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Euler MJ, Duff K, King JB, Hoffman JM. Recall and recognition subtests of the repeatable battery for the assessment of neuropsychological status and their relationship to biomarkers of Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:885-902. [PMID: 36110031 PMCID: PMC10014490 DOI: 10.1080/13825585.2022.2124229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
Recently, two new recognition subtests for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were developed and initially validated in a cohort of older adults who were cognitively intact or classified as amnestic Mild Cognitive Impairment (MCI) or mild Alzheimer's disease (AD). The current paper extends that validation by comparing the recall and recognition subtests of the RBANS, including the existing and recently developed scores, to three commonly used biomarkers in AD in an expanded sample from the initial validation. One hundred fifty-four older adults (65 intact, 46 MCI, 43 AD) were administered the RBANS, which included the recently developed subtests for Story Recognition and Figure Recognition (hits, false positives, total correct), as part of a study on memory and biomarkers. Participants also completed magnetic resonance imaging to obtain hippocampal volumes, positron emission tomography to obtain amyloid plaque deposition, and a blood draw to obtain APOE ε4 status. Whereas correlations between recall scores and biomarkers tended to be moderate (average r = ±0.48), these correlations were comparable across the three recognition total scores (average r = ±0.42), but tended to be lower for recognition hits (average r = ±0.28) and false positives (average r = ±0.38). These results further validate the existing and recently developed recognition scores on the RBANS as providing useful information about brain and genetic pathology in older adults with intact and impaired cognitive functioning.
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Affiliation(s)
- Matthew J Euler
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
- Radiology and Imaging Sciences, Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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2
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Abdelnour C, Poston KL. Cognitive Impairment in Neurodegenerative Movement Disorders. Semin Neurol 2023; 43:81-94. [PMID: 36940727 DOI: 10.1055/s-0043-1764204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Patients with neurodegenerative movement disorders can develop cognitive impairment during the disease. Cognitive symptoms have been associated with decreased quality of life, higher caregiver burden, and earlier institutionalization, and are therefore critical for physicians to understand and address. The evaluation of cognitive performance of patients with neurodegenerative movement disorders is important for providing adequate diagnosis, management, prognosis, and support patients and their caregivers. In this review, we discuss the features of the cognitive impairment profile of commonly encountered movement disorders: Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome, and Huntington's disease. In addition, we provide neurologists with practical guidance and evaluation tools for the assessment and management of these challenging patients.
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Affiliation(s)
- Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
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3
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Pathomechanisms of cognitive impairment in progressive supranuclear palsy. J Neural Transm (Vienna) 2023; 130:481-493. [PMID: 36862189 DOI: 10.1007/s00702-023-02613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
Progressive supranuclear palsy (PSP) is a neurodegenerative disorder characterized by early postural instability and falls, oculomotor dysfunction (vertical supranuclear gaze palsy), parkinsonism with poor response to levodopa, pseudobulbar palsy, and cognitive impairment. This four-repeat tauopathy is morphologically featured by accumulation of tau protein in neurons and glia causing neuronal loss and gliosis in the extrapyramidal system associated with cortical atrophy and white matter lesions. Cognitive impairment being frequent in PSP and more severe than in multiple system atrophy and Parkinson disease, is dominated by executive dysfunction, with milder difficulties in memory, and visuo-spatial and naming dysfunctions. Showing longitudinal decline, it has been related to a variety of pathogenic mechanisms associated with the underlying neurodegenerative process, such as involvement of cholinergic and muscarinergic dysfunctions, and striking tau pathology in frontal and temporal cortical regions associated with reduced synaptic density. Altered striatofrontal, fronto-cerebellar, parahippocampal, and multiple subcortical structures, as well as widespread white matter lesions causing extensive connectivity disruptions in cortico-subcortical and cortico-brainstem connections, support the concept that PSP is a brain network disruption disorder. The pathophysiology and pathogenesis of cognitive impairment in PSP, as in other degenerative movement disorders, are complex and deserve further elucidation as a basis for adequate treatment to improve the quality of life of patients with this fatal disease.
