Abstract
Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) not only differ for the time of onset of cognitive deficits but also present variability in affected functions which are relevant in understanding underlying pathology. Cognitive performance of two global cognitive screening scales, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), as well as of a neuropsychological test battery, was evaluated in 18 DLB and 21 PDD patients. Feasibility for each cognitive test was investigated. Both MMSE and MoCA are feasible assessments in PDD and DLB patients. MoCA was more sensitive in discriminating groups as higher number of DLB patients showed pathological performances on the Digit Span Forward subitem (p = 0.049). The Stroop test in PDD and the Trail Making Tests—A and B, and the Benton’s judgment of line orientation tests in both groups were considered not feasible. Among feasible cognitive tests in at least one group, Rey–Osterrieth complex figure test copy (p = 0.013) and semantic fluency (p = 0.038) are sensitive in discriminating DLB from PDD cognitive profile. Trail Making Tests—A and B, the Benton’s judgment of line orientation and the Stroop tests are not feasible for assessing patients with frank dementia. Longitudinal studies should not include those tasks to reduce the risk of missing data once disease progresses and dementia develops. DLB patients present more severe and widespread cognitive dysfunction than PDD, particularly in attentive, visuospatial, and language domains.
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References
Aldridge GM, Birnschein A, Denburg NL, Narayanan NS (2018) Parkinson’s disease dementia and dementia with Lewy bodies have similar neuropsychological profiles. Front Neurol 9:1–8. https://doi.org/10.3389/fneur.2018.00123
Biundo R, Weis L, Facchini S, Formento-Dojot P, Vallelunga A, Pilleri M, Antonini A (2014) Cognitive profiling of Parkinson disease patients with mild cognitive impairment and dementia. Parkinsonism Relat Disord 20(4):394–399. https://doi.org/10.1016/j.parkreldis.2014.01.009
Biundo R, Weis L, Bostantjopoulou S, Stefanova E, Falup-Pecurariu C, Kramberger MG, Aarsland D (2016) MMSE and MoCA in Parkinson’s disease and dementia with Lewy bodies: a multicenter 1-year follow-up study. J Neural Transm 123(4):431–438. https://doi.org/10.1007/s00702-016-1517-6
Borenstein M (2009) Effect sizes for continuous data. Handb of Res Synth Meta-Anal 2:221–235
Brønnick, K (2015) Cognitive profile in Parkinson’s disease dementia. In: M. Emre (Ed.) Cognitive Impairment and Dementia in Parkinson’s Disease. Oxford University Press, Oxford, pp. 27–45 10.1093/med/9780199681648.003.0004.
Brown EG, Tanner CM (2017) Impaired cognition and the risk of Parkinson disease trouble in mind. JAMA Neurol 74(12):1398–1400. https://doi.org/10.1001/jamaneurol.2017.1474
Compta Y, Parkkinen L, O’Sullivan SS, Vandrovcova J, Holton JL, Collins C, Revesz T (2011) Lewy- and Alzheimer-type pathologies in Parkinson’s disease dementia: which is more important? Brain 134:1493–1505. https://doi.org/10.1093/brain/awr031
IBM Corp (2013) IBM SPSS Statistics for Windows, Version 22.0. IBM Corp, Armonk
Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, Dubois B (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22(12):1689–1707. https://doi.org/10.1002/mds.21507
Fiorenzato E, Weis L, Falup-Pecurariu C, Diaconu S, Siri C, Reali E, Biundo R (2016) Montreal cognitive assessment (MoCA) and Mini-mental state examination (MMSE) performance in progressive supranuclear palsy and multiple system atrophy. J Neural Transm 123(12):1435–1442. https://doi.org/10.1007/s00702-016-1589-3
Fiorenzato E, Biundo R, Cecchin D, Frigo AC, Kim J, Weis L, Antonini A (2018) Brain amyloid contribution to cognitive dysfunction in early-stage Parkinson’s disease: the PPMI dataset. J Alzheimer’s Dis 66(1):229–237. https://doi.org/10.3233/JAD-180390
Fujishiro H, Iseki E, Higashi S, Kasanuki K, Murayama N, Togo T, Sato K (2010) Distribution of cerebral amyloid deposition and its relevance to clinical phenotype in Lewy body dementia. Neurosci Lett. https://doi.org/10.1016/j.neulet.2010.09.036
Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson disease. Arch Neurol 56(1):33–39
Hepp DH, Vergoossen DLE, Huisman E, Lemstra AW, Bank NB, Berendse HW, Van De Berg WDJ (2016) Distribution and load of amyloid-b pathology in Parkinson disease and dementia with Lewy bodies. J Neuropathol Exp Neurol 75(10):936–945. https://doi.org/10.1093/jnen/nlw070
Irwin D, Hurtig H (2018) The contribution of Tau, Amyloid-beta and alpha-Synuclein pathology to dementia in Lewy body disorders. J Alzheimer’s Dis Parkinsonism 8(4):55. https://doi.org/10.4172/2161-0460.1000444
Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N (1997) The PDQ-8: development and validation of a short-form Parkinson’s disease questionnaire. Psychol Health 12:805–814. https://doi.org/10.1080/08870449708406741
Kalaitzakis ME, Graeber MB, Gentleman SM, Pearce RKB (2008) Striatal β-amyloid deposition in Parkinson disease with Dementia. J Neuropathol Exp Neurol 67(2):155–161. https://doi.org/10.1097/NEN.0b013e31816362aa
Kramberger MG, Auestad B, Garcia-Ptacek S, Abdelnour C, Olmo JG, Walker Z, Aarsland D (2017) Long-term cognitive decline in dementia with Lewy bodies in a large multicentre, International cohort. J Alzheimer’s Dis 57(3):787–795. https://doi.org/10.3233/JAD-161109
Litvan I, Goldman JG, Tröster AI, Schmand BA, Weintraub D, Petersen RC, Emre M (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement disorder society task force guidelines. Mov Disord 27(3):349–356. https://doi.org/10.1002/mds.24893
Litvan I, Kieburtz K, Tröster AI, Aarsland D (2018) Strengths and challenges in conducting clinical trials in Parkinson’s disease mild cognitive impairment. Mov Disord 33(4):520–527. https://doi.org/10.1002/mds.27345
Mandal PK, Pettegrew JW, Masliah E, Hamilton RL, Mandal R (2006) Interaction between Aβ peptide and α synuclein: molecular mechanisms in overlapping pathology of Alzheimer’s and Parkinson’s in dementia with Lewy body disease. Neurochem Res 31(9):1153–1162. https://doi.org/10.1007/s11064-006-9140-9
McKeith I, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Kosaka K (2017) Diagnosis and management of dementia with Lewy bodies. Fourth consensus of the DLB consortium. Neurology 89(1):88–100. https://doi.org/10.1212/01.wnl.0000187889.17253.b1
Melzer TR, Stark MR, Keenan RJ, Myall DJ, MacAskill MR, Pitcher TL, Anderson TJ (2019) Beta amyloid deposition is not associated with cognitive impairment in Parkinson’s disease. Front Neurol. https://doi.org/10.3389/fneur.2019.00391
Mondon K, Gochard A, Marqué A, Armand A, Beauchamp D, Prunier C, Hommet C (2007) Visual recognition memory differentiates dementia with Lewy bodies and Parkinson’s disease dementia. J Neurol Neurosurg Psychiatr 78(7):738–741. https://doi.org/10.1136/jnnp.2006.104257
Petrova M, Mehrabian-Spasova S, Aarsland D, Raycheva M, Traykov L (2015) Clinical and neuropsychological differences between mild Parkinson’s disease dementia and dementia with Lewy bodies. Dement Geriatr Cognit Disord Extra 5(2):212–220. https://doi.org/10.1159/000375363
Spillantini MG, Goedert M (2000) The α-Synucleinopathies: Parkinson’s disease, dementia with Lewy bodies, and multiple system atrophy. Ann N Y Acad Sci 920(1):16–27. https://doi.org/10.1111/j.1749-6632.2000.tb06900.x
Stinton C, McKeith I, Taylor JP, Lafortune L, Mioshi E, Mak E, O’Brien JT (2015) Pharmacological management of Lewy body dementia: a systematic review and meta-analysis. Am J Psychiatr 172(8):731–742. https://doi.org/10.1176/appi.ajp.2015.14121582
Taler V, Phillips NA (2008) Language performance in Alzheimer’s disease and mild cognitive impairment: a comparative review. J Clin Exp Neuropsychol 30(5):501–556. https://doi.org/10.1080/13803390701550128
Thomas AJ, Attems J, Colloby SJ, O’Brien JT, Mckeith I, Walker R, Walker Z (2017) Autopsy validation of 123 I-FP-CIT dopaminergic neuroimaging for the diagnosis of DLB. Neurology 88:276–328. https://doi.org/10.1212/WNL.0000000000003512
Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25(15):2649–2685. https://doi.org/10.1002/mds.23429
Troyer AK, Moscovitch M, Winocur G, Alexander MP, Stuss D (1998) Clustering and switching on verbal fluency: the effects of focal frontal- and temporal-lobe lesions. Neuropsychologia. https://doi.org/10.1016/S0028-3932(97)00152-8
Walker L, McAleese KE, Thomas AJ, Johnson M, Martin-Ruiz C, Parker C, Attems J (2015) Neuropathologically mixed Alzheimer’s and Lewy body disease: burden of pathological protein aggregates differs between clinical phenotypes. Acta Neuropathol 129:729–748. https://doi.org/10.1007/s00401-015-1406-3
Yamanishi T, Tachibana H, Oguru M, Matsui K, Toda K, Okuda B, Oka N (2013) Anxiety and depression in patients with Parkinson’s disease. Intern Med 52(5):539–545
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We acknowledge Dr Marco Ciavarro of the IRCSS Neuromed Institute, Pozzilli, IS, Italy for neuropsychological critical discussion.
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Martini, A., Weis, L., Schifano, R. et al. Differences in cognitive profiles between Lewy body and Parkinson’s disease dementia. J Neural Transm 127, 323–330 (2020). https://doi.org/10.1007/s00702-019-02129-2
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DOI: https://doi.org/10.1007/s00702-019-02129-2