The goal of the present study is to explore the diagnostic and prognostic value of neurophysiological biomarkers obtained through paired-pulse Transcranial Magnetic Stimulation (TMS) techniques in individuals affected by Parkinson's disease (PD) with and without cognitive decline.
The main questions it aims to answer are:
* TMS measures of cortical excitability are able to distinguish between PD patients cognitively normal, PD-Mild Cognitive Impairment (PD-MCI) and PD-Dementia (PD-D)? * TMS measures of cortical excitability are able to predict progression of PD patient cognitive status from cognitively normal to PD-MCI and PD-D?
Age > 18 years
Ability to undergo an extensive neuropsychological evaluation
Ability to sign informed consent for the study
Diagnosed with idiopathic PD according to the latest revision of the MDS criteria
Systemic diseases of significant severity, including cardiovascular and cerebrovascular conditions (e.g., active neoplasms requiring chemotherapy, or end-stage heart failure)
Presence of any active neurological disease, in addition to PD
Presence of a cochlear implant, ferromagnetic brain device or near the site of brain stimulation, pacemaker, brain electrodes for DBS, electromechanical devices with IPG, or any other implantable stimulator, including peripheral ones
History of epilepsy
Single group
Transcranial Magnetic Stimulation
Diagnostic testPaired stimulation protocols of TMS to collect SAI, SICI, ICF measures
To compare SAI, SICI and ICF among PD patients who cognitively progressed from normal cognitive status to MCI or dementia, and from MCI to dementia.
Paired-pulse Trans-cranial magnetic stimulation techniques (Short-Latency Afferent Inhibition - SAI), Short-Interval Intracortical Inhibition - SICI, and Intra-Cortical Facilitation - ICF.
To compare SAI, SICI and ICF among PD patients with different cognitive condition (normal, MCI and dementia).
Paired-pulse Trans-cranial magnetic stimulation techniques (Short-Latency Afferent Inhibition - SAI), Short-Interval Intracortical Inhibition - SICI, and Intra-Cortical Facilitation - ICF.
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