Neurological

Use of neuropsychological profiles to differentiate MCI progression from Alzheimer’s disease vs. Lewy body dementia

The following article is part of the conference coverage of the virtual annual meeting of the International Congress on Parkinson’s and Movement Disorders (MDS). Neurology Advisor staff will share the latest news related to research from leading neurology experts. Look back for the latest news from the MDS 2021 Annual Virtual Meeting.

Using neuropsychological profiles to predict the progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD) or Lewy body dementia (LBD) is challenging but can be useful for early therapeutic interventions, according to those on the International Congress of. presented study results Virtual Congress on Parkinson’s and Movement Disorders (MDS) 2021, which will take place from September 17 to 22, 2021.

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Clinicians typically rely on clinical symptoms as well as neurocognitive assessments and neuroimaging to predict progression to AD or LBD in patients with mild cognitive impairment. Differentiating AD from LBD early on can help identify treatment approaches that can delay disease progression.

The current study aimed to understand the specific neuropsychological features that could help differentiate between the two neurological disorders AD and LBD.

A researcher from the National and Kapodistrian University of Athens in Greece searched publication databases for studies published after 2005 that assessed clinical or neuropsychological features that may help distinguish progression to AD or LBD in patients with MCI. A total of 17 articles were included in this review.

The main consensus of these articles was that episodic waves and memory deficits in detection are more characteristic of progression to AD. This pattern is in contrast to that of the progression to DLB, in which patients show more executive functional, attention and visuospatial impairments, combined with difficulties in language fluency and concentration.

In addition, amnesiac symptoms can be used to stratify patients in which patients with MCI are more likely to progress to AD versus LBD with memory loss.

The author of the review noted that cognitive scoring alone is not enough to robustly predict disease progression. However, quantitative electroencephalogram assessment can provide better patient stratification. Patients with MCI who presented with preserved hippocampal volume were more likely to develop LBD than AD. By combining these methods, a more robust prediction can be made in which patients who present with preserved hippocampal volume and who are not amnesiac are more likely to progress to LBD.

The review author noted that some published evidence was conflicting and that predicting the progression to AD or LBD in patients with MCI remained challenging.

“Further studies are needed as there are sometimes conflicting results and the combination of clinical symptoms with neurocognitive assessment and neuroimaging is currently the ideal method for predicting MCI progression to various forms of dementia,” concluded the researcher.

reference

Voskou P. Differentiation of the progression of a mild cognitive impairment (MCI) to Alzheimer’s disease (AD) vs. dementia with Lewy bodies (DLB): is this neuropsychologically possible? Presented at: MDS Virtual Congress 2021; 17.-22. September 2021. Executive summary 82.

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