Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease

Rasheda El-Nazer, Charles Howard Adler, Thomas G. Beach, Christine M. Belden, Jonathan Artz, Holly A. Shill, Erika M Driver-Dunckley, Shyamal Mehta, Marwan N. Sabbagh, Geidy E. Serrano, Lucia I. Sue, Edward Zamrini, Jared F. Benge

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Verbal fluency deficits are common in patients with Parkinson's disease. The association of these impairments with regional neuropathological changes is unexplored. Objectives: Determine if patients with verbal fluency impairments have greater neuropathological burden in frontal, temporal, and limbic regions and if Lewy bodies or neurofibrillary tangles were associated with verbal fluency impairments. Methods: Data was derived from the Arizona Study of Aging and Neurodegenerative Disorders. 47 individuals who completed phonemic and semantic verbal fluency tasks and met clinicopathological criteria for Parkinson's disease (with and without comorbid Alzheimer's disease) were included. Impairment on fluency tasks was defined by normative data, and the density of neuropathology in temporal, limbic, and frontal regions was compared between groups. Results: Individuals with semantic fluency impairments had greater total pathology (Lewy bodies + neurofibrillary tangles) in limbic structures (W = 320.0, p = .033, r pb = .33), while those who had phonemic fluency impairments had increased total neuropathology in frontal (W = 364.5, p = .011, r pb = .37), temporal (W = 356.5, p = .022, r pb = .34), and limbic regions (W = 357.0, p = .024, r pb = .34). Greater Lewy body density was found in those with verbal fluency impairments, though trends for greater neurofibrillary tangle density were noted as well. Conclusions: Impaired phonemic fluency was associated with higher Lewy body and tangle burden in frontal, temporal, and limbic regions, while impaired semantic fluency was associated with greater limbic pathology. Though neurofibrillary tangles trended higher in several regions in those with impaired verbal fluency, higher Lewy body density in general was associated with verbal fluency deficits. Implications for research and clinical practice are discussed.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
DOIs
StatePublished - Jan 1 2019

Fingerprint

Lewy Bodies
Neurofibrillary Tangles
Parkinson Disease
Semantics
Temporal Lobe
Pathology
Body Burden
Neurodegenerative Diseases
Alzheimer Disease
Neuropathology
Research

Keywords

  • Alzheimer's disease
  • Limbic system
  • Neuropathology
  • Parkinson's disease
  • Verbal fluency

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease. / El-Nazer, Rasheda; Adler, Charles Howard; Beach, Thomas G.; Belden, Christine M.; Artz, Jonathan; Shill, Holly A.; Driver-Dunckley, Erika M; Mehta, Shyamal; Sabbagh, Marwan N.; Serrano, Geidy E.; Sue, Lucia I.; Zamrini, Edward; Benge, Jared F.

In: Parkinsonism and Related Disorders, 01.01.2019.

Research output: Contribution to journalArticle

El-Nazer, Rasheda ; Adler, Charles Howard ; Beach, Thomas G. ; Belden, Christine M. ; Artz, Jonathan ; Shill, Holly A. ; Driver-Dunckley, Erika M ; Mehta, Shyamal ; Sabbagh, Marwan N. ; Serrano, Geidy E. ; Sue, Lucia I. ; Zamrini, Edward ; Benge, Jared F. / Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease. In: Parkinsonism and Related Disorders. 2019.
@article{d55c109383944619a367b9c6b9da4f9d,
title = "Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease",
abstract = "Background: Verbal fluency deficits are common in patients with Parkinson's disease. The association of these impairments with regional neuropathological changes is unexplored. Objectives: Determine if patients with verbal fluency impairments have greater neuropathological burden in frontal, temporal, and limbic regions and if Lewy bodies or neurofibrillary tangles were associated with verbal fluency impairments. Methods: Data was derived from the Arizona Study of Aging and Neurodegenerative Disorders. 47 individuals who completed phonemic and semantic verbal fluency tasks and met clinicopathological criteria for Parkinson's disease (with and without comorbid Alzheimer's disease) were included. Impairment on fluency tasks was defined by normative data, and the density of neuropathology in temporal, limbic, and frontal regions was compared between groups. Results: Individuals with semantic fluency impairments had greater total pathology (Lewy bodies + neurofibrillary tangles) in limbic structures (W = 320.0, p = .033, r pb = .33), while those who had phonemic fluency impairments had increased total neuropathology in frontal (W = 364.5, p = .011, r pb = .37), temporal (W = 356.5, p = .022, r pb = .34), and limbic regions (W = 357.0, p = .024, r pb = .34). Greater Lewy body density was found in those with verbal fluency impairments, though trends for greater neurofibrillary tangle density were noted as well. Conclusions: Impaired phonemic fluency was associated with higher Lewy body and tangle burden in frontal, temporal, and limbic regions, while impaired semantic fluency was associated with greater limbic pathology. Though neurofibrillary tangles trended higher in several regions in those with impaired verbal fluency, higher Lewy body density in general was associated with verbal fluency deficits. Implications for research and clinical practice are discussed.",
keywords = "Alzheimer's disease, Limbic system, Neuropathology, Parkinson's disease, Verbal fluency",
author = "Rasheda El-Nazer and Adler, {Charles Howard} and Beach, {Thomas G.} and Belden, {Christine M.} and Jonathan Artz and Shill, {Holly A.} and Driver-Dunckley, {Erika M} and Shyamal Mehta and Sabbagh, {Marwan N.} and Serrano, {Geidy E.} and Sue, {Lucia I.} and Edward Zamrini and Benge, {Jared F.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.parkreldis.2019.05.014",
language = "English (US)",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Regional neuropathology distribution and verbal fluency impairments in Parkinson's disease

