High specificity of MMSE pentagon scoring for diagnosis of prodromal dementia with Lewy bodies

Cagnin, Annachiara; Bussè, Cinzia; Jelcic, Nela; Gnoato, Francesca; Mitolo, Micaela; Caffarra, Paolo

doi:10.1016/j.parkreldis.2014.12.007

Cited by 39 publications

(34 citation statements)

References 12 publications

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“…This fact has been underlined above with respect to the CDT, and is also suggested by recent studies showing that the copy of two intersecting pentagons (Fig. 3), included in the Mini-Mental State Examination [72], may provide elements for differential diagnosis of degenerative dementias [73,74]. Although error analysis in drawing tasks may not reveal a straightforward procedure [22,28,44], several clinical phenomena observed in drawing have been sufficiently characterized in their possible cognitive and neural correlates, as it will be discussed in the next sections of this paper.…”

Section: Drawing Tasks Frequently Used In Dementiamentioning

confidence: 58%

“…Different scoring criteria can likely explain the reason why other authors failed to detect differences between LBD and AD in pentagon copying [108,159], but more extended copying tests might show significantly lower performance in LBD with respect to AD patients [108]. Recently, it has been demonstrated that qualitative analysis of the pentagon copy test can provide additional information for distinguishing AD from LBD patients, since a lower number of angles is among distinctive features of LBD patients' copies [73,167], and can also predict development of LBD in MCI patients [74].…”

Section: Drawing Disorders In Lewy Body Dementiamentioning

confidence: 99%

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Drawing Disorders in Alzheimer’s Disease and Other Forms of Dementia

Trojano

Gainotti

2016

JAD

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Abstract. Drawing is a multicomponential process that can be impaired by many kinds of brain lesions. Drawing disorders are very common in Alzheimer's disease and other forms of dementia, and can provide clinical information for the distinction of the different dementing diseases. In our review we started from an overview of the neural and cognitive bases of drawing, and from a recollection of the drawing tasks more frequently used for assessing individuals with dementia. Then, we analyzed drawing disorders in dementia, paying special attention to those observed in Alzheimer's disease, from the prodromal stages of the amnesic mild cognitive impairment to the stages of full-blown dementia, both in the sporadic forms with late onset in the entorhino-hippocampal structures and in those with early onset in the posterior neocortical structures. We reviewed the drawing features that could differentiate Alzheimer's disease from vascular dementia and from the most frequent forms of degenerative dementia, namely frontotemporal dementia and Lewy body disease. Finally, we examined some peculiar aspects of drawing disorders in dementia, such as perseverations, rotations, and closing-in. We argue that a careful analysis of drawing errors helps to differentiate the different forms of dementia more than overall accuracy in drawing.

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Section: Drawing Tasks Frequently Used In Dementiamentioning

confidence: 58%

Section: Drawing Disorders In Lewy Body Dementiamentioning

confidence: 99%

Drawing Disorders in Alzheimer’s Disease and Other Forms of Dementia

Trojano

Gainotti

2016

JAD

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“…49 Figure 1 shows a hypothetical model for the development of dementia with Lewy bodies. In patients with mild cognitive impairment, those with non-amnestic cognitive profile, 53 with parkinsonism or fluctuations, 54 with slowing on electroencephalography, 55 or problems with pentagon drawing 56 have an increased risk for developing dementia with Lewy bodies. In addition, patients with idiopathic RBD, 57 primary autonomic dysfunction, 58 and frequent delirium have increased risk of dementia with Lewy bodies.…”

Section: Prodromal and Early Lewy Body Dementiasmentioning

confidence: 99%

Lewy body dementias

et al. 2015

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The broad importance of dementia is undisputed, with Alzheimer’s disease justifiably getting the most attention. However, dementia with Lewy bodies and Parkinson’s disease dementia, now called Lewy body dementias, are the second most common type of degenerative dementia in patients older than 65 years. Despite this, Lewy body dementias receive little attention and patients are often misdiagnosed, leading to less than ideal management. Over the past 10 years, considerable effort has gone into improving diagnostic accuracy by refining diagnostic criteria and using imaging and other biomarkers. Dementia with Lewy bodies and Parkinson’s disease dementia share the same pathophysiology, and effective treatments will depend not only on successful treatment of symptoms but also on targeting the pathological mechanisms of disease, ideally before symptoms and clinical signs develop. We summarise the most pertinent progress from the past 10 years, outlining some of the challenges for the future, which will require refinement of diagnosis and clarification of the pathogenesis, leading to disease-modifying treatments.

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“…The fluctuations in mental status, conceived as a low-grade chronic delirium, may be due to profound cholinergic deficits in addition to neocortical Lewy body pathology 202 . Visuospatial and constructional deficits are frequently seen in early AD, but are also suggestive of Lewy body pathology 203,204 , where they foreshadow more-rapid decline and visual hallucinations 205 . In comparison with AD, however, memory functions are often preserved in the early stages of DLB, although episodic memory deficits are frequently reported with older age, possibly due to mixed Lewy body and AD pathology 24 .…”

Section: Lewy Body Dementiamentioning

confidence: 99%

A clinicopathological approach to the diagnosis of dementia

2017

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The most definitive classification systems for dementia are based on the underlying pathology which, in turn, is categorized largely according to the observed accumulation of abnormal protein aggregates in neurons and glia. These aggregates perturb molecular processes, cellular functions and, ultimately, cell survival, with ensuing disruption of large-scale neural networks subserving cognitive, behavioural and sensorimotor functions. The functional domains affected and the evolution of deficits in these domains over time serve as footprints that the clinician can trace back with various levels of certainty to the underlying neuropathology. The process of phenotyping and syndromic classification has substantially improved over decades of careful clinicopathological correlation, and through the discovery of in vivo biomarkers of disease. Here, we present an overview of the salient features of the most common dementia subtypes — Alzheimer disease, vascular dementia, frontotemporal dementia and related syndromes, Lewy body dementias, and prion diseases — with an emphasis on neuropathology, relevant epidemiology, risk factors, and signature signs and symptoms.

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High specificity of MMSE pentagon scoring for diagnosis of prodromal dementia with Lewy bodies

Cited by 39 publications

References 12 publications

Drawing Disorders in Alzheimer’s Disease and Other Forms of Dementia

Drawing Disorders in Alzheimer’s Disease and Other Forms of Dementia

Lewy body dementias

A clinicopathological approach to the diagnosis of dementia

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