Evoked mid-frontal activity predicts cognitive dysfunction in Parkinson's disease

J Neurol Neurosurg Psychiatry. 2023 Nov;94(11):945-953. doi: 10.1136/jnnp-2022-330154. Epub 2023 Jun 1.

Abstract

Background: Cognitive dysfunction is a major feature of Parkinson's disease (PD), but the pathophysiology remains unknown. One potential mechanism is abnormal low-frequency cortical rhythms which engage cognitive functions and are deficient in PD. We tested the hypothesis that mid-frontal delta/theta rhythms predict cognitive dysfunction in PD.

Method: We recruited 100 patients with PD and 49 demographically similar control participants who completed a series of cognitive control tasks, including the Simon, oddball and interval-timing tasks. We focused on cue-evoked delta (1-4 Hz) and theta (4-7 Hz) rhythms from a single mid-frontal EEG electrode (cranial vertex (Cz)) in patients with PD who were either cognitively normal, with mild-cognitive impairments (Parkinson's disease with mild-cognitive impairment) or had dementia (Parkinson's disease dementia).

Results: We found that PD-related cognitive dysfunction was associated with increased response latencies and decreased mid-frontal delta power across all tasks. Within patients with PD, the first principal component of evoked electroencephalography features from a single electrode (Cz) strongly correlated with clinical metrics such as the Montreal Cognitive Assessment score (r=0.34) and with National Institutes of Health Toolbox Executive Function score (r=0.46).

Conclusions: These data demonstrate that cue-evoked mid-frontal delta/theta rhythms directly relate to cognition in PD. Our results provide insight into the nature of low-frequency frontal rhythms and suggest that PD-related cognitive dysfunction results from decreased delta/theta activity. These findings could facilitate the development of new biomarkers and targeted therapies for cognitive symptoms of PD.

Keywords: COGNITION; EEG; PARKINSON'S DISEASE.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cognitive Dysfunction* / complications
  • Dementia* / complications
  • Electroencephalography / methods
  • Humans
  • Parkinson Disease*
  • Theta Rhythm / physiology