Cognitive and behavioral dysfunction in Parkinson's disease: neurochemical and clinicopathological contributions

J Neural Transm (Vienna). 2004 Oct;111(10-11):1287-301. doi: 10.1007/s00702-004-0178-z. Epub 2004 Jul 7.


The cognitive and behavioral sequelae (i.e., nonmotor profile) of Parkinson's disease (PD), with executive dysfunction and depression being most prominent, have typically been overshadowed due to an emphasis on motor symptomatology. The apparent categorization of PD as a disorder isolated to the dopaminergic system may be a generalization of the disease pathology. Dopamine therapy, used for the treatment of motor symptoms, has not consistently been shown to resolve nonmotor impairments. Research evidence indicates that nondopaminergic neurotransmitter systems (i.e., serotonergic, noradrenergic, & cholinergic) are disrupted in PD and may contribute to cognitive and behavioral dysfunction. Furthermore, Lewy bodies within cortical and subcortical structures can add to the nonmotor profile in PD. Pharmacological interventions for the treatment of cognitive and behavioral impairments associated with PD are few, especially for nondemented patients. The current review of the literature highlights evidence that associates nonmotor dysfunctions with neurochemical and clinicopathological correlates of PD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Brain / pathology*
  • Brain Chemistry / physiology*
  • Cognition Disorders / etiology*
  • Cognition Disorders / metabolism
  • Cognition Disorders / pathology
  • Cognition Disorders / psychology*
  • Humans
  • Lewy Body Disease / metabolism
  • Lewy Body Disease / pathology
  • Mental Disorders / etiology*
  • Mental Disorders / metabolism
  • Mental Disorders / pathology
  • Mental Disorders / psychology*
  • Neurotransmitter Agents / deficiency
  • Neurotransmitter Agents / physiology
  • Parkinson Disease / complications*
  • Parkinson Disease / metabolism
  • Parkinson Disease / pathology
  • Parkinson Disease / psychology*


  • Neurotransmitter Agents