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Patients with Parkinson’s disease (PD) exhibit impairments in executive function and working memory. As opposed to motor symptoms of the disease the physiological origins of cognitive defi cits are not well understood. The aim of the present study was to delineate mechanisms of cognitive impairment in PD using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI). Twenty-two patient and 10 matched control subjects accomplished Wisconsin Card Sorting Test (WCST) – standard clinical measure of executive function and then underwent fMRI during performance of the N-Back working memory task.The correlation analysis comparing BOLD signal intensity changes with number of categories achieved in WCST revealed a signifi cant positive correlation within supramarginal gyrus, inferior parietal gyrus, middle and inferior frontal gyrus and caudate nucleus. Signifi cant negative correlations with executive impairment were observed within fusiform and parahippocampal gyrus, as well as enthorhinal and perirhinal cortex. These results suggest that cognitive impairment in PD may origin in consequence of distorted interaction between episodic and working memory systems.
Several functional neuroimaging studies in patients with Parkinson's disease (PD) have suggested that changes in the fronto-parietal-striatal networks are associated with deficits in executive functioning. However, executive functions (EF) are multifaceted and include three dissociable components: working memory, response inhibition, and task-switching. This study investigated which component of executive functioning is most strongly associated with fronto-parietal-striatal efficiency in PD. PD patients (with and without executive dysfunction), and age-matched healthy subjects, completed a battery of cognitive tests previously shown to discriminate among the three EF components. Principal component analysis conducted on the selected cognitive test variables yielded three expected EF components. The component scores were used in regression analysis to assess the relationship between the EF efficiency and blood oxygenation level-dependent (BOLD) signal related to performing the n-back, an experimental task that draws upon multiple components of executive functioning: working memory, response inhibition, and task-switching. We found distinct neural correlates of specific executive dysfunctions in patients with PD. However, all of them seem to be associated with fronto-parietal-striatal efficiency.
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