Mild cognitive impairment in De Novo Parkinson's disease according to movement disorder guidelines.

Litvan and colleagues recently proposed the Movement Disorder Society Task Force diagnostic criteria for mild cognitive impairment in Parkinson’s disease (PD-MCI). These criteria were needed to overcome the heterogeneity of criteria adopted in previous studies, with a mean MCI prevalence of 27% (range, 19%–38%) reported in nondemented Parkinson’s disease (PD) patients2; MCI may already be present at the time of the clinical diagnosis of PD, with prevalence ranging from 18.9% to 36% reported in newly diagnosed drug-naive patients. n a recent study4 we examined a cohort of 121 newly diagnosed drug-naive PD patients (mean age, 66.6 +-7.3 years; mean education, 9.2 +- 4.1 years; mean disease duration, 13.9 +- 11.3 months; mean UPDRS II score, 5.2 +- 3.3; mean UPDRS III score, 16.9 +- 8.4) adopting recently proposed preliminary MCI research criteria. All patients fulfilled research diagnostic criteria for idiopathic PD; atypical parkinsonian disorders such as multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration and other neurological or major medical conditions were considered exclusion criteria. A 1.5T MRI was performed on all patients to evaluate radiological signs of atypical parkinsonisms, neoplastic lesions, hydrocephalus, or extensive vascular damage, and a 123IFP-CIT SPECT was performed to confirm nigrostriatal degeneration. All patients received an L-dopa challenge to evaluate acute dopaminergic treatment efficacy; only patients with a consistent (>30%) improvement in tapping test were considered eligible. Furthermore, 100 age-matched subjects enrolled from among patients’ family members served as healthy controls (HCs; mean age, 66.8 +- 6.3 years; mean education, 9.2 +- 4.2 years); these subjects were free from parkinsonism, dementia, major depression, and psychosis.