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Salis F, Costaggiu D, Mandas A. Mini-Mental State Examination: Optimal Cut-Off Levels for Mild and Severe Cognitive Impairment. Geriatrics (Basel) 2023; 8:12. [PMID: 36648917 PMCID: PMC9844353 DOI: 10.3390/geriatrics8010012] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Considering the need to intercept neurocognitive damage as soon as possible, it would be useful to extend cognitive test screening throughout the population. Here, we propose differential cut-off levels that can be used to identify mild and severe cognitive impairment with a simple and widely used first-level neurocognitive screening test: the Mini-Mental State Examination (MMSE). We studied a population of 262 patients referred for cognitive impairment testing using the MMSE and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a neuropsychological battery. The sample consisted of 262 participants with mean age 73.8 years (60-87), of whom 154 (58.8%) women. No significant gender-related differences in cognitive ability were identified. The two tests (MMSE and RBANS) showed a moderate correlation in identifying cognitive deficit. We used RBANS as a categorial variable to identify different degrees of cognitive impairment. Youden's J indexes were used to consider the better sensitivity/specificity balance in the 24-point cut-off score for severe cognitive deficit, 29.7-point score for mild cognitive deficit, and 26.1-point score for both mild and severe cognitive deficit. The study shows that the MMSE does not identify early cognitive impairment. Though different cut-offs are needed to discriminate different impairment degrees, the 26.1-point score seems to be preferable to the others.
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Affiliation(s)
- Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 Bvio Sestu, 09042 Monserrato, Italy
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Jaeger J, Yang L, Li Y, Castrillo-Viguera C, Haeberlein SB, Dam T, O'Gorman J. Development of a cognitive composite for measuring change in progressive supranuclear palsy. Parkinsonism Relat Disord 2021; 92:94-100. [PMID: 34736158 DOI: 10.1016/j.parkreldis.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 09/13/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Individuals with progressive supranuclear palsy (PSP) experience cognitive changes that are challenging to follow without a validated neuropsychological test battery to measure progression. This study describes a composite measure to evaluate cognition in individuals with PSP. METHODS Baseline cognitive test data from 486 participants with PSP in the PASSPORT (NCT03068468) study included the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Color Trails Test (CTT) parts 1 and 2, letter-number sequencing, and letter fluency. Data were analyzed using summary statistics and a matrix of Pearson correlations. A hypothetical factor structure was constructed and validated. RESULTS Observed correlations were highest for scores between story memory and story recall (correlation coefficient = 0.78) and lowest for scores between letter fluency and picture naming (correlation coefficient = 0.11), and picture naming and figure copy (correlation coefficient = 0.12). After excluding picture naming and Color Trails Test (CTT) parts 1 and 2, a 3-factor structure was hypothesized for the remaining 13 tests. Confirmatory factor analysis demonstrated goodness of fit within acceptable limits (comparative fit index and Tucker-Lewis index = 0.98, standardized root-mean-square residual and root-mean-square error of approximation = 0.05-0.06). Mixed-model repeated-measures analysis of change from baseline to week 52 in RBANS and PSP cognitive composite score produced mean-to-standard-deviation ratios of 0.418 and 0.780, respectively. CONCLUSIONS This novel composite endpoint, based on RBANS and designed to account for motor impairments in PSP, improves on current cognitive assessments PSP.
