Objective: The Tower of Hanoi measures executive functions using non-verbal
content and requires perception of position in space. The main objective
of this study is to standardize the use of the TOH as a measurement tool in
Parkinson’s disease. Patients and Methods: Of the Control Group subjects, 192
(59.6%) were women, 223 subjects (69.25%) were able to perform the TOH with
3 discs. In the Parkinson’s Group, there were 57 women (39.3%), and 66 subjects
(45.5%) did not get past that level. Results: If we take the TOH (with 3 or 4
discs) as a tool for discriminating between those who have dysexecutive syndrome
and those who do not, we find that the Parkinson’s Group presents dysexecutive
syndrome significantly more frequently than the Control Group (p ≤
0.0064). Conclusion: We can conclude that dysexecutive syndrome is frequent
in Parkinson’s patients and it is more prevalent than in the general population.
References
[1]
de Rijk, M.C., Launer, L., Berger, K., Breteler, M., Dartigues, J., Baldereschi, M. and Hofman, A. (2000) Prevalence of Parkinson’s Disease in Europe: A Collaborative Study of Population-Based Cohorts. Neurology, 54, 21-23.
[2]
Song, Y., Gu, Z., An, J., Chan, P., Chinese Parkinson Study Group (2014) Gender Differences on Motor and Non-Motor Symptoms of de Novo Patients with Early Parkinson’s Disease. Neurological Sciences, 35, 1991-1996. https://doi.org/10.1007/s10072-014-1879-1
[3]
Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A. and Kragh-Sorensen, P. (2003) Prevalence and Characteristics of Dementia in Parkinson Disease: An 8-Year Prospective Study. Archives of Neurology, 60, 387-392. https://doi.org/10.1001/archneur.60.3.387
[4]
Hely, M.A., Reid, W.G., Adena, M.A., Halliday, G.M. and Morris, J.G. (2008) The Sydney Multicenter Study of Parkinson’s Disease: The Inevitability of Dementia at 20 Years. Movement Disorders, 23, 837-844. https://doi.org/10.1002/mds.21956
[5]
Lezak, M.D. (1993) Newer Contributions to the Neuropsychological Assessment of Executive Functions. Journal of Head Trauma Rehabilitation, 8, 24-31. https://doi.org/10.1097/00001199-199303000-00004
[6]
Lezak, M.D. (1995) Neuropsychological Assessment. 3rd Edition, Oxford University Press, New York.
[7]
Simon, H. (1975) The Functional Equivalence of Problem Solving Skills. Cognitive Psychology, 7, 268-288. https://doi.org/10.1016/0010-0285(75)90012-2
[8]
Lezak, M.D. (1994) Domains of Behavior from a Neuropsychological Perspective: The Whole Story. Integrative Views of Motivation, Cognition, and Emotion, Volume 41 of the Nebraska Symposium on Motivation, University of Nebraska Press, Lincoln, 23-55.
[9]
Folstein, M., Folstein, S. and McHugh, P. (1975) Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12, 189-198. https://doi.org/10.1016/0022-3956(75)90026-6
[10]
Goldberg, T.E., Saint-Cyr, J.A. and Weinberger, D.R. (1990) Assessment of Procedural Learning and Problem Solving in Schizophrenic Patients by Tower of Hanoi Type Tasks. Journal of Neuropsychiatry and Clinical Neurosciences, 2, 165-173. https://doi.org/10.1176/jnp.2.2.165
[11]
Parks, R.W. and Cardoso, J. (1997) Parallel Distributed Processing and Executive Functioning, Tower of Hanoi Neural Network Model in Healthy Controls and Left Frontal Lobe Patients. The Journal of Neuroscience, 89, 217-240.
