Identifying parkinsonism in mild cognitive impairment

被引：3

作者：

Fernando, Rishira ^{[1
]}

Thomas, Alan J. ^{[1
]}

Hamilton, Calum A. ^{[1
]}

Durcan, Rory ^{[1
]}

Barker, Sally ^{[1
]}

Ciafone, Joanna ^{[1
]}

Barnett, Nicola ^{[1
]}

Olsen, Kirsty ^{[1
]}

Firbank, Michael ^{[1
]}

Roberts, Gemma ^{[1
,2
]}

Lloyd, Jim ^{[2
]}

Petrides, George ^{[2
]}

Colloby, Sean ^{[1
]}

Allan, Louise M. ^{[3
]}

McKeith, Ian G. ^{[1
]}

O'Brien, John T. ^{[4
]}

Taylor, John-Paul ^{[1
]}

Donaghy, Paul C. ^{[1
,5
]}

机构：

[1] Newcastle Univ, Translat & Clin Res Inst, Newcastle Upon Tyne, England

[2] Newcastle Upon Tyne Hosp NHS Fdn Trust, Nucl Med Dept, Newcastle Upon Tyne, England

[3] Univ Exeter, Ctr Res Ageing & Cognit Hlth, Exeter, England

[4] Univ Cambridge, Sch Clin Med, Dept Psychiat, Cambridge, England

[5] Newcastle Univ, Translat & Clin Res Inst, Level 3 Biomed Res Bldg,Campus Ageing & Vital, Newcastle Upon Tyne NE4 5PL, England

来源：

JOURNAL OF THE NEUROLOGICAL SCIENCES | 2024年 / 458卷

关键词：

Dementia with Lewy bodies; Alzheimer's disease; Mild cognitive impairment; Parkinsonism; Unified Parkinson's disease rating scale; DEMENTIA;

D O I：

10.1016/j.jns.2024.122941

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction: Clinical parkinsonism is a core diagnostic feature for mild cognitive impairment with Lewy bodies (MCI -LB) but can be challenging to identify. A five -item scale derived from the Unified Parkinson's Disease Rating Scale (UPDRS) has been recommended for the assessment of parkinsonism in dementia. This study aimed to determine whether the five -item scale is effective to identify parkinsonism in MCI. Methods: Participants with MCI from two cohorts (n = 146) had a physical examination including the UPDRS and [123I]-FP-CIT SPECT striatal dopaminergic imaging. Participants were classified as having clinical parkinsonism (P+) or no parkinsonism (P-), and with abnormal striatal dopaminergic imaging (D+) or normal imaging (D-). The five -item scale was the sum of UPDRS tremor at rest, bradykinesia, action tremor, facial expression, and rigidity scores. The ability of the scale to differentiate P+D+ and P -D- participants was examined. Results: The five -item scale had an AUROC of 0.92 in Cohort 1, but the 7/8 cut-off defined for dementia had low sensitivity to identify P+D+ participants (sensitivity 25%, specificity 100%). Optimal sensitivity and specificity was obtained at a 3/4 cut-off (sensitivity 83%, specificity 88%). In Cohort 2, the five -item scale had an AUROC of 0.97, and the 3/4 cut-off derived from Cohort 1 showed sensitivity of 100% and a specificity of 82% to differentiate P+D+ from P -D- participants. The five -item scale was not effective in differentiating D+ from D- participants. Conclusions: The five -item scale is effective to identify parkinsonism in MCI, but a lower threshold must be used in MCI compared with dementia.

引用

页数：5