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Cerebral Cortex 1992; 2:513-525
© Oxford University Press 1992

research-article

Attention and Sentence Processing Deficits in Parkinson's Disease: The Role of Anterior Cingulate Cortex

Murray Grossman, Peter Crino, Martin Reivich, Matthew B. Stem and Howard I. Hurtig

Department of Neurology, University of Pennsylvania School of Medicine, and The Graduate Hospital Philadelphia, Pennsylvania 19104-4283

Correspondence should be addressed to Murray Grossman, Cognitive Neurology Section, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4283

Parkinson's disease (PD) is a complex neurodegenerative condition involving a motor disorder that is related to reduced dopaminergic input to the striatum. Intellectual deficits are also seen in PD, but the pathophysiology of these difficulties is poorly understood. Regional cerebral blood flow (rCBF) was studied in neurologically intact subjects during the performance of attention-demanding, sentence processing tasks using positron emission tomography (PET). The results demonstrated significantly increased rCBF in a distributed set of cerebral regions during the detection of an adjective or a particular agent in a sentence, including anterior cingulate cortex, left inferior and middle frontal cortex, left inferior temporo-occipital cortex, posterolateral temporal cortex, left caudate, and left thalamus. We identified defects in this cerebral network by studying PD patients with two PET techniques. Resting PET studies revealed a significant correlation between regional cerebral glucose metabolism in anterior cingulate cortex and deficits in attending to subtle grammatical aspects of sentences. Studies of PD patients with the PET activation technique revealed little change in anterior cingulate and left frontal CBF during performance of the adjective detection or agent detection tasks. These data suggest that a defect in anterior cingulate cortex contributes to the cognitive impairments observed in PD.


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