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Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months
OBJECTIVE: This study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448556/ https://www.ncbi.nlm.nih.gov/pubmed/34404743 http://dx.doi.org/10.1212/WNL.0000000000012450 |
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author | Matar, Elie White, Simon R. Taylor, John-Paul Thomas, Alan McKeith, Ian G. Kane, Joseph P.M. Surendranathan, Ajenthan Halliday, Glenda M. Lewis, Simon J.G. O'Brien, John T. |
author_facet | Matar, Elie White, Simon R. Taylor, John-Paul Thomas, Alan McKeith, Ian G. Kane, Joseph P.M. Surendranathan, Ajenthan Halliday, Glenda M. Lewis, Simon J.G. O'Brien, John T. |
author_sort | Matar, Elie |
collection | PubMed |
description | OBJECTIVE: This study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive fluctuations, and sleep disturbance. METHODS: One hundred sixteen patients with Lewy body dementia (DLB = 72, PDD = 44) underwent assessment at baseline and 3 and 6 months as part of a prospective multicenter randomized controlled trial. Linear mixed models were constructed for core outcome measures using the Mini-Mental State Examination (MMSE), motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Dementia Cognitive Fluctuations Scale (DCFS), and Neuropsychiatric Inventory (NPI). RESULTS: Within the time frame of our study (6 months), we were able to identify a significant cognitive decline of 1.3 points on the MMSE (p = 0.002) and significant worsening of motor parkinsonism with an increase in UPDRS-III score of 3.2 points (p = 0.018). Fluctuation severity also increased using the DCFS with a 6-month change in score of 1.3 points (p = 0.001). Uniquely, a signal for increased severity of sleep symptoms of 1.2 points (NPI-sleep) was also detectable (p = 0.04). Significant changes in neuropsychiatric symptoms were not detected. There was no difference in rates of change of scores between DLB and PDD. DISCUSSION: Clinically significant rates of change in core clinical features can be detected and quantified in Lewy body dementia over a relatively short period (6 months) using common clinical instruments and thus may be useful as clinical endpoints for therapeutic trials of disease-modifying and symptomatic agents. |
format | Online Article Text |
id | pubmed-8448556 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-84485562021-09-20 Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months Matar, Elie White, Simon R. Taylor, John-Paul Thomas, Alan McKeith, Ian G. Kane, Joseph P.M. Surendranathan, Ajenthan Halliday, Glenda M. Lewis, Simon J.G. O'Brien, John T. Neurology Research Article OBJECTIVE: This study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive fluctuations, and sleep disturbance. METHODS: One hundred sixteen patients with Lewy body dementia (DLB = 72, PDD = 44) underwent assessment at baseline and 3 and 6 months as part of a prospective multicenter randomized controlled trial. Linear mixed models were constructed for core outcome measures using the Mini-Mental State Examination (MMSE), motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Dementia Cognitive Fluctuations Scale (DCFS), and Neuropsychiatric Inventory (NPI). RESULTS: Within the time frame of our study (6 months), we were able to identify a significant cognitive decline of 1.3 points on the MMSE (p = 0.002) and significant worsening of motor parkinsonism with an increase in UPDRS-III score of 3.2 points (p = 0.018). Fluctuation severity also increased using the DCFS with a 6-month change in score of 1.3 points (p = 0.001). Uniquely, a signal for increased severity of sleep symptoms of 1.2 points (NPI-sleep) was also detectable (p = 0.04). Significant changes in neuropsychiatric symptoms were not detected. There was no difference in rates of change of scores between DLB and PDD. DISCUSSION: Clinically significant rates of change in core clinical features can be detected and quantified in Lewy body dementia over a relatively short period (6 months) using common clinical instruments and thus may be useful as clinical endpoints for therapeutic trials of disease-modifying and symptomatic agents. Lippincott Williams & Wilkins 2021-09-07 /pmc/articles/PMC8448556/ /pubmed/34404743 http://dx.doi.org/10.1212/WNL.0000000000012450 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Matar, Elie White, Simon R. Taylor, John-Paul Thomas, Alan McKeith, Ian G. Kane, Joseph P.M. Surendranathan, Ajenthan Halliday, Glenda M. Lewis, Simon J.G. O'Brien, John T. Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title | Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title_full | Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title_fullStr | Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title_full_unstemmed | Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title_short | Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months |
title_sort | progression of clinical features in lewy body dementia can be detected over 6 months |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448556/ https://www.ncbi.nlm.nih.gov/pubmed/34404743 http://dx.doi.org/10.1212/WNL.0000000000012450 |
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