الفهرس 
PARKINSON’S DISEASE; ETIOLOGY AND CLINICAL PICTUREOnly 14 pages are availabe for public view
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Abstract
Parkinson’s Disease (PD) is the second most common neurodegenerative disease that affects 1–2% of people older than 60 years of age (Chen et al., 2001).
Egypt has higher prevalence of PD about 35 in 100000 as was studied previously (Khedr et al., 2015).
Although PD has long been considered predominantly motor disorder, non-motor signs and symptoms have recently gained increasing recognition as part of PD as PD patients have an almost six-fold increased risk of developing dementia compared with age-matched individuals without PD (Alves et al., 2006).
Enormous data found that non-motor symptoms occur at any stage of the disease that can be used as a prediction for the patient’s future state. Many studies confirmed that NMS could be more disabling than motor part of PD as increasing rates of mortality and morbidity detected in patients with severe degree of NMS especially if they are not captured early for treatment (Savica et al., 2010), These disabling NMS grouped mainly as cognitive impairment, neuropsychiatric issues (as depression, apathy, etc.) and autonomic dysfunctions.
PD-MCI is relatively more important topic of interest in PD, more common in nondemented PD patients (mean prevalence 27%) and associated with increasing age, duration of illness and disease severity (Litvan et al., 2012).
In light of this data, this study aimed to assess cognitive dysfunction in Egyptian patients with idiopathic PD ranging from mild cognitive impairment (MCI) to Parkinson’s disease Dementia (PDD) and correlate these findings with the clinical and radiological characteristics of patients.
The current study investigated cognition and Non-motor symptoms in Thirty-five idiopathic PD patients attending Ain shams university movement disorders clinic diagnosed by a movement disorder neurologist based on the UK bank criteria for idiopathic Parkinson’s disease, in comparison to Thirty-five age, sex and education matched healthy controls
Entire enrolled PD patients were subjected to an extensive clinical evaluation including Comprehensive medical history and neurological examination.
Disease Severity was assessed using MDS-UPDRS during OFF and ON states, H&Y and Schwab and England activities of daily living scale while gait was assessed during ON & off state by FOG, BBS, 10 meters walking test and TUG.
Cognitive function was assessed during ON state with MMSE and detailed neuropsychological testing that included 2 scales for each domain of cognitive assessment, we used WCST and verbal fluency of Addenbrook Cognitive Examination (ACE) for executive function, WMS and 3-items recall of MMSE for memory, digit span of WMS and trail making of MoCA for attention, language similarity of ACE and language of MoCA for language, visuospatial of MoCA and clock drawing of ACE for visuospatial assessment.
Also, NMS were assessed by using Arabic version of NMSS, BDI scale and PDQ-39. Moreover, MRI brain was done for all the patients to assess white matter hyperintensities lesions using Fazekas and Scheltens scales.
This study highlights the relatively high frequencies of both cognitive impairment, depression and NMSs in our PD patients, and it provides a basis for promoting routine screening as well as detailed neuropsychological battery to detect PD-MCI and associated NMS.