Temporal dynamics of cognitive functioning in people with Parkinson’s disease
Cognitive domains are central to diagnosing cognitive impairment in people with Parkinson's disease (PwPD), yet are defined by expert consensus and cross-sectional data that assume temporal stability. This study examined whether cognitive domains remain stable or reorganize dynamically over time in PwPD. Using dynamic exploratory graph analysis, we analyzed 19 cognitive test scores from 355 PwPD across four yearly assessments (24,372 data points) from the DEMPARK/LANDSCAPE-study to identify dynamic organization of cognitive dimensions. Panel graphical vector autoregression models assessed dynamic couplings among dimensions. Five dynamic cognitive dimensions emerged, diverging substantially from theoretical domains and cross-sectional dimensions at baseline. Dynamic coupling revealed a temporal separation between card-sorting/cognitive flexibility and visuoconstruction. Cognitive domains in PwPD reorganize over time rather than remaining stable, challenging the static assumption of diagnostic criteria. Using PD as an exemplar, findings demonstrate the need for dynamic frameworks potentially revealing condition-specific temporal architectures when applied to other neurodegenerative disorders.
Authors
- Rüdiger Hilker-Roggendorf
- Daniel Scharfenberg (ORCID: https://orcid.org/0000-0003-2781-3143)
- Anja Ophey (ORCID: https://orcid.org/0000-0001-5858-7762)
- Sandra Roeske (ORCID: https://orcid.org/0000-0002-8262-4356)
- Kathrin Reetz (ORCID: https://orcid.org/0000-0002-9730-9228)
- Marie K. Deserno (ORCID: https://orcid.org/0000-0002-7187-7569)
- Oliver Riedel (ORCID: https://orcid.org/0000-0002-1721-502X)
- Jan Kassubek
- Alexander Storch
- Jörg B. Schulz
- Karsten Witt
- Richard Dodel
- Monika Balzer-Geldsetzer
- Elke Kalbe
- Inga Liepelt-Scarfone
- Daniela Berg
- Claudia Trenkwalder
- Brit Mollenhauer
Institutions
- Carl von Ossietzky Universität Oldenburg (DE)
- German Center for Neurodegenerative Diseases (DE)
- Christian-Albrechts-Universität zu Kiel (DE)
- Klinikum Vest (DE)
- Leibniz Institute for Prevention Research and Epidemiology - BIPS (DE)
- Universitätsmedizin Göttingen (DE)
- Universitätsklinikum Aachen (DE)
- Paracelsus Elena Klinik Kassel (DE)
- Jülich Aachen Research Alliance (DE)
- Hertie Institute for Clinical Brain Research (DE)
- Evangelisches Krankenhaus Oldenburg (DE)
- University Hospital Cologne (DE)
- University Hospital Ulm (DE)
- IB Hochschule (DE)
- University of Rostock (DE)
- Amsterdam University of Applied Sciences (NL)
- University of Duisburg-Essen (DE)
- University of Göttingen (DE)
- Ludwig-Maximilians-Universität München (DE)
- University of Amsterdam (NL)
- RWTH Aachen University (DE)
- Ruhr University Bochum (DE)
Publication Details
- Journal
- npj Parkinson s Disease
- Published
- 2026-04-06
- DOI
- https://doi.org/10.1038/s41531-026-01338-3
- Primary Topic
- Parkinson's Disease Mechanisms and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Bundesministerium für Bildung und Forschung
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Studienstiftung des Deutschen Volkes
- Novartis Pharma