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Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies

OBJECTIVE: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at the mild cognitive impairment (MCI) stage, with particular emphasis on visual space and object perception abilities. METHODS: Fifty-t...

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Autores principales: Cagnin, Annachiara, Bussè, Cinzia, Gardini, Simona, Jelcic, Nela, Guzzo, Caterina, Gnoato, Francesca, Mitolo, Micaela, Ermani, Mario, Caffarra, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677697/
https://www.ncbi.nlm.nih.gov/pubmed/26674638
http://dx.doi.org/10.1159/000441184
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author Cagnin, Annachiara
Bussè, Cinzia
Gardini, Simona
Jelcic, Nela
Guzzo, Caterina
Gnoato, Francesca
Mitolo, Micaela
Ermani, Mario
Caffarra, Paolo
author_facet Cagnin, Annachiara
Bussè, Cinzia
Gardini, Simona
Jelcic, Nela
Guzzo, Caterina
Gnoato, Francesca
Mitolo, Micaela
Ermani, Mario
Caffarra, Paolo
author_sort Cagnin, Annachiara
collection PubMed
description OBJECTIVE: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at the mild cognitive impairment (MCI) stage, with particular emphasis on visual space and object perception abilities. METHODS: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25) and AD (MCI-AD: n = 28) at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS) and questionnaires for cognitive fluctuations and sleep disorders were also administered. RESULTS: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9) detected in 72% of patients, followed by REM sleep behavior disorder (60%) and fluctuations (60%). Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. CONCLUSIONS: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB.
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spelling pubmed-46776972015-12-15 Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies Cagnin, Annachiara Bussè, Cinzia Gardini, Simona Jelcic, Nela Guzzo, Caterina Gnoato, Francesca Mitolo, Micaela Ermani, Mario Caffarra, Paolo Dement Geriatr Cogn Dis Extra Original Research Article OBJECTIVE: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at the mild cognitive impairment (MCI) stage, with particular emphasis on visual space and object perception abilities. METHODS: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25) and AD (MCI-AD: n = 28) at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS) and questionnaires for cognitive fluctuations and sleep disorders were also administered. RESULTS: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9) detected in 72% of patients, followed by REM sleep behavior disorder (60%) and fluctuations (60%). Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. CONCLUSIONS: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB. S. Karger AG 2015-11-24 /pmc/articles/PMC4677697/ /pubmed/26674638 http://dx.doi.org/10.1159/000441184 Text en Copyright © 2015 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.
spellingShingle Original Research Article
Cagnin, Annachiara
Bussè, Cinzia
Gardini, Simona
Jelcic, Nela
Guzzo, Caterina
Gnoato, Francesca
Mitolo, Micaela
Ermani, Mario
Caffarra, Paolo
Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title_full Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title_fullStr Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title_full_unstemmed Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title_short Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies
title_sort clinical and cognitive phenotype of mild cognitive impairment evolving to dementia with lewy bodies
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677697/
https://www.ncbi.nlm.nih.gov/pubmed/26674638
http://dx.doi.org/10.1159/000441184
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