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Parkinson’s disease

Cognitive deficits are common in individuals with Parkinson’s disease, including occurrence of formal dementia, reflecting loss of dopaminergic signalling, as well as dysfunction of other systems including cholinergic and noradrenergic neurotransmitters1. Parkinson’s disease has been associated with cognitive impairment across a range of domains, including aspects of cognitive flexibility, inhibitory control, sustained attention, planning, and memory2. Our recommended test battery for Parkinson’s disease covers the key cognitive domains impaired in individuals with Parkinson’s, as well as, being sensitive to cognitive domains that may not be affected by the disease but could be affected by medications.

The tests in this battery significantly predict conversion to dementia in patients with Parkinson’s disease3 and offer many advantages over widely used neuropsychological tests for sensitivity to cognitive impairment in Parkinson’s disease4. The tests are also highly sensitive to Parkinson’s disease progression, with the ability to discriminate additional cognitive impairment arising from comorbid depression and detect untoward effects of medications on cognition5-8.

Our recommended battery is clinically relevant with cognitive decline over time on these tests, correlating with the loss of day-to-day functioning in patients with Parkinson’s disease9.


  • Episodic memory
  • Working memory
  • Executive function
  • Planning
  • Information processing



The One Touch Stockings of Cambridge (OTS) task was sensitive to deteriorations in executive function found in a longitudinal study which revealed time-dependent deteriorations in executive function over 5 years.1

Nathan et al., 2015: Poster presented at ADPD.

Key References

Robbins TW, Cools R. Cognitive deficits in Parkinson's disease: a cognitive neuroscience perspective. Mov Disord. 2014 Apr 15;29(5):597-607.

Dorsey ER, Constantinescu R, Thompson JP, et al. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology. 2007; 68(5): 384-6.

Kalia LV, Lang AE. Parkinson's disease. Lancet. 2015 Apr 17. pii: S0140-6736(14)61393-3.

Kowal, S., Dall, T., Chakrabarti, R., Storm, M., & Jain, A. (2013). The current and projected economic burden of Parkinson's disease in the United States. Movement Disorders, 28(3), 311-318. http://dx.doi.org/10.1002/mds.25292

  1. Robbins, T. W., & Cools, R. (2014). Cognitive deficits in Parkinson's disease: A cognitive neuroscience perspective. Movement Disorders,29(5), 597-607. doi:10.1002/mds.25853
  2. Kudlicka A., Clare L., Hindle J. V. (2011). Executive functions in Parkinson’s disease: systematic review and meta-analysis. Mov. Disord. 26, 2305–231510.1002/mds.23868
  3. Olde Dubbelink K.T., Stoffers D., Deijen J.B., Twisk J.W., Stam C.J., Berendse H.W. (2013) Cognitive decline in Parkinson's disease is associated with slowing of resting-state brain activity: a longitudinal study. Neurobiology of Aging;34:408–418.
  4. McKinlay A, Grace RC, Kaller CP, Dalrymple-Alford JC, Anderson TJ, Fink J, Roger D. (2009) Assessing cognitive impairment in Parkinson’s disease: a comparison of two tower tasks. Applied Neuropsychology;16(3):177–185.
  5. Owen, A. M., James, M., Leigh, P. N., Summers, B. A., Quinn, N. P., Marsden, C. D., & Robbins T. W. (1992). Fronto-striatal cognitive deficits at different stages of Parkinson's disease. Brain, 115, 1727-1751
  6. Owen A. M., Beksinska, M., James, M., Leigh, P. N., Summers, B. A., Marsden, C. D., Quinn, N. P., Sahakian, B. J., & Robbins T. W. (1993). Visuo-spatial memory deficits at different stages of Parkinson's disease. Neuropsychologia, 31, 627-644.
  7. Schneider-Gold C, Bellenberg B, Prehn C, Krogias C, Schneider R, Klein J, et al. (2015) Cortical and Subcortical Grey and White Matter Atrophy in Myotonic Dystrophies Type 1 and 2 Is Associated with Cognitive Impairment, Depression and Daytime Sleepiness. PLoS ONE 10(6): e0130352. doi:10.1371/journal.pone.0130352
  8. Stefanova E, Potrebic A, Ziropadja L., et al. (2006) Depressed mood and executive dysfunction in early Parkinson’s disease. J Neurol Sci; 248: 131-7.
  9. Nathan PJ, Williams-Gray CH, Abbott RA, Mason SL, Foltynie T, Robbins TW, McAllister, CJ1, Barker RA (2015) Characterization Of Cognitive Decline Over 5 Years in an Incident Parkinson’s Disease Cohort: Results from the CamPaIGN Study.  Poster presented to AD/PD 2015, Nice, France.