Vipiteno

Researchers are investigating the potential of neurophysiological biomarkers from paired-pulse Transcranial Magnetic Stimulation (TMS) techniques to diagnose and predict cognitive impairment in individuals with Parkinson's disease (PD). Cognitive decline is a common and challenging symptom in PD, affecting up to 80% of patients in advanced stages. The study aims to determine if TMS measures of cortical excitability can distinguish between PD patients who are cognitively normal, have mild cognitive impairment (PD-MCI), or dementia (PD-D), and whether these measures can predict cognitive progression over time. Participants will undergo paired-pulse TMS testing to collect measures such as Short Interval Cortical Inhibition (SICI), Short Latency Afferent Inhibition (SAI), and Intracortical Facilitation (ICF). These tests explore the function of neural circuits involved in cognition. The study will categorize patients based on cognitive status and assess them at baseline, then again at one, two, and three years follow-up. The goal is to compare TMS measures between groups and evaluate their value in predicting cognitive decline progression from normal to MCI and from MCI to dementia. During the study, participants will receive comprehensive neurological and neuropsychological evaluations alongside TMS tests at each time point. Researchers will monitor changes in TMS measures and cognitive status over three years. The primary outcomes include comparing SAI, SICI, and ICF among PD patients at different cognitive stages and those who experience cognitive progression. This long-term follow-up will help clarify the diagnostic and prognostic role of these neurophysiological biomarkers in Parkinson's disease cognitive impairment.