Executive dysfunction in P arkinson's disease: A review
Abstract
Executive dysfunction can be present from the early stages of Parkinson's disease (PD). It is characterized by deficits in internal control of attention, set shifting, planning, inhibitory control, dual task performance, and on a range of decision-making and social cognition tasks. Treatment with dopaminergic medication has variable effects on executive deficits, improving some, leaving some unchanged, and worsening others. In this review, we start by defining the specific nature of executive dysfunction in PD and describe suitable neuropsychological tests. We then discuss how executive deficits relate to pathology in specific territories of the basal ganglia, consider the impact of dopaminergic treatment on executive function (EF) in this context, and review the changes in EFs with disease progression. In later sections, we summarize correlates of executive dysfunction in PD with motor performance (e.g., postural instability, freezing of gait) and a variety of psychiatric (e.g., depression, apathy) and other clinical symptoms, and finally discuss the implications of these for the patients' daily life.
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Some individuals with PD are impaired in decision-making tasks that require internal attentional control.
“Previous studies have shown that some individuals with PD are impaired in decision-making tasks that require internal attentional control (Brown & Marsden, 1988; Dirnberger & Jahanshahi, 2013), which is posited to reflect a resource capacity issue.”
From Perception of Physical Demand, Mental Demand, and Performance: A Comparison of Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Dirnberger & Jahanshahi, 2013
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- Authors
- Dirnberger, G., & Jahanshahi, M.
- Affiliations
- Universität für Weiterbildung Krems (AT)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Jahanshahi, Marjan
- ORCID
- Jahanshahi, Marjan
- Venue
- Journal of Neuropsychology
- Publisher
- Wiley
- Published
- 2013-09
- Volume
- 7
- Issue
- 2
- Pages
- 193-224
- ISSN
- 1748-6645 (ISSN-L)
- 1748-6653
- OpenAlex
- W2049075351
- Cited by
- 486
- References
- 10
- Citations by year
- 2026: 27 · 2025: 33 · 2024: 25 · 2023: 20 · 2022: 49 · 2021: 41 · 2020: 56 · 2019: 40 · 2018: 40 · 2017: 44 · 2016: 41 · 2015: 47 · 2014: 20 · 2013: 3
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- executive dysfunction, Parkinson's disease, dopaminergic therapy, basal ganglia, set-shifting, inhibitory control, dual-task performance, decision-making, social cognition, depression, apathy, freezing of gait, postural instability, disease progression, neuropsychological assessment
- MeSH terms
- Basal Ganglia, Cognition Disorders, Humans, Parkinson Disease, Disease Progression, Dopamine Agonists, Executive Function, Symptom Assessment
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