Minor Hallucinations in Alzheimer’s Disease

Ruiz, Manuel; Arias, Alfonso Martínez; Sánchez-Llanos, Ernesto; Gil, Maria Pilar; López-Ortega, Ricard; Dakterzada, Faride; Purroy, Francisco; Piñol‐Ripoll, Gerard

doi:10.3233/jad-180234

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Asking about hallucinations at an early stage makes it possible to have a description of them not by relatives but by the patients themselves. The most frequent symptoms were passage (26.7% of patients) and presence (24.3%) of hallucinations, which is consistent with a previous study on MCI patients [ 32 ]. Globally, 63.5% of the pro-DLB group had hallucinations and 31% had at least two types of hallucinations.…”

Section: Discussionsupporting

confidence: 91%

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

et al. 2022

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Background Isolated subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) are the prodromal phases of dementia with Lewy bodies (DLB). MEMENTO is a nationwide study of patients with SCI and MCI with clinic, neuropsychology, biology, and brain imaging data. We aimed to compare SCI and MCI patients with symptoms of prodromal DLB to others in this study at baseline. Methods Participants of the French MEMENTO cohort study were recruited for either SCI or MCI. Among them, 892 were included in the Lewy sub-study, designed to search specifically for symptoms of DLB. Probable prodromal DLB diagnosis (pro-DLB group) was done using a two-criteria cutoff score among the four core clinical features of DLB. This Pro-DLB group was compared to two other groups at baseline: one without any core symptoms (NS group) and the one with one core symptom (1S group). A comprehensive cognitive battery, questionnaires on behavior, neurovegetative and neurosensory symptoms, brain 3D volumetric MRI, CSF, FDG PET, and amyloid PET were done. Results The pro-DLB group comprised 148 patients (16.6%). This group showed more multidomain (59.8%) MCI with slower processing speed and a higher proportion of patients with depression, anxiety, apathy, constipation, rhinorrhea, sicca syndrome, and photophobia, compared to the NS group. The pro-DLB group had isolated lower P-Tau in the CSF (not significant after adjustments for confounders) and on brain MRI widening of sulci including fronto-insular, occipital, and olfactory sulci (FDR corrected), when compared to the NS group. Evolution to dementia was not different between the three groups over a median follow-up of 2.6 years. Conclusions Patients with symptoms of prodromal DLB are cognitively slower, with more behavioral disorders, autonomic symptoms, and photophobia. The occipital, fronto-insular, and olfactory bulb involvement on brain MRI was consistent with symptoms and known neuropathology. The next step will be to study the clinical, biological, and imaging evolution of these patients. Trial registration Clinicaltrials.gov, NCT01926249

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Section: Discussionsupporting

confidence: 91%

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

et al. 2022

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“…Asking about hallucinations at an early stage makes it possible to have a description of them not by relatives but by the patients themselves. The most frequent symptoms were passage (26.7% of patients) and presence (24.3%) hallucinations, which is consistent with a previous study on MCI patients [32]. Globally, 63.5% of the pro-DLB group had hallucinations and 31% had at least two types of hallucinations.…”

Section: Clinical Issuessupporting

confidence: 90%

Prodromal characteristics of Dementia with Lewy Bodies: baseline results of the Memento nationwide cohort

Blanc‬

Bouteloup

Paquet

et al. 2022

Preprint

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Background: Isolated subjective cognitive impairment (SCI) and mild neurocognitive impairment (MCI) are prodromal phase of dementia with Lewy bodies (DLB). Memento is a nationwide study of patients with SCI and MCI with clinic, neuropsychology, biology and brain imaging data. We aimed to compare SCI and MCI patients with symptoms of prodromal DLB to others in this study at baseline. Methods: Participants of the French Memento cohort study recruited for either SCI or MCI. Among them, 892 were included in the Lewy sub-study, designed to search specifically for symptoms of DLB. Probable prodromal DLB group (pro-DLB) was done using a two-criteria cut-off score among the four core clinical features of DLB. This Pro-DLB group was compared to two other groups at baseline: one without any core symptoms (NS group), and the one with one core symptom (1S group). A comprehensive cognitive battery, questionnaires on behavior, neurovegetative and neurosensory symptoms, brain 3D volumetric MRI, CSF, FDG PET and amyloid PET were done.Results: The Pro-DLB group comprised 148 patients (16.6%). This group showed more multidomain (59.8%) MCI with slower processing speed and a higher proportion of patients with depression, anxiety, apathy, constipation, rhinorrhea, sicca syndrome, and photophobia. The Pro-DLB group had isolated lower P-Tau and on brain MRI widening of sulci including fronto-insular, occipital, and olfactory sulci (FDR corrected). Conclusions: Patients with symptoms of prodromal DLB are cognitively slower, with more behavioral disorders, autonomic symptoms, and photophobia. Biomarkers confirmed the non-Alzheimer profile. The occipital, fronto-insular, and olfactory bulb involvement on brain MRI was consistent with symptoms and known neuropathology. The next step will be to study the clinical, biological, and imaging evolution of these patients.Trial registration: Clinicaltrials.gov, NCT01926249 .

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“…Concerning minor hallucinations, one study found prevalences of 13% in amnestic MCI and 21% in untreated mild and moderate AD, with higher frequency of presence hallucinations followed by passage hallucinations and visual illusions [63]. Of note, the frequency and severity of psychosis are usually higher for those bearing amyloid pathology [64].…”

Section: Prevalence and Clinical Relevancementioning

confidence: 99%

Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions

Agüera-Ortíz

Babulal

Bruneau

et al. 2022

JAD

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Psychotic phenomena are among the most severe and disruptive symptoms of dementias and appear in 30% to 50% of patients. They are associated with a worse evolution and great suffering to patients and caregivers. Their current treatments obtain limited results and are not free of adverse effects, which are sometimes serious. It is therefore crucial to develop new treatments that can improve this situation. We review available data that could enlighten the future design of clinical trials with psychosis in dementia as main target. Along with an explanation of its prevalence in the common diseases that cause dementia, we present proposals aimed at improving the definition of symptoms and what should be included and excluded in clinical trials. A review of the available information regarding the neurobiological basis of symptoms, in terms of pathology, neuroimaging, and genomics, is provided as a guide towards new therapeutic targets. The correct evaluation of symptoms is transcendental in any therapeutic trial and these aspects are extensively addressed. Finally, a critical overview of existing pharmacological and non-pharmacological treatments is made, revealing the unmet needs, in terms of efficacy and safety. Our work emphasizes the need for better definition and measurement of psychotic symptoms in dementias in order to highlight their differences with symptoms that appear in non-dementing diseases such as schizophrenia. Advances in neurobiology should illuminate the development of new, more effective and safer molecules for which this review can serve as a roadmap in the design of future clinical trials.

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Minor Hallucinations in Alzheimer’s Disease

Cited by 9 publications

References 24 publications

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

Prodromal characteristics of Dementia with Lewy Bodies: baseline results of the Memento nationwide cohort

Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions

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