Cognitive Impairments in Parkinson’s Disease: Professional Support and Unmet Rehabilitation Needs in Patients with and without Self-Reported Cognitive Impairments—A Secondary Analysis

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

very interesting research but can be improved

explain that k-s test show no normal distribution and support the use of non-parametric tests, delete phrase in page 4 : if normally distributed, so you present all continuous variables in mean and sd independent that all are no normally distributed. In kruskal wallis test is necceary post hoc pairwise comparisons to detect between with pairs of groups are the differences, explain and show them in tables. It will be good to perform a multiple multinomial regression to evaluate with variables characterize the groups. Finally explain why you dont need approval of ethic comintee

Author Response

Thank you very much for taking the time to review this manuscript. Please see the attachment for the responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files. 

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

First of all, thank you for the opportunity to review the article.

Cognitive impairments in Parkinson’s disease: Professional support and unmet rehabilitation needs in patients with and without self-reported cognitive impairments. This deals with a very relevant and pertinent issue today, disabling chronic diseases, such as Parkinson's, and therefore all knowledge that can be revealed on the subject is beneficial.

The article is well-founded, but it would be important to highlight in greater detail what cognitive deficiencies are when talking about Parkinson's disease, for example without mentioning orientation, gnosis, praxis, social cognition. In methodological terms, it is a descriptive study but with interesting results and relevant to an international audience.

Author Response

Thank you very much for taking the time to review this manuscript. Please see the attachment for the responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files. 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The study aimed to analysis Professional support and unmet rehabilitation needs in patients with Parkinson’s disease either with or without self-reported cognitive impairments. The work is interesting and important. Please find the following comments:

1- Title: seems good

2- Abstract: good

3- Introduction: Well written, Revise line 52

4- Methods:
- Specify that is a secondary-analysis
- Define the inclusion criteria
- Define the abbreviation PDQ-39 IN LINE 98
- Did the patients filled all PDQ-39 or the items that are related to cognitive
- Clarify better the categorization of participants, With-or without cognitive impairments

4- Results: Clear

5- Discussion: There is no research or clinical recommendations

 

Author Response

Thank you very much for taking the time to review this manuscript. Please see the attachment for the responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files. 

Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for submitting your manuscript to the journal. Your study on cognitive impairments in Parkinson’s disease (PD) and the associated unmet rehabilitation needs is both timely and relevant. However, there are several areas where further clarifications and additions could strengthen the manuscript. Here is a detailed review along with some suggestions for improvement:

1. The manuscript addresses a significant gap in the field by focusing on non-motor symptoms, specifically cognitive impairments in PD, which is commendably relevant. It would be beneficial to discuss how this focus on non-motor symptoms compares with current trends in PD research within the literature review section.

2. Acknowledge the use of the PDQ-39 despite its known limitations, explaining the decision and discussing how it might have affected your results.

3. The references are appropriate; however, including a few more recent studies could provide a stronger backdrop for your findings.

4. Discuss the potential impact of proxy responses on the study outcomes more thoroughly, considering how proxies might report differently than patients.

Author Response

Thank you very much for taking the time to review this manuscript. Please see the attachment for the responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files. 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

pare is now better, I suggest to perform a multiople logistic regression for each two groups to asses the effect of baseline covariables of interest

Author Response

Dear reviewer

Thank you very much for taking your time to review our manuscript. We are happy to hear that you find the paper has improved. 

You ‘suggest to perform a multiople logistic regression for each two groups to asses the effect of baseline covariables of interest’

This is an interesting suggestion. Still, we kindly disagree on performing such an analysis on our paper which is purely descriptive. 

A multiple logistic regression would indeed be very relevant to pursue within a study with another aim.

The current aim for which we have argued in the background is:

This study aims to further analyze these national survey data to explore professional support and unmet rehabilitation needs among people living with PD with and without perceived cognitive impairments.  More specifically, we aim to determine any significant differences among people living with PD with and without perceived cognitive impairments regarding 1) which health professionals they have been in contact with and 2) which unmet needs for rehabilitation services they have reported.

Hence, the aim of the study is purely descriptive and not to test variables that might explain the prevalence/risk of cognitive impairments.

We hope that you will recognize this disposition.

Best wishes, on behalf of the authors

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for revising the manuscript

Author Response

Dear reviewer

Thank you for taking your time to review our manuscript and for a positive responsen.- 

BW