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01-10-2018 | Original Communication

Neuropsychiatric symptoms and α-Synuclein profile of patients with Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease

Authors: Anastasia Bougea, Leonidas Stefanis, George P. Paraskevas, Evangelia Emmanouilidou, Efthimia Efthymiopoulou, Kostas Vekrelis, Elisabeth Kapaki

Published in: Journal of Neurology | Issue 10/2018

Abstract

Introduction

Given the overlapping of neuropathological, neurochemical and neuropsychiatric profiles of Parkinson’s disease dementia (PDD), dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD), their differential diagnosis is challenging. Specific neuropsychiatric features or biomarkers, such as cerebrospinal fluid (CSF) α-Synuclein (α-Syn), may aid in differential diagnosis. This study aims to compare the neuropsychiatric and CSF α-Syn profiles in these conditions, and to investigate the possible association between CSF α-Syn levels and neuropsychiatric symptoms.

Methods

We conducted a prospective cross-sectional study, between January 2013 and January 2015, with 16 PDD, 28 DLB and 19 AD patients. All participants underwent a detailed clinical, neuropsychological, neuropsychiatric [Neuropsychiatric Inventory (NPI)] and CSF α-Syn analysis.

Results

Significantly greater NPI Hallucinations Subitem score was found in the PDD and DLB groups compared to AD (both p < 0.001). NPI Agitation score was greater in the DLB compared to PDD group (p = 0.012). NPI Sleep score was greater in the DLB compared to AD group (p = 0.001). Total NPI score was greater in the DLB compared to AD and PDD groups. To discriminate between the DLB and AD and between DLB and PDD groups, logistic regression analysis showed that both NPI scores and α-Syn levels were independently associated. There was no correlation between NPI scores and α-Syn levels. Increased NPI scores and α-Syn levels are associated with greater likelihood for being in DLB than in PDD or AD groups. ROC analysis showed that the combination of NPI and α-Syn increases the discriminative ability of each marker alone (p < 0.001) with AUC equal to 0.95 (95% CI 0.91–0.99).

Conclusion

NPI scores and CSF α-Syn levels were useful as independent variables to differentiate DLB from PDD and AD.

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Title: Neuropsychiatric symptoms and α-Synuclein profile of patients with Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease
Authors: Anastasia Bougea
Leonidas Stefanis
George P. Paraskevas
Evangelia Emmanouilidou
Efthimia Efthymiopoulou
Kostas Vekrelis
Elisabeth Kapaki
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 10/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8992-7

At a glance: The STEP trials

Springer Medicine

Neuropsychiatric symptoms and α-Synuclein profile of patients with Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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