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Ildebrando Appollonio, MD; Jordan Grafman, PhD; Kim Clark; Paolo Nichelli, MD; Thomas Zeffiro, MD; Mark Hallett, MD

Arch Neurol. 1994;51(4):359-367.

Abstract
Objective
To study explicit and implicit memory processes in patients with Parkinson's disease.

Design
Case-control design. All subjects were given a neuropsychological test battery, and the test scores were compared among the groups.

Setting
Government-funded research facility. All subjects were examined as outpatients.

Patients
We tested nondemented (n=13) and demented (n=5) patients with Parkinson's disease and normal controls (n=12) matched for age, gender, and educational level.

Main Outcome Measures
Memory for verbal and pictorial stimuli under both explicit and implicit retrieval conditions.

Results
Both nondemented and demented patients with Parkinson's disease exhibited impairment on tests of explicit memory. Their impairment could be graded based on the level of effort required by the task: impaired free recall in nondemented patients and impaired free recall, cued recall, and recognition in demented patients. By contrast, neither group showed evidence of impairment on automatic (modality monitoring and word frequency estimation) or implicit (word and picture fragment identification) memory tasks. Correlation analyses did not support any association between the effortful memory deficits and neurologic variables, mood, or performance on executive function tests.

Conclusions
Memory deficits in patients with Parkinson's disease primarily involve the conscious, effortful strategic aspects of searching long-term memory.

Author Affiliations
From the Cognitive Neuroscience Section (Drs Appollonio, Grafman, Nichelli, and Hallett and Ms Clark) and the Human Motor Control Section (Drs Zeffiro and Hallett), Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md; and the Departments of Neurology, University of Milan, San Gerardo Hospital, Monza, Italy (Dr Appollonio), and the University of Modena (Italy) (Dr Nichelli).

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