Parkinson hastalığında biliş ve sosyal bilişte alan odaklı sözlü ve sözsüz ayrışmalar.

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IntroductionBeyond motor symptoms, Parkinson's disease (PD) affects cognition and social cognition. This is already evident in cognitively intact PD, but is especially prominent in those with mild cognitive impairment (PD-MCI). The impact of processing modality (verbal vs. non-verbal) remains unclear. We examined differences across verbal and non-verbal components of cognition and Theory of Mind (ToM) in subjects with PD or PD-MCI compared to healthy controls (HC).MethodsSeventy-seven participants (HC = 26; PD = 28; PD-MCI = 23) completed a battery of neuropsychological tests to assess verbal and non-verbal cognition, verbal and non-verbal ToM. Data were analyzed using non-parametric statistics and multinomial logistic regression models.ResultsBoth PD groups showed statistically significant impairments compared to HC, with more pronounced deficits in PD-MCI. Verbal cognition was reduced in both PD groups (HC = 3.55 ± 0.59; PD = 2.76 ± 0.95; PD-MCI = 2.73 ± 0.95; χ2 = 27.46, p 2 = 0.34), while non-verbal cognition was only affected in PD-MCI (HC = 3.54 ± 1.92; PD-MCI = 2.59 ± 1.40; χ2 = 16.17, p 2 = 0.19). Verbal ToM was selectively impaired in PD-MCI (HC = 6.27 ± 1.00; PD-MCI = 4.94 ± 1.95; χ2 = 9.07, p = 0.01, η2 = 0.10), while non-verbal ToM was substantially preserved (p > 0.33). The regression analysis confirmed that lower scores in verbal and non-verbal cognition were associated with a higher likelihood of PD-MCI classification.DiscussionThe pattern emerging from our findings is consistent with a framework in which domain-specific vulnerabilities are primary, while modality may influence performance in interaction with task complexity and executive demand. This 2 × 2 framework (domain X modality) refines our understanding of cognitive decline in PD and underscores the need for domain- and modality-sensitive assessments.

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