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Horta-Barba A, Pagonabarraga J, Martínez-Horta S, Busteed L, Pascual-Sedano B, Illán-Gala I, Marin-Lahoz J, Aracil-Bolaños I, Pérez-Pérez J, Sampedro F, Bejr-Kasem H, Kulisevsky J. Cognitive and behavioral profile of progressive supranuclear palsy and its phenotypes. J Neurol 2021; 268:3400-3408. [PMID: 33704556 DOI: 10.1007/s00415-021-10511-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although several progressive supranuclear palsy (PSP) phenotypes have recently been described, studies identifying cognitive and neuropsychiatric differences between them are lacking. METHODS An extensive battery of cognitive and behavioural assessments was administered to 63 PSP patients, 25 PD patients with similar sociodemographic characteristics, and 25 healthy controls. We analysed differences in phenomenology, frequency and severity of cognitive and neuropsychiatric symptoms between PSP, PD and HC, and between PSP subtypes. RESULTS Regarding phenotypes, 64.6% met criteria for Richardson's syndrome (PSP-RS), 10.7% PSP with predominant Parkinsonism (PSP-P), 10.7% with PSP progressive gait freezing (PSP-PGF), and 10.7% PSP with predominant speech/language disorder (PSP-SL). Impairment was more severe in the PSP group than in the PD and HC groups regarding motor scores, cognitive testing and neuropsychiatric scales. Cognitive testing did not clearly differentiate between PSP phenotypes, but PSP-RS and PSP-SL appeared to have more cognitive impairment than PSP-PGF and PSP-P, mainly due to an increased impairment in frontal executive domains. Regarding neuropsychiatric disturbances, no specific behavior was more common in any of the PSP subtypes. CONCLUSION Motor deficits delineate the phenotypes included in currently accepted MDS-PSP criteria. Cognition and behavioural disturbances are common in PSP and allow us to distinguish this disorder from other neurological diseases, but they do not differentiate between PSP phenotypes.
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Affiliation(s)
- Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain. .,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain. .,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain. .,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
| | - Saül Martínez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Laura Busteed
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain
| | - Berta Pascual-Sedano
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Ignacio Illán-Gala
- Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Juan Marin-Lahoz
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Ignacio Aracil-Bolaños
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Jesús Pérez-Pérez
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Helena Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas, 90-08041, Barcelona, Spain. .,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain. .,Institut d'Investigacions Biomèdiques- Sant Pau (IIB-Sant Pau), Barcelona, Spain. .,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain. .,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain.
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VandeVrede L, Ljubenkov PA, Rojas JC, Welch AE, Boxer AL. Four-Repeat Tauopathies: Current Management and Future Treatments. Neurotherapeutics 2020; 17:1563-1581. [PMID: 32676851 PMCID: PMC7851277 DOI: 10.1007/s13311-020-00888-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Four-repeat tauopathies are a neurodegenerative disease characterized by brain parenchymal accumulation of a specific isoform of the protein tau, which gives rise to a wide breadth of clinical syndromes encompassing diverse symptomatology, with the most common syndromes being progressive supranuclear palsy-Richardson's and corticobasal syndrome. Despite the lack of effective disease-modifying therapies, targeted treatment of symptoms can improve quality of life for patients with 4-repeat tauopathies. However, managing these symptoms can be a daunting task, even for those familiar with the diseases, as they span motor, sensory, cognitive, affective, autonomic, and behavioral domains. This review describes current approaches to symptomatic management of common clinical symptoms in 4-repeat tauopathies with a focus on practical patient management, including pharmacologic and nonpharmacologic strategies, and concludes with a discussion of the history and future of disease-modifying therapeutics and clinical trials in this population.
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Affiliation(s)
- Lawren VandeVrede
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA.