AU - El-Nazer, Rasheda

AU - Adler, Charles Howard

AU - Beach, Thomas G.

AU - Belden, Christine M.

AU - Artz, Jonathan

AU - Shill, Holly A.

AU - Driver-Dunckley, Erika M

AU - Mehta, Shyamal

AU - Sabbagh, Marwan N.

AU - Serrano, Geidy E.

AU - Sue, Lucia I.

AU - Zamrini, Edward

AU - Benge, Jared F.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Verbal fluency deficits are common in patients with Parkinson's disease. The association of these impairments with regional neuropathological changes is unexplored. Objectives: Determine if patients with verbal fluency impairments have greater neuropathological burden in frontal, temporal, and limbic regions and if Lewy bodies or neurofibrillary tangles were associated with verbal fluency impairments. Methods: Data was derived from the Arizona Study of Aging and Neurodegenerative Disorders. 47 individuals who completed phonemic and semantic verbal fluency tasks and met clinicopathological criteria for Parkinson's disease (with and without comorbid Alzheimer's disease) were included. Impairment on fluency tasks was defined by normative data, and the density of neuropathology in temporal, limbic, and frontal regions was compared between groups. Results: Individuals with semantic fluency impairments had greater total pathology (Lewy bodies + neurofibrillary tangles) in limbic structures (W = 320.0, p = .033, r pb = .33), while those who had phonemic fluency impairments had increased total neuropathology in frontal (W = 364.5, p = .011, r pb = .37), temporal (W = 356.5, p = .022, r pb = .34), and limbic regions (W = 357.0, p = .024, r pb = .34). Greater Lewy body density was found in those with verbal fluency impairments, though trends for greater neurofibrillary tangle density were noted as well. Conclusions: Impaired phonemic fluency was associated with higher Lewy body and tangle burden in frontal, temporal, and limbic regions, while impaired semantic fluency was associated with greater limbic pathology. Though neurofibrillary tangles trended higher in several regions in those with impaired verbal fluency, higher Lewy body density in general was associated with verbal fluency deficits. Implications for research and clinical practice are discussed.

AB - Background: Verbal fluency deficits are common in patients with Parkinson's disease. The association of these impairments with regional neuropathological changes is unexplored. Objectives: Determine if patients with verbal fluency impairments have greater neuropathological burden in frontal, temporal, and limbic regions and if Lewy bodies or neurofibrillary tangles were associated with verbal fluency impairments. Methods: Data was derived from the Arizona Study of Aging and Neurodegenerative Disorders. 47 individuals who completed phonemic and semantic verbal fluency tasks and met clinicopathological criteria for Parkinson's disease (with and without comorbid Alzheimer's disease) were included. Impairment on fluency tasks was defined by normative data, and the density of neuropathology in temporal, limbic, and frontal regions was compared between groups. Results: Individuals with semantic fluency impairments had greater total pathology (Lewy bodies + neurofibrillary tangles) in limbic structures (W = 320.0, p = .033, r pb = .33), while those who had phonemic fluency impairments had increased total neuropathology in frontal (W = 364.5, p = .011, r pb = .37), temporal (W = 356.5, p = .022, r pb = .34), and limbic regions (W = 357.0, p = .024, r pb = .34). Greater Lewy body density was found in those with verbal fluency impairments, though trends for greater neurofibrillary tangle density were noted as well. Conclusions: Impaired phonemic fluency was associated with higher Lewy body and tangle burden in frontal, temporal, and limbic regions, while impaired semantic fluency was associated with greater limbic pathology. Though neurofibrillary tangles trended higher in several regions in those with impaired verbal fluency, higher Lewy body density in general was associated with verbal fluency deficits. Implications for research and clinical practice are discussed.

KW - Alzheimer's disease

KW - Limbic system

KW - Neuropathology

KW - Parkinson's disease

KW - Verbal fluency

UR - http://www.scopus.com/inward/record.url?scp=85065766518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065766518&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2019.05.014

DO - 10.1016/j.parkreldis.2019.05.014

M3 - Article

C2 - 31109728

AN - SCOPUS:85065766518

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

ER -