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HOME > J Mov Disord > Volume 15(3); 2022 > Article
Original Article Potential Link Between Cognition and Motor Reserve in Patients With Parkinson’s Disease
Seok Jong Chung1,2,3orcid , Yae Ji Kim4,5orcid , Yun Joong Kim1,2,3orcid , Hye Sun Lee6orcid , Mijin Yun7orcid , Phil Hyu Lee1orcid , Yong Jeong3,4,8orcid , Young H. Sohn1orcid
Journal of Movement Disorders 2022;15(3):249-257
DOI: https://doi.org/10.14802/jmd.22063
Published online: September 7, 2022
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1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
2Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
3YONSEI BEYOND LAB, Yongin, Korea
4Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
5KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, Korea
6Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
7Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
8Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
Corresponding author:  Yong Jeong, Tel: +82-42-350-4324, Fax: +82-42-350-7160, 
Email: yong@kaist.ac.kr
Young H. Sohn, Tel: +82-2-2228-1601, Fax: +82-2-393-0705, 
Email: yhsohn62@yuhs.ac
Received: 18 April 2022   • Revised: 24 May 2022   • Accepted: 17 June 2022

Objective
To investigate whether there is a link between cognitive function and motor reserve (i.e., individual capacity to cope with nigrostriatal dopamine depletion) in patients with newly diagnosed Parkinson’s disease (PD).
Methods
A total of 163 patients with drug-naïve PD who underwent 18F-FP-CIT PET, brain MRI, and a detailed neuropsychological test were enrolled. We estimated individual motor reserve based on initial motor deficits and striatal dopamine depletion using a residual model. We performed correlation analyses between motor reserve estimates and cognitive composite scores. Diffusion connectometry analysis was performed to map the white matter fiber tracts, of which fractional anisotropy (FA) values were well correlated with motor reserve estimates. Additionally, Cox regression analysis was used to assess the effect of initial motor reserve on the risk of dementia conversion.
Results
The motor reserve estimate was positively correlated with the composite score of the verbal memory function domain (γ = 0.246) and with the years of education (γ = 0.251). Connectometry analysis showed that FA values in the left fornix were positively correlated with the motor reserve estimate, while no fiber tracts were negatively correlated with the motor reserve estimate. Cox regression analysis demonstrated that higher motor reserve estimates tended to be associated with a lower risk of dementia conversion (hazard ratio, 0.781; 95% confidence interval, 0.576–1.058).
Conclusion
The present study demonstrated that the motor reserve estimate was well correlated with verbal memory function and with white matter integrity in the left fornix, suggesting a possible link between cognition and motor reserve in patients with PD.


JMD : Journal of Movement Disorders