Cognitive and neuropsychiatric disorders in extrapyramidal diseases

Abstract

The affliction of basal ganglia and their associations, which underlies extrapyramidal diseases, leads not only to diverse movements, but also to a broad spectrum of neuropsychological disorders, including cognitive, emotional-personality, and psychotic ones. The basis for these disorders are most commonly dysfunction of one or a few parallel frontostriatal circuits combining the basal ganglia with the thalamus, limbic structures, frontal and other cortical regions into the uniform functional system. The pattern of neuropsychological disorders has both specific and common features, the discussion of which is the subject matter of this paper. Analysis of the specific features of neuropsychological and behavioral disorders allows one to specify the localization of a pathological process and its extent, which may be of important differential diagnostic value. Cognitive and emotional-personality impairments sometimes develop earlier than motor disorders and their detection may be of significance for the early diagnosis of Parkinson’s disease or Huntington’s disease in persons who are predisposed to these diseases. Moreover, to establish the nature of mental disorders and the degree of their disadapting effect and to identify the affected and preserved components in the psychic processes are important for the choice of adequate pharmacotherapy and the elaboration of neuropsychological rehabilitation programs.

Keywords

• cognitive impairments
• neuropsychological disorders
• extrapyramidal diseases