| | - Peter A Ljubenkov
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Julio C Rojas
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Ariane E Welch
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
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VandeVrede L, Dale ML, Fields S, Frank M, Hare E, Heuer HW, Keith K, Koestler M, Ljubenkov PA, McDermott D, Ohanesian N, Richards J, Rojas JC, Thijssen EH, Walsh C, Wang P, Wolf A, Quinn JF, Tsai R, Boxer AL. Open-Label Phase 1 Futility Studies of Salsalate and Young Plasma in Progressive Supranuclear Palsy. Mov Disord Clin Pract 2020; 7:440-447. [PMID: 32373661 PMCID: PMC7197321 DOI: 10.1002/mdc3.12940] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is a neurodegenerative disease without approved therapies, and therapeutics are often tried off-label in the hope of slowing disease progression. Results from these experiences are seldom shared, which limits evidence-based knowledge to guide future treatment decisions. OBJECTIVES To describe an open-label experience, including safety/tolerability, and longitudinal changes in biomarkers of disease progression in PSP-Richardson's syndrome (PSP-RS) patients treated with either salsalate or young plasma and compare to natural history data from previous multicenter studies. METHODS For 6 months, 10 PSP-RS patients received daily salsalate 2,250 mg, and 5 patients received monthly infusions of four units of young plasma. Every 3 months, clinical severity was assessed with the Progressive Supranuclear Palsy Rating Scale (PSPRS), and MRI was obtained for volumetric measurement of midbrain. A range of exploratory biomarkers, including cerebrospinal fluid levels of neurofilament light chain, were collected at baseline and 6 months. Interventional data were compared to historical PSP-RS patients from the davunetide clinical trial and the 4-Repeat Tauopathy Neuroimaging Initiative. RESULTS Salsalate and young plasma were safe and well tolerated. PSPRS change from baseline (mean ± standard deviation [SD]) was similar in salsalate (+5.6 ± 9.6), young plasma (+5.0 ± 7.1), and historical controls (+5.6 ± 7.1), and change in midbrain volume (cm3 ± SD) did not differ between salsalate (-0.07 ± 0.03), young plasma (-0.06 ± 0.03), and historical controls (-0.06 ± 0.04). No differences were observed between groups on any exploratory endpoint. CONCLUSIONS Neither salsalate nor young plasma had a detectable effect on disease progression in PSP-RS. Focused open-label clinical trials incorporating historical clinical, neuropsychological, fluid, and imaging biomarkers provide useful preliminary data about the promise of novel PSP-directed therapies.
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Affiliation(s)
- Lawren VandeVrede
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Marian L. Dale
- OHSU Parkinson Center and Movement Disorder Program, Department of NeurologyOregon Health and Science UniversityPortland, OregonUSA
| | - Scott Fields
- Department of Pharmaceutical ServicesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Megan Frank
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Emma Hare
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Hilary W. Heuer
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Kellie Keith
- OHSU Parkinson Center and Movement Disorder Program, Department of NeurologyOregon Health and Science UniversityPortland, OregonUSA
| | - Mary Koestler
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Peter A. Ljubenkov
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Dana McDermott
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Noelle Ohanesian
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Jennifer Richards
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Julio C. Rojas
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Elisabeth H. Thijssen
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Neurochemistry Laboratory, Department of Clinical ChemistryVU University Medical CenterAmsterdamThe Netherlands
| | - Christine Walsh
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Ping Wang
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Amy Wolf
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Joseph F. Quinn
- OHSU Parkinson Center and Movement Disorder Program, Department of NeurologyOregon Health and Science UniversityPortland, OregonUSA
| | - Richard Tsai
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Adam L. Boxer
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Duff K, Randolph C, Boxer AL. Cognitive decline on the Repeatable Battery for the Assessment of Neuropsychological Status in progressive supranuclear palsy. Clin Neuropsychol 2020; 34:529-540. [PMID: 31559910 PMCID: PMC7083686 DOI: 10.1080/13854046.2019.1670865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
Objective: Progressive supranuclear palsy (PSP) is associated with a variety of cognitive deficits, but few studies have reported on its cognitive trajectory across time, especially on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).Methods: Two hundred twenty participants diagnosed with Richardson's syndrome of PSP (PSP-RS) were evaluated with the RBANS at baseline, six months, and one year with alternate forms.Results: When using dependent t-tests, significant declines were observed on all Indexes of the RBANS from baseline to six months (ps < 0.01). Between six months and one year, significant declines were observed on three Indexes of the RBANS (ps < 0.05). Using existing regression-based change formulae from cognitively intact older adults, these participants with PSP showed significant decline on all RBANS Indexes (ps < 0.01) across one year. Finally, new regression-based change formulae were developed on this sample of individuals with PSP-RS to more precisely evaluate cognitive change in this condition.Conclusion: In this large, longitudinal cohort of participants with PSP-RS, many (but not all) showed notable cognitive decline across six months and one year on the RBANS. The different methods of examining change across time yielded different results, with regression-based methods appearing to more accurately capture decline in this sample. These findings are expected to allow clinicians to more accurately evaluate cognitive trajectories in patients with PSP, as well as make better estimates of prognosis and offer more appropriate treatment recommendations. Such findings are also expected to inform clinical trials as to the changes in cognitive outcomes with this neurological condition.
