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Social cognitive impairment in early Parkinson's disease: A novel “mild impairment”?

  • Author Footnotes
    1 Co-first/Equal authorship contribution.
    Virginie Czernecki
    Correspondence
    Corresponding author. Department of Neurology, Pitié-Salpêtrière Hospital, 47-83 bd de l’Hôpital, 75013, Paris, France.
    Footnotes
    1 Co-first/Equal authorship contribution.
    Affiliations
    Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France

    Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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  • Author Footnotes
    1 Co-first/Equal authorship contribution.
    Eve Benchetrit
    Footnotes
    1 Co-first/Equal authorship contribution.
    Affiliations
    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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  • Marion Houot
    Affiliations
    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Centre of Excellence of Neurodegenerative Disease (CoEN), Pitié-Salpêtrière Hospital, Paris, France
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  • Fanny Pineau
    Affiliations
    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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  • Graziella Mangone
    Affiliations
    Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France

    Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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  • Jean-Christophe Corvol
    Affiliations
    Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France

    Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
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  • Marie Vidailhet
    Affiliations
    Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France

    Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
    Search for articles by this author
  • Richard Levy
    Affiliations
    Sorbonne Université, Inserm, CNRS, Institut du Cerveau - Paris Brain Institute - ICM, Paris, France

    Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
    Search for articles by this author
  • Author Footnotes
    1 Co-first/Equal authorship contribution.

      Highlights

      • Social cognition impairment affects about one-third of PD patients in early stages of the disease.
      • Around 20% of these patients show no other signs of cognitive impairment.
      • Social cognition impairment in PD patients may represent the most common neuropsychological deficit in early-stage PD.
      • These findings support the presence of a sixth MCI subtype which could be called “Mild Social Cognition Impairment (MSCI)".

      Abstract

      Introduction

      Social cognition (SC) deficit has recently been described in the early stages of Parkinson's disease (PD), but findings remain unclear. Our objective was to determine the frequency of SC impairment in newly-diagnosed PD patients and whether it is independent of Mild Cognitive Impairment (MCI).

      Methods

      We enrolled 109 patients with idiopathic PD diagnosed within the previous four years (ICEBERG cohort) and 39 healthy participants. SC was evaluated using the Mini-Social Cognition and Emotional Assessment (Mini-SEA) that allows a multi-domain assessment of SC. Relationships between SC and clinical characteristics, global cognitive efficiency, mood, anxiety, apathy and impulse control disorders, were also evaluated.

      Results

      30% of patients had significant socio-emotional impairment. Moreover, SC deficit in isolation was 3.5 times more frequent than MCI in isolation (20.2% vs 5.5% respectively). Both emotion identification and Theory of Mind were impaired compared to healthy participants. No effect of age, level of education, disease severity, dopamine replacement therapy, or global cognitive efficiency were found. Only scores on the Frontal Assessment Battery were correlated with SC abilities.

      Conclusion

      SC impairment is frequent in early PD and should be given more consideration. It often occurs in the absence of any other cognitive disorder and may represent the most common neuropsychological deficit in early-stage PD. In line with the definition of PD-MCI criteria, we consider the addition of a sixth MCI sub-type termed “Mild Social Cognition Impairment (MSCI)”. Further studies are required to validate the addition of this new MCI domain.

      Keywords

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