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Biomedical Research

An International Journal of Medical Sciences

Short Communication - Biomedical Research (2018) Volume 29, Issue 7

Influence of depression on the executive functioning of patients with advanced idiopathic Parkinson's disease without dementia

Hurtado-González CA1,2*, De la Cruz-Cifuentes O3, Triviño O3, Rinco A3, Seminec D4, De la Cruz- Cifuentes G5, Olayo BRI3,6

1School of Psychology, Coperativa University of Colombia in Cali, Cali Branch Campus, Colombia

2Center for Evaluation and Functional Neuro-Rehabilitation for Patients with Parkinson's Disease, Salamanca, Spain

3School of Medicine, Libre University Cali, Colombia

4Faculty of Psychology, Research Group Basic and Applied Clinical Neurosciences, Cooperative University of Colombia, Colombia

5Watson Clinic, Urgent Care Family Practice, Florida, USA

6Instiute of Biomedical Research, School of Medicine Free University, Cail, Colombia

*Corresponding Author:
Hurtado-González CA
School of Psychology
Coperativa University of Colombia in Cali
Cali Branch Campus, Colombia

Accepted on January 31, 2018

DOI: 10.4066/biomedicalresearch.29-17-2163

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Depression, Executive functioning, Parkinson´s disease.


Parkinson's disease (PD) is a neurodegenerative disease characterized by symptoms such as bradykinesia, stiffness, instability and postural tremor [1]. It affects the basic, instrumental and advanced activities of daily life, affecting the deterioration of individual, social and family life quality [2-5].


To study the influence of depression on executive functioning in patients with advanced idiopathic and non-dementia Parkinson's disease (IPDD) at Hoehn and Yahr III and IV stages [6].


50 subjects (34 men, 16 women) diagnosed with IPDD, in stages III and IV of the Hoehn and Yahr scale, and 50 healthy subjects (20 men, 30 women) without cognitive impairment of similar socio-demographic characteristics (Table 1).

Variables  Group with PD Comparison group Contrast test 
Value g. l. P-sig
Age 64.86 ± 6.53 53.75 ± 8.49 T=7.28 96 0.000**
IC 95%: 63.00-66.72 IC 95%: 51.28-56.22
Rank: 47-75 (Median: 65.5) Rank: 45-75 (Median: 52.0)
Gender Males 66.0% (33) 39.6% (20) Chi2= 6.86 1 0.009**
Women 34.0% (17) 60.4% (30)
Civil status Married 88.0% (43) 83.3% (41) Chi2= 6.92 3 0.075NS
Single 4.0% (3) 8.3% (5)
Widowers 8.0% (4) 2.1% (2)
Divorced 0% (-) 6.3% (2)
Stairway Basi studies 68.0% (36) 35.4% (18) Chi2= 12.01 2 0.002**
Middle studies 22.0% (12) 31.3% (15)
High studies 10.0% (2) 33.3% (17)

Table 1. Difference of means. Group of subjects with PE and comparison group.

Inclusion criteria

Group 1: Diagnosis of Parkinson's disease is performed by a specialist in Neurology; stages III and IV of the Hoehn and Yahr scale [6]; no dementia: score in the Mini Mental Parkinson-MMP, a score equal to or greater than 27 and in the Dementia Rating Scale a score equal to or greater than 130 [7,8]; not present less than ten years of evolution of the illness; do not present a history of clinically demonstrable neurological, neuropsychological and/or psychopathological alterations; do not present a history of alcohol abuse and/or toxic substances; subjects should not have undergone any kind of functional neurosurgery for the treatment of Parkinson's disease; "Age between 45 and 80 y; to present a level of education of at least 6 years.

Group 2: Same criteria as Group 1, except for the diagnosis of Parkinson's disease.


Yesavage Depression Scale (IDSS) [9]; executive functions: "Initiation/Perseveration of the Dementia Rating Scale DRS [8]"; "Motor Planning, Semantic Verbal Fluency and Task Change of the SCOPA-COG" [10]; and "Alternating Verbal Fluency and Action of Parkinson's Disease Cognitive Rating Scale-PD-CRS" [11].


From clinical history, clinical and neurological data of interest were obtained. If the subject fulfilled the criteria to be part of the study, an evaluation was made with the tests discussed above.

Statistical analysis

Mean difference, student T, Mann-Whitney U-test, Spearman's Rho.


There were statistically significant differences between patients with IPDD and the comparison group (p<0.000) (Table 2) in all executive functioning components evaluated. Significant differences were also found between the two groups in the total score obtained on the scale of Yesavage (p<0.01 and Table 2) [9].

Initiation-perseverance (Mattis) 29.00 0.001
Motor planning (Mattis) 26.43 0.001
Verbal fluency semantic (Scopa-Cog) 28.32 0.001
Task change (Scopa-Cog) 27.41 0.001
Alternating verbal fluency (PDCRS) 28.12 0.001

Table 2. Mann-Whitney U-test.

There is a statistically significant negative correlation between the total score obtained on the Yesavage scale and the scores obtained in the tasks of semantic verbal fluency (rho=-0.248; p=0.047) and task change of SCOPA-COG (rho=-0.314; p=0.001) (Table 3) [10].

Measurement instrument Rho p
Verbal fluency (Scopa-Cog) -0.248 0.047
Task change (Scopa-Cog) -0.314 0.001

Table 3. Spearman's Rho.


Subjects with IPDD in stages III and IV of the Hoehn and Yahr scale have higher depressive symptoms than the normal group of subjects.

The presence of depressive symptomatology in patients with IPDD correlates negatively with performance in executive functioning tasks, specifically in semantic verbal fluency tasks and SCOPA-COG task change.

Depressive symptomatology influences the executive functioning of subjects diagnosed with IPDD, which may be clinically related to dysfunction fronto subcortical and dorsolateral cortex circuits, brain structures that correlate with neurobehavioral disorders such as depression.

It is suggested to generate functional neurorehabilitation plans, which aim to improve the quality of life in people with this type of diagnosis.

For the field of neurosciences, and for us neuroscientists, Parkinson's disease continues to be a dilemma from its etiology to its treatment, but this does not stop us from continuing to investigate different practices and experiments that lead to the slowing down of the disease, and of course to the improvement of their quality of life.