Predicting cognitive decline using neuropsychiatric symptoms in prodromal Lewy body dementia: A longitudinal study.
Predicting cognitive decline using neuropsychiatric symptoms in prodromal Lewy body dementia: A longitudinal study.
复制标题
利用前驱路易体痴呆的神经精神症状预测认知能力下降：一项纵向研究。
DOI：
10.1016/j.parkreldis.2023.105762
复制
发表时间：
2023
影响因子：
4.1
通讯作者：
Wright LM
中科院分区：
文献类型：
--
作者：
Wright LM
简介路易体痴呆 (LBD) 中的神经精神症状 (NPS) 在疾病进展的早期频繁发生。这些症状与生活质量较差、护理人员负担和功能限制有关。然而，概述 NPS 与前驱 LBD 认知能力下降之间纵向关系的证据有限。方法 123 名参与者来自三项队列研究。与可能的路易体痴呆（MCI-LB，n = 67）和帕金森病（PD-MCI，n = 56）相关的轻度认知障碍（MCI）患者完成了全面的认知和神经精神评估，并进行了纵向随访。线性回归和混合效应模型评估了基线 NPS 与基线和随时间变化的认知之间的关系。结果在 MCI-LB 中，总体 NPS 负担与执行功能 (p = 0.026) 和处理速度 (p = 0.028) 随时间的下降相关，基线异常运动行为与注意力下降相关 (p < 0.025)。焦虑与基线时较差的视觉空间功能 (p = 0.016) 以及基线时 (p = 0.017) 和跨时间点 (p = 0.024) 的注意力较差显着相关。在 PD-MCI 中，精神病与基线 (p = 0.008) 和跨时间点 (p = 0.002) 较差的执行功能相关，但与纵向变化没有关联。结论 LBD 的核心神经精神成分与前驱疾病的认知没有很强的相关性。这可能表明 NPS 的神经病理学机制可能与认知障碍的神经病理学机制不同。然而，非核心 NPS 可能与认知变化更直接相关。未来的研究需要利用神经影像技术来探索前驱 LBD 中 NPS 的神经病理学基础。
IntroductionNeuropsychiatric symptoms (NPS) in Lewy body dementias (LBD) occur frequently and early in disease progression. Such symptoms are associated with worse quality of life, caregiver burden and functional limitations. Limited evidence exists, however, outlining the longitudinal relationship between NPS and cognitive decline in prodromal LBD.Methods123 participants were derived from three cohort studies. Patients with mild cognitive impairment (MCI) relating to probable dementia with Lewy bodies (MCI-LB, n = 67) and Parkinson's disease (PD-MCI, n = 56) completed comprehensive cognitive and neuropsychiatric assessment and were followed up longitudinally. Linear regression and mixed effects models assessed the relationship between baseline NPS and cognition at baseline and over time.ResultsIn MCI-LB, overall NPS burden was associated with declines over time in executive function (p = 0.026) and processing speed (p = 0.028) and baseline aberrant motor behaviour was associated with declines in attention (p < 0.025). Anxiety was significantly associated with poorer visuospatial functioning (p = 0.016) at baseline and poorer attention both at baseline (p = 0.017) and across time points (p = 0.024). In PD-MCI, psychosis was associated with poorer executive functioning at baseline (p = 0.008) and across time points (p = 0.002) but had no association with changes longitudinally.ConclusionsCore neuropsychiatric components of LBD are not strongly associated with cognition in prodromal disease. This may suggest that neuropathological mechanisms underlying NPS may not be the same as those underlying cognitive impairment. Non-core NPS, however, may be more directly associated with cognitive change. Future studies utilising neuroimaging techniques are needed to explore the neuropathological basis of NPS in prodromal LBD.
影响因子：
4.1
作者：
Schrag, A;Hovris, A;Jahanshahi, M
通讯作者：
Jahanshahi, M
影响因子：
120.7
作者：
Lyketsos, CG;Lopez, O;DeKosky, S
通讯作者：
DeKosky, S