Motor signs in dementia disorders exploring associations with cognition and MRI changes

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Abstract
Introduction:Motor symptoms develop to varying degrees in neurodegenerative disorders. This study investigated differences in motor symptoms and associations between motor symptoms, cognition, and computerized MRI brain atrophy patterns, in patients with cognitive decline due to neurodegenerative and cerebrovascular disorders. Methods:Patients were prospectively included and underwent cognitive testing, MRI, clinical motor evaluation using the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) and quantitative motor (Q-Motor) assessment, including grip lift, pronation/supination, and finger-tapping tasks. Statistical analyses included analysis of variance and covariance, and multiple linear regression.Results:We included 131 participants (Alzheimer's disease (AD, n = 49), cerebrovascular disease, including mixed cerebrovascular disease and AD (Vascular, n = 17), Parkinson's spectrum disorders (PSD, n = 12), subjective cognitive decline (SCD, n = 38), and healthy controls (HC, n = 15)). Compared with SCD and HC, the Vascular and PSD groups showed significant differences in motor symptoms, with predominantly poorer performances in both Q-Motor and UPDRS. No significant differences were found for AD compared to all other groups. More pronounced motor symptoms in the grip lift and pronation/supination tasks were associated with lower scores on the Mini-Mental State Examination and Addenbrooke’s Cognitive Examination, and with a larger volume of white matter hyperintensities. Conclusion:Our findings suggest that clinical motor scales, e.g., UPDRS, are relevant in detecting motor symptoms in neurodegenerative and cerebrovascular disorders in general, not exclusively PSD. Q-Motor may have limited value for differential diagnosis, but appears to be indicative of disease stage and global cognition.