[12]
Royall, D.R., Cordes, J.A. and Polk, M. (1998) CLOX, an Executive Clock Drawing Task. Journal of Neurology, Neurosurgery, and Psychiatry, 64, 588-594. https://doi.org/10.1136/jnnp.64.5.588
[13]
Gibb, W.R.G. and Lees, A.J. (1988) The Relevance of the Lewy Body to the Pathogenesis of Idiopathic Parkinson’s Disease. Journal of Neurology, Neurosurgery, and Psychiatry, 51, 745-752. https://doi.org/10.1136/jnnp.51.6.745
[14]
Marinus, J., Visser, M., Stiggelbout, A.M., Rabey, J.M., Martínez-Martín, P., Bonuccelli, U., Kraus, P.H. and van Hilten, J.J. (2004) A Short Scale for the Assessment of Motor Impairments and Disabilities in Parkinson’s Disease, the SPES/SCOPA. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 388-395. https://doi.org/10.1136/jnnp.2003.017509
[15]
Zigmond, A.S. and Snaith, R.P. (1983) Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
[16]
Calne, S., Schulzer, M., Mak, E., Guyette, C., Rohs, G., Hatchard, S., Murphy, D., Hodder, J., Gagnon, C., Weatherby, S., Beaudet, L., Duff, J. and Pegler, S. (1996) Validating a Quality of Life Rating Scale for Idiopathic Parkinsonism, Parkinson’s Impact Scale (PIMS). Parkinsonism & Related Disorders, 2, 55-61. https://doi.org/10.1016/1353-8020(95)00026-7
[17]
Marinus, J., Visser, M., Martínez-Martín, P., van Hilten, J.J. and Stiggelbout, A.M. (2003) A Short Psychosocial Questionnaire for Patients with Parkinson’s Disease, the SCOPA-PS. Journal of Clinical Epidemiology, 56, 61-67. https://doi.org/10.1016/S0895-4356(02)00569-3
[18]
Martínez-Martín, P., Rodríguez-Blázquez, C., Forjaz, M.J. and de Pedro, J. (2009) The Clinical Impression of Severity Index for Parkinson’s Disease, International Validation Study. Movement Disorders, 24, 211-217. https://doi.org/10.1002/mds.22320
[19]
Menon, C., Hall, J., Hobson, V., Johnson, L. and O’Bryant, S.E. (2012) Normative Performance on the Executive Clock Drawing Task in a Multi-Ethnic Bilingual Cohort, a Project FRONTIER Study. International Journal of Geriatric Psychiatry, 27, 959-966. https://doi.org/10.1002/gps.2810
[20]
Crowe, M., Allman, R.M., Triebel, K., Sawyer, P. and Martin, R.C. (2010) Normative Performance on an Executive Clock Drawing Task (CLOX) in a Community-Dwelling Sample of Older Adults. Archives of Clinical Neuropsychology, 25, 610-617. https://doi.org/10.1093/arclin/acq047
[21]
Nyborn, J.A., Himali, J.J., Beiser, A.S., Devine, S.A., Du, Y., Kaplan, E., O’Connor, M.K., Rinn, W.E., Denison, H.S., et al. (2013) The Framingham Heart Study Clock Drawing Performance, Normative Data from the Offspring Cohort. Experimental Aging Research, 39, 80-108. https://doi.org/10.1080/0361073X.2013.741996
[22]
Ceravolo, R., Pagni, C., Tognoni, G. and Bonuccelli, U. (2012) The Epidemiology and Clinical Manifestations of Dysexecutive Syndrome in Parkinson’s Disease. Frontiers in Neurology, 3, 159. https://doi.org/10.3389/fneur.2012.00159
[23]
Dirnberger, G. and Jahanshahi, M. (2013) Executive Dysfunction in Parkinson’s Disease, A Review. Journal of Neuropsychology, 7, 193-224.
[24]
Levy, G., Jacobs, D.M., Tang, M.-X., Coté, J.L., Louis, E.D., Alfaro, B., Mejia, H., Stern, Y. and Marder, K. (2002) Memory and Executive Function Impairment Predict Dementia in Parkinson’s Disease. Movement Disorders, 17, 1221-1226. https://doi.org/10.1002/mds.10280
[25]
Godefroy, O., Azouvi, P., Robert, P., Roussel, M., LeGall, D. and Meulemans, T. (2010) Dysexecutive Syndrome, Diagnostic Criteria and Validation Study. Annals of Neurology, 68, 855-864. https://doi.org/10.1002/ana.22117