Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies
Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies
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DOI：
10.1017/s0033291717003956
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发表时间：
2018-10-01
影响因子：
6.9
通讯作者：
Thomas, Alan J.
中科院分区：
文献类型：
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作者：
Donaghy, Paul C.;Taylor, John-Paul;Thomas, Alan J.
背景。轻度认知障碍（MCI）的准确临床特征变得越来越重要。本研究的目的是比较路易体型MCI （MCI- lb）和阿尔茨海默病MCI （MCI- ad）的神经精神症状和认知特征。参与者年龄为60岁，患有轻度认知障碍。每位患者都进行了全面的临床和神经心理学评估，并进行了2 β -碳甲氧基-3 β -（4-碘苯基）-n -（3-氟丙基）-nortropane单光子发射计算机断层扫描（FP-CIT SPECT）。如果出现两种或两种以上路易体痴呆的诊断特征（视幻觉、认知波动、运动帕金森症、快速眼动睡眠行为障碍或FP-CIT SPECT阳性），则诊断为MCI-LB。根据2017年DLB诊断标准所定义的支持性神经精神症状（非视觉幻觉、妄想、焦虑、抑郁和冷漠）的存在与否，计算路易体神经精神支持性症状计数（LBNSSC）。MCI-LB （n = 41）的LBNSSC高于MCI-AD （n = 24; 1.8 1.1 v. 0.7 +/- 0.9, p = 0.001）。67%的MCI-LB患者有上述两种或两种以上症状，而16%的MCI-AD患者有上述症状（似然比= 4.2,p < 0.001）。MCI-LB受试者在注意力、视觉空间功能和语言流畅性测试中得分较低。然而，单独的认知测试分数并不能准确区分MCI-LB和mci - ad。MCI-LB与神经精神症状和认知特征相关，与已建立的DLB相似。这支持了基于DLB的核心诊断特征和异常FP-CIT SPECT成像来识别MCI-LB的概念。2017年DLB诊断标准中确定的支持性神经精神临床特征的存在有助于区分MCI-LB和MCI-AD。
Background. The accurate clinical characterisation of mild cognitive impairment (MCI) is becoming increasingly important. The aim of this study was to compare the neuropsychiatric symptoms and cognitive profile of MCI with Lewy bodies (MCI-LB) with Alzheimer's disease MCI (MCI-AD).Methods. Participants were >= 60 years old with MCI. Each had a thorough clinical and neuropsychological assessment and 2 beta-carbomethoxy-3 beta-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computed tomography FP-CIT SPECT). MCI-LB was diagnosed if two or more diagnostic features of dementia with Lewy bodies were present (visual hallucinations, cognitive fluctuations, motor parkinsonism, rapid eye movement sleep behaviour disorder or positive FP-CIT SPECT). A Lewy body Neuropsychiatric Supportive Symptom Count (LBNSSC) was calculated based on the presence or absence of the supportive neuropsychiatric symptoms defined by the 2017 DLB diagnostic criteria: non-visual hallucinations, delusions, anxiety, depression and apathy.Results. MCI-LB (n = 41) had a higher LBNSSC than MCI-AD (n = 24; 1.8 1.1 v. 0.7 +/- 0.9, p = 0.001). 67% of MCI-LB had two or more of those symptoms, compared with 16% of MCI-AD (Likelihood ratio = 4.2, p < 0.001). MCI-LB subjects scored lower on tests of attention, visuospatial function and verbal fluency. However, cognitive test scores alone did not accurately differentiate MCI-LB from MCI-AD.Conclusions. MCI-LB is associated with neuropsychiatric symptoms and a cognitive profile similar to established DLB. This supports the concept of identifying MCI-LB based on the presence of core diagnostic features of DLB and abnormal FP-CIT SPECT imaging. The presence of supportive neuropsychiatric clinical features identified in the 2017 DLB diagnostic criteria was helpful in differentiating between MCI-LB and MCI-AD.