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The neurobiology and neural circuitry of cognitive changes in Parkinson's disease revealed by functional neuroimaging

Authors

  • Nicola J. Ray PhD,

    1. Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
    2. Research Imaging Center, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
    3. Division of Brain, Imaging, and Behavior–Systems Neuroscience, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
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  • Antonio P. Strafella MD, PhD, FRCPC

    Corresponding author
    1. Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
    2. Research Imaging Center, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
    3. Division of Brain, Imaging, and Behavior–Systems Neuroscience, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
    • Toronto Western Hospital and Institute, CAMH Research Imaging Center, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8 Canada
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  • Relevant conflicts of interest/financial disclosures: A.P.S. is supported by the Canada Research Chair program and the E.J. Safra Foundation. N.J.R is supported by the Parkinson Society Canada.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Patients with Parkinson's disease (PD) often develop a spectrum of cognitive symptoms that can evolve into dementia. Dopamine (DA) replacement medications, though improving motor symptoms, can exert both positive and negative effects on cognitive ability, depending on the severity of the disease and the specific skill being tested. By considering the behavioral and clinical aspects of disease- and treatment-mediated changes in cognition alongside the pathophysiology of PD, an understanding of the factors that govern the heterogeneous expression of cognitive impairment in PD is beginning to emerge. Here, we review the neuroimaging studies revealing the neural correlates of cognitive changes after DA loss and DA replacement as well as those that may accompany the conversion from milder stages of cognitive impairment to frank dementia. © 2012 Movement Disorder Society

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