Autonomic symptoms are predictive of dementia with Lewy bodies

Hu, Wenzheng; Лю, Шуай; Wang, Fei; Zhu, Han; Du, Xiaoshan; Ma, Lulin; Gan, Jinghuan; Wu, Hao; Wang, Xiaodan; Ji, Yong

doi:10.1016/j.parkreldis.2021.11.023

Cited by 9 publications

(9 citation statements)

References 16 publications

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“…Further underscoring the importance of assessing autonomic dysfunction at a more granular level, regression analyses demonstrated that items related to gastrointestinal/thermo‐regulation symptoms were more strongly associated with functional abilities and clinical dementia symptom severity, compared to both versions of the ASC in the LBD‐module. This finding is consistent with hypotheses of primary dysfunction in the enteric nervous system in α‐synucleinopathies, pathological studies α‐synucleinopathy distribution, 14,26,27 and previous literature demonstrating that gastrointestinal symptoms are the most prominent autonomic symptoms in DLB 13 . Notably, only two of the five gastrointestinal/thermo‐regulation symptoms identified on the CFA were included in the ASC V3.1, while four of the five symptoms found in previous literature to differentiate DLB from AD 9 were included.…”

Section: Discussionsupporting

confidence: 89%

“…This finding is consistent with hypotheses of primary dysfunction in the enteric nervous system in α-synucleinopathies, pathological studies α-synucleinopathy distribution, 14,26,27 and previous literature demonstrating that gastrointestinal symptoms are the most prominent autonomic symptoms in DLB. 13 Notably, only two of the five gastrointestinal/thermo-regulation symptoms identified on the CFA were included in the ASC V3. In conclusion, this study provides important information about autonomic symptom reporting in DLB, the psychometric properties of the ASC used in the NACC LBD-module, and potential importance of autonomic system differentiation in neurodegenerative conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of autonomic dysfunction in DLB is made difficult by the fact that the autonomic symptom presentation is highly variable across patients. One recent study 13 found most prominent dysfunction in gastrointestinal systems, followed by orthostatic dizziness, urinary frequency, and daytime hyperhidrosis, with gastrointestinal dysfunction and hyperhidrosis preceding memory loss by the longest period of time, as self‐reported by patients and caregivers. Another 9 found cold intolerance, problems with sexual performance, orthostatic dizziness, urinary dysfunction, and constipation to be the most frequently reported symptoms, all falling above 40%.…”

Section: Introductionmentioning

confidence: 99%

“…12 Furthermore, autonomic dysfunction typically precedes the development of cognitive impairment in DLB. 13 While physiological methods to measure autonomic dysfunction in clinical settings are limited, self-reported symptoms are correlated with objective measures of orthostatic hypotension. 11 Thus, accurate self-report measurement of autonomic dysfunction is of critical importance for purposes of early detection and prognosis in DLB.…”

Section: Introductionmentioning

confidence: 99%

“…Fourth, individuals with Lewy body disease who reported constipation and/or urinary incontinence, in addition to orthostatic hypotension, had increased mortality rates compared to those with only orthostatic hypotension or no orthostatic hypotension within 3 years 12 . Furthermore, autonomic dysfunction typically precedes the development of cognitive impairment in DLB 13 . While physiological methods to measure autonomic dysfunction in clinical settings are limited, self‐reported symptoms are correlated with objective measures of orthostatic hypotension 11 .…”

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Waters

Kiselica

2022

Int J Geriat Psychiatry

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Introduction: Autonomic dysfunction is an important feature of Lewy Body Dementia (DLB), but measurement of autonomic symptoms has been limited in both previous research and clinical practice. Accurate measurement of autonomic dysfunction has the potential to improve our understanding of the course and progression of DLB, given that autonomic symptoms typically precede cognitive impairment and are associated with functional impairment. The primary aim of this study was to examine the psychometric properties of the two versions (3.0 and 3.1) of the NACC LBD-module Autonomic Symptom Checklist (ASC). Methods: Psychometric analyses of the ASC (internal consistency, reliability, factor structure, and validity) were conducted on data acquired from 245 individuals with DLB from the NACC database. ASC V3.0 was contrasted on these attributes to V3.1. Results:Results suggested an underlying factor structure for the ASC, and confirmatory factor analysis (CFA) revealed 3 factors, which generally aligned with discrete autonomic systems. The ASC V3.0 and CFA-identified scales were comparable in terms of reliability, which were both improved relative to the ASC V3.1.In terms of ecological validity, CFA-identified items related to gastrointestinal/ thermoregulation symptoms were significantly more associated with functional outcomes compared to the unitary ASC. Conclusion:Findings underscore the importance of differentiation within the autonomic system. Future research into autonomic symptom classes and lab-based pathophysiological measurement of autonomic dysfunction in DLB has the potential to support early identification and inform treatment planning.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Waters

Kiselica

2022

Int J Geriat Psychiatry

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Autonomic dysfunction in dementia with Lewy bodies: Focusing on cardiovascular and respiratory dysfunction

Mizukami

2023

PCN Reports

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Dementia with Lewy bodies (DLB) is the second most common cause of dementia after Alzheimer's disease. The disease is characterized by many Lewy bodies appearing in the patient's cerebrum. DLB frequently presents with a variety of autonomic symptoms from the early or prodromal stages of the disease, and these are listed as supportive features in the diagnostic criteria. As several useful assessment methods for evaluating autonomic function in DLB have been reported, this review will focus on cardiovascular and respiratory dysfunction and its assessments. Cardiovascular disorders, such as orthostatic hypotension and abnormal heart rate variability, have been reported in DLB patients. Decreased myocardial uptake by metaiodobenzylguanidine myocardial scintigraphy has been added as an indicative biomarker for DLB in the 2017 revision of the diagnostic criteria. We have reported reduced ventilatory response to hypercapnia, abnormal respiratory rhythm, and high frequency of sleep‐disordered breathing as abnormalities of the respiratory regulatory system associated with DLB. Since autonomic dysfunction is highly prevalent in DLB from the early or prodromal phase of the disease and is associated with reduced activities of daily living and quality of life, the evaluation of autonomic dysfunction is also useful in the differential diagnosis of DLB from Alzheimer's disease. There are fewer studies on the respiratory regulatory system than on the cardiovascular system, thus further research is needed to explore its role in DLB.

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Mild cognitive impairment in dementia with Lewy bodies: an update and outlook

Ka¹

2023

J Neural Transm

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Autonomic symptoms are predictive of dementia with Lewy bodies

Cited by 9 publications

References 16 publications

Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Autonomic dysfunction in dementia with Lewy bodies: Focusing on cardiovascular and respiratory dysfunction

Mild cognitive impairment in dementia with Lewy bodies: an update and outlook

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