice

Hindawiwww.hindawi.com Volume 2018

Parkinson’s Disease

Evidence-Based Complementary andAlternative Medicine

Volume 2018Hindawiwww.hindawi.com

Submit your manuscripts atwww.hindawi.com