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Aim: Sleep disorders can be associated with an increased risk for cognitive decline in patients with Parkinson's disease (PD). The aim of this study was to examine the association between cognitive status and presence of sleep symptoms and sleep disorders in PD patients., Methods: We evaluated excessive sleepiness, other sleep symptoms, and performed polysomnography and neuropsychological evaluation in 79 patients. They were classified as having normal cognition (PDNC), mild cognitive impairment (PDMCI), or dementia (PDD)., Results: There were 29 PDNC, 39 PDMCI, and 11 PDD patients. PDD patients were older, had higher scores on the Unified Parkinson's Disease Rating Scale, and lower Schwab and England Activities of Daily Living scores than PDNC patients. After analysis of the polysomnographic variables, it was also found that PDD patients had a lower sleep efficiency, lower total sleep time, and lower number of sleep state changes than PDNC patients. In a stepwise analysis, defining Mattis Dementia Rating Scale scores as the dependent variable, the results were a model that selected three variables that accounted for 59% of the variation in the Mattis Dementia Rating Scale score: wake time after sleep onset, number of state changes, and schooling., Conclusion: We found a significant association between global cognitive performance and wake time after sleep onset and the number of state changes during sleep measured in the polysomnography of PD patients. However, we did not find any other association between sleep disorders or symptoms and cognitive status or cognitive performance of PD patients., (© 2019 The Authors. Psychiatry and Clinical Neurosciences © 2019 Japanese Society of Psychiatry and Neurology.)

Diseases with a choreic phenotype can be due to a variety of genetic etiologies. As testing for Huntington's disease (HD) becomes more available in previously resource-limited regions, it is becoming apparent that there are patients in these areas with other rare genetic conditions which cause an HD-like phenotype. Documentation of the presence of these conditions is important in order to provide appropriate diagnostic and clinical care for these populations. Information for this article was gathered in two ways; the literature was surveyed for publications reporting a variety of genetic choreic disorders, and movement disorders specialists from countries in Latin America and the Caribbean were contacted regarding their experiences with chorea of genetic etiology. Here we discuss the availability of molecular diagnostics for HD and for other choreic disorders, along with a summary of the published reports of affected subjects, and authors' personal experiences from the regions. While rare, patients affected by non-HD genetic choreas are evidently present in Latin America and the Caribbean. HD-like 2 is particularly prevalent in countries where the population has African ancestry. The incidence of other conditions is likely determined by other variations in ethnic background and settlement patterns. As genetic resources and awareness of these disorders improve, more patients are likely to be identified, and have the potential to benefit from education, support, and ultimately molecular therapies., (Copyright © 2018. Published by Elsevier Ltd.)

Objective: The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD)., Method: Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests., Results: There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others., Conclusion: Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

Objective: Some studies about the Movement Disorders Society checklist for the diagnosis of Parkinson's disease (PD) dementia (PDD) suggested that its accuracy was not totally satisfactory. Our study focused to evaluate the two items of the checklist related to the cognitive assessment., Methods: We assessed 95 consecutive patients with a diagnosis of PD using the UPDRS, Hoehn and Yahr, Schwab and England scales, Pfeffer Functional Activities Questionnaire, MMSE, Clinical Dementia Rating, clock drawing test, verbal fluency test (animals), digit span, word list battery of CERAD, Frontal Assessment Battery and the 15-item Geriatric Depression Scale The cognitive diagnosis was based on the MDS diagnostic criteria for PDD. The checklist was completed later by a blinded investigator. The data were evaluated using descriptive analysis and calculation of sensitivity, and specificity of the checklist for the diagnosis of PDD., Results: 33 patients (35%) were diagnosed with PDD. The ROC curve showed that the MMSE cut-off score < 26 had the highest accuracy (sensitivity: 94%, specificity: 55%) for the diagnosis of PDD. Using the checklist with original cut-off scores we found sensitivity of 97% and specificity of 58%. Using an alternative way to interpret the cognitive assessment of the checklist we found sensitivity of 94% and specificity of 89% for the diagnosis of PDD., Conclusions: Our findings suggest that to improve the accuracy of the checklist, it would be necessary to adjust the way we use and interpret the cut-off scores of the MMSE and of the subtests, without the need to eliminate their use., (Copyright © 2015 Elsevier Ltd. All rights reserved.)