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Affiliation(s)
- Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT
| | | | - Adam L. Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA
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10
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Abstract
Objectives: Recently, new criteria for sensitive and specific clinical diagnosis of progressive supranuclear palsy (PSP) have been addressed while distinct clinical phenotypes of the disorder have been increasingly described in the literature. This study aimed to describe past and present aspects of the disease as well as to highlight the cognitive and behavioral profile of PSP patients in relation to the underlying pathology, genetics and treatment procedures.Methods: A Medline and Scopus search was performed to identify articles published on this topic. Articles published solely in English were considered.Results: The most common clinical characteristics of PSP included early postural instability and falls, vertical supranuclear gaze palsy, parkinsonism with poor response to levodopa and pseudobulbar palsy. Frontal dysfunction and verbal fluency deficits were the most distinct cognitive impairments in PSP while memory, visuospatial and social cognition could also be affected. Apathy and impulsivity were also present in PSP patients and had significant impact on relatives and caregivers.Conclusions: PSP is a neurodegenerative disorder with prominent tau neuropathology. Movement, motivation and communication impairments in patients with PSP may limit participation in everyday living activities. Comprehensive neuropsychological assessments are of significant importance for PSP cognitive evaluation. Pharmacologic and non-pharmacologic approaches could be applied in order to relieve patients and improve quality of life.Clinical Implications: Executive dysfunction is the most notable cognitive impairment and dominates the neuropsychological profile of patients with PSP.
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Affiliation(s)
| | - Kleopatra H Schulpis
- Institute of Child Health, Research Center, "Aghia Sophia" Children's Hospital, Athens, Greece
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11
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Cao H, Hou C, Huang S, Zhou X, Yang J, Xu JB, Cao X, Li Z, Zhang W, Zhang M, Liu X, Zhou X. The Evaluation of Cognitive Impairment in Alcohol-Dependent Patients Through RBANS Combined With ERPs. Front Psychiatry 2020; 11:598835. [PMID: 33551868 PMCID: PMC7858675 DOI: 10.3389/fpsyt.2020.598835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Recently, the cognitive impairment of patients with alcohol dependence has attracted more and more attention. The combination of Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and event-related potentials (ERPs) for evaluating the degree of cognitive impairment in patients with alcohol dependence has not undergone enough in-depth investigation. Method: Sixty patients with alcohol dependence were selected as alcohol-dependence group, whereas 40 healthy volunteers served as a normal control group. The original scores of the RBANS sub-items, the incubation period, and volatility of ERPs between the two groups were compared, and the correlation among the above indicators in the alcohol-dependence group was further analyzed. Results: The RBANS test showed that the original scores of speech function, attention function, delayed memory, and immediate attention in the alcohol-dependence group were significantly lower than those in the normal control group. Compared with the normal control group, the latencies of P200 and P300 in the alcohol-dependence group were significantly prolonged, and the amplitude of P200 and P300 was significantly reduced. Correlation analysis between RBANS and ERPs in alcohol-dependence group showed that immediate attention score was positively correlated with P300 and P200 amplitude, visual breadth score was positively correlated with P200 latency, and attention function score was negatively correlated with P300 latency. Conclusion: As RBANS scale was highly correlated with the results of ERPs, the combined use of these two scales may serve as an objective basis for early diagnosis of cognitive impairment in patients with alcohol dependence.
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Affiliation(s)
- Hui Cao
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Chao Hou
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Saiping Huang
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Xiafeng Zhou
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Jun Yang
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Jia Bin Xu
- Department of Psychiatry, Mental Hospital of Jiangxi Province, Nanchang, China
| | - Xiaoyun Cao
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Zhenguang Li
- Department of Electrophysiology, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Wei Zhang
- Department of Radiology, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Mei Zhang
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Xuejun Liu
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Xuhui Zhou
- Department of Psychiatry, The Second People's Hospital of Hunan Province, The Hospital of Hunan University of Chinese Medicine, Changsha, China
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