J Korean Geriatr Psychiatry.  2015 Oct;19(2):72-78. 10.0000/jkgp.2015.19.2.72.

Extrapyramidal Signs and Impairment of Cognitive Subdomains in Mild Cognitive Impairment : A Clinical Research Center for Dementia of South Korea (CREDOS) Study

Affiliations
  • 1Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. paulkim@skku.edu
  • 2Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea.
  • 3Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 5Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Department of Neurology, Konkuk University School of Medicine, Seoul, Korea.
  • 7Department of Neurology, Inha University School of Medicine, Incheon, Korea.
  • 8Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVES
This study investigated the association between extrapyramidal signs (EPS) and five cognitive sub-domains in a large number of patients with mild cognitive impairment (MCI).
METHODS
Our analyses considered 1,943 patients with MCI drawn from the nationwide Clinical Research of Dementia of South Korea study. EPS were defined as presence in patients with at least 1 of 11 operationally specified features. We assessed five cognitive sub-domains : attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuropsychological Screening Battery-Dementia version. The associations of EPS with each cognitive sub-domain were analyzed with a multiple linear regression model after controlling for confounding factors : sex, age, education years, diabetes, hypertension, severity of global function, depressive symptoms, and white matter hyperintensities (WMH).
RESULTS
138 MCI patients (7.1%%) had EPS. This group had more global cognitive deterioration and severe WMH. MCI patients with EPS showed lower performance compared to those without EPS in 3 cognitive sub-domains: attention (p=0.05), visuospatial function (p=0.02), and frontal/executive function (p<0.0001). The language sub-domain and the memory sub-domain did not differ between the EPS positive and the EPS negative groups.
CONCLUSION
EPS in MCI are associated with greater cognitive impairment in specific functional sub-domains rather than with global greater cognitive deterioration.

Keyword

Mild cognitive impairment; Extrapyramidal signs; Cognition
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