Fluctuations in attention

Ballard, Clive; Aarsland, Dag; McKeith, Ian G.; Jt, O’Brien; Gray, Alistair; Cormack, Francesca; Burn, David J.; Cassidy, T; Starfeldt, R.; Jp, Larsen; Brown, Richard M.; Tovée, Martin J.

doi:10.1212/01.wnl.0000036908.39696.fd

Cited by 256 publications

(184 citation statements)

References 51 publications

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“…Attention and vigilance is similar to Lewy body dementia and shows a fluctuating course. Reaction time is increased and attention to new signals is decreased (7).…”

Section: Introductionmentioning

confidence: 99%

Impaired cognitive performance and hippocampal atrophy in Parkinson disease

Yıldız¹,

Erer²,

Zarifoğlu³

et al. 2015

Turk J Med Sci

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Background/aim: Dementia is common in Parkinson disease (PD). Since magnetic resonance imaging has been used, hippocampal atrophy has been shown in PD patients with or without dementia. In this study we sought the correlation of cognitive decline with bilateral hippocampal volume in PD patients.Materials and methods: Thirty-three patients with diagnosis of idiopathic PD and 16 healthy subjects were included in this study. PD patients were divided into two groups as normal cognitive function and mild cognitive impairment (MCI). The Mini-Mental State Examination and detailed cognitive assessment tests were performed for all patients for cognitive analyses. Depression was excluded by the Geriatric Depression Scale. Results:The mean onset age of disease was 55 years for PD patients without dementia and 59 for PD patients with MCI. According to the Hoehn-Yahr scales, 24% of patients had grade 1, 58% had grade 2, and 18% had grade 3 disease. Right and left hippocampal volumes decreased along with cognitive test scores in PD patients. Increased right hippocampal volume was correlated with forward number test in the MCI-PD group. Conclusion:These findings suggest that memory deficit is associated with hippocampal atrophy in PD patients.

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“…Attention and vigilance is similar to Lewy body dementia and shows a fluctuating course. Reaction time is increased and attention to new signals is decreased (7).…”

Section: Introductionmentioning

confidence: 99%

Impaired cognitive performance and hippocampal atrophy in Parkinson disease

Yıldız¹,

Erer²,

Zarifoğlu³

et al. 2015

Turk J Med Sci

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“…CAF is a neuropsychological test [6] able to evidence, on the basis of patient and caregivers interviews, the presence of fluctuating consciousness. The questionnaires are able to discriminate 85% of DLB patients, as confirmed by autopsy [7]. Cognitive fluctuations are considered a clinical feature typical of DLB, described in 70-80% of these patients, only in 14-20% of AD patients and in 15-30% of VaD subjects [8].…”

Section: Synucleinopathies: Dementia With Lewy Bodiesmentioning

confidence: 81%

Is There a Place for Clinical Neurophysiology Assessments in Synucleinopathies?

Onofrj¹,

Bonanni²,

Thomas³

et al. 2011

Neuroimaging for Clinicians - Combining Research and Practice

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IntroductionParkinson Disease (PD), Dementia with Lewy Bodies (DLB) and Multiple System Atrophy (MSA) are characterized by deposition of Lewy Bodies (LB), consisting of eosinophilic intracellular (intraneural in PD and DLB and intraglial in MSA) inclusions of -synuclein and allowing the three disorders to be categorized as synucleinopathies. The identification in the last two decades of specific clinical features of synucleinopathies has been a major breakthrough in Neurology, as it prompted a reconsideration of diagnostic and therapeutic approaches to dementia and parkinsonism. The recognition of synuclein and ubiquitin markers in dementia resulted in the reclassification of patients previously considered as affected by Alzheimer Disease (AD) and Vascular Dementia (VaD), and there is now agreement that DLB is the second most common cause of dementia in elderly population: its prevalence is reported to be in the 25-43% range in different studies. DLB is clinically characterized by the presence of prominently dysexecutive dementia (frontal lobe or subcortical dementia according to earlier classification [1]), cognitive fluctuations, consisting of remitting-relapsing episodes of blunted conscience reaching levels of stupor, by the occurrence of visual hallucinations and delusions, by parkinsonian motor signs and hypersensitivity to neuroleptic treatment, ranging from worsening of parkinsonism to the possible lethal neuroleptic-malignant syndromes [2]. Yet, variances of presentation and overlapping symptoms with AD and Fronto-Temporal lobe Degeneration (FTD), could be misleading in the process of addressing a clinical diagnosis with consequent therapeutic risks(e.g. introducing neuroleptic treatments in patient with DLB), or economic costs (e.g. addressing patients with DLB to treatment protocols dedicated to AD patients, based on vaccines or antibodies against amyloid proteins, a neuropathological feature of AD). It is evident the stringent need for improvement of reliable diagnostic tools (u.e. biomarkers) to differentiate the diseases associated with dementia. In 2010 the National Institute of Health, NIH, held a symposium focused on the development of possible biomarkers for DLB. Among the different suggested biomarkers, neurophysiological assessments were reconsidered, as a large amount of neurophysiological studies had been devoted to AD and PD, whose characteristics are shared by DLB. www.intechopen.com Neuroimaging for Clinicians -Combining Research and Practice 300We contributed to several studies on this argument along the years, and in the present chapter we discuss the role of clinical neurophysiological studies in DLB in comparison with other disorders. The essential background of our original studies laid in the fact that most historical studies were performed when the DLB clinical entity was unknown and therefore some of the past results were marred by absent recognition of this clinical entity. Synucleinopathies: Dementia with lewy bodiesSynucleinopathies comprise a diverse groups of neurodegenerati...

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“…Although also described in other forms of dementia, visuospatial impairment is more severe in PDD patients (Huber et al, 1989), and it has been suggested that impaired performance in visuospatial tasks may be related to problems with sequential organization of behavior, thus expressing a frontal executive dysfunction rather than pure parieto-occipital pathology (Stern et al, 1983). Attention is compromised with presence of attentive fluctuations (Ballard et al, 2002). Psychotic symptoms are frequently associated with dementia in PD, with a prevalence ranging between 25 and 30% (Ravina et al, 2007).…”

Section: Dementiamentioning

confidence: 99%

“…The investigators reported an improvement of 2.1 scores in the MMSE compared to the placebo group (p=0.013), with no change in the UPDRS scores at the end of the study. However, although this trial suggested that donepezil can improve cognition in patients with PD without worsening of motor function, the study results are limited by the small sample size and by the crossover design, as no washout period was allowed between the two stages of the trial (Aarsland et al, 2002). The second study involved 16 patients randomized to receive donepezil 2.5-10 mg or placebo for 18 weeks.…”

Section: Donepezilmentioning

confidence: 99%