Background: Behavioral and psychological symptoms of dementia (BPSD) frequently complicate the clinical picture of cognitive impairment. The present study was aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy. Subjects and Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium. Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups, with LBD patients showing higher scores for hallucinations and psychosis cluster (vs. MCI). In primary dementias, we found a negative correlation between NPI total score and tau levels , while a positive non- significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy, on both hemispheres and hallucinations. GCA-F scores were positively correlated with psychosis cluster and agitation/aggression. Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores. Discussion and Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.
Background: Behavioral and psychological symptoms of dementia (BPSD) frequently complicate the clinical picture of cognitive impairment. The present study was aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy. Subjects and Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium. Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups, with LBD patients showing higher scores for hallucinations and psychosis cluster (vs. MCI). In primary dementias, we found a negative correlation between NPI total score and tau levels , while a positive non- significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy, on both hemispheres and hallucinations. GCA-F scores were positively correlated with psychosis cluster and agitation/aggression. Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores. Discussion and Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.
Behavioral and Psychological Symptoms of Dementia: correlation with Frontal Atrophy and CSF Tau levels in patients with cognitive impairment
LICOLLARI, ERG
2020/2021
Abstract
Background: Behavioral and psychological symptoms of dementia (BPSD) frequently complicate the clinical picture of cognitive impairment. The present study was aimed to investigate the BPSD distribution in subjects with cognitive impairment, and the potential correlations between BPSD and neurodegeneration in terms of cerebrospinal fluid (CSF) tau and brain atrophy. Subjects and Methods: One-hundred patients with mild cognitive impairment (MCI) or dementia (Alzheimer’s disease, AD; Lewy-body disease, LBD; frontotemporal dementia, FTD; vascular dementia, VD) underwent a complete diagnostic workup, including 3T-MRI and/or CT and CSF. Cortical atrophy was assessed with medial temporal atrophy (MTA), posterior atrophy (PA), and global cortical atrophy-frontal lobe (GCA-F) scales. BPSD were rated using the Neuropsychiatric Inventory (NPI), and BPSD clusters were defined according to the European Alzheimer Disease Consortium. Results: Delusions, hallucinations, and psychosis cluster were differently distributed among the diagnostic groups, with LBD patients showing higher scores for hallucinations and psychosis cluster (vs. MCI). In primary dementias, we found a negative correlation between NPI total score and tau levels , while a positive non- significant relationship was observed in MCI. Higher GCA-F scores were associated with delusions and apathy, on both hemispheres and hallucinations. GCA-F scores were positively correlated with psychosis cluster and agitation/aggression. Conversely, nighttime disturbances were positively correlated with both GCA-F and MTA scores. Discussion and Conclusion: Our results suggest that psychotic symptoms are significantly more represented in LBD patients and that CSF tau and frontal atrophy are associated with the occurrence and severity of BPSD in clinical practice. Longitudinal studies are however required to ascertain their actual predictive value.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/13273