Cognition and Other Non-Motor Symptoms in an At-Risk Cohort for Parkinson's Disease Defined by REM-Sleep Behavior Disorder and Hyposmia

Laure Pauly*, Armin Rauschenberger, Claire Pauly, Valerie E Schröder, Gilles Van Cutsem, Anja K Leist, Rejko Krüger*, NCER-PD Consortium

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review


BACKGROUND: REM-sleep behavior disorder (RBD) and other non-motor symptoms such as hyposmia were proposed by the Movement Disorder Society as research criteria for prodromal Parkinson's disease (P-PD). Global cognitive deficit was later added.

OBJECTIVE: To compare non-motor symptoms, focusing on cognition, between a P-PD group and a matched control group.

METHODS: In this cross-sectional, case-control study, in a first set of analyses, we performed extensive cognitive testing on people with (n = 76) and a control group without (n = 195) probable RBD and hyposmia. Furthermore, we assessed motor and non-motor symptoms related to Parkinson's Disease (PD). After propensity score matching, we compared 62 P-PD with 62 age- and sex-matched controls. In addition, we performed regression analyses on the total sample (n = 271). In a second set of analyses, we used, a.o., the CUPRO to evaluate retrograde procedural memory and visuo-constructive functions.

RESULTS: People with P-PD showed significantly poorer performances in global cognition, visuo-constructive and executive functions, mainly in mental flexibility (p < 0.001; p = 0.004; p = 0.003), despite similar educational levels (p = 0.415). We observed significantly more motor and non-motor symptoms (p < 0.001; p = 0.004), higher scores for depression (p = 0.004) and apathy (p < 0.001) as well as lower quality of life (p < 0.001) in P-PD.

CONCLUSIONS: Our findings confirm that global cognitive, executive, and visuo-constructive deficits define the P-PD group. In addition, depression, apathy, and lower quality of life were more prevalent in P-PD. If replicated in other samples, executive and visuo-constructive deficits should be considered in non-motor P-PD. Determining specific patterns will support early recognition of PD, secondary prevention of complications and the development of neuroprotective treatments.

Original languageEnglish
Pages (from-to)545-556
Number of pages12
JournalJournal of Parkinson's Disease
Issue number3
Publication statusPublished - 23 Apr 2024


  • Humans
  • Parkinson Disease/complications
  • REM Sleep Behavior Disorder/etiology
  • Male
  • Female
  • Aged
  • Middle Aged
  • Cross-Sectional Studies
  • Case-Control Studies
  • Cognitive Dysfunction/etiology
  • Anosmia/etiology
  • Prodromal Symptoms
  • Executive Function/physiology
  • Neuropsychological Tests
  • Cognition/physiology


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