Document Detail


Neuropsychiatric Features of Frontal Lobe Dysfunction in Autopsy-Confirmed Patients with Lewy Bodies and "Pure" Alzheimer Disease.
MedLine Citation:
PMID:  23567425     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To compare patients with autopsy-confirmed Alzheimer disease (AD) and dementia with Lewy bodies (DLB) on the frequency of behaviors related to frontal system dysfunction and the association of these behaviors with dementia severity. METHODS: We performed a cross-sectional survey of a longitudinal cohort at a university research center for AD on a volunteer sample of 19 DLB and 38 AD participants with autopsy-confirmed diagnoses, similar in age (DLB: 77.3, AD: 77.5), education (DLB: 15.2, AD: 14.7), and Mini-Mental State Examination (MMSE) score (DLB: 20.6, AD: 20.5), with impairment ranging from mild deficits to moderate dementia. The Frontal Systems Behavior Scale (FrSBe)-Family Rating Form assessing patient apathy, disinhibition, and executive dysfunction by a knowledgeable informant was used. RESULTS: A two-way analysis of variance with the FrSBe total as the dependent variable revealed a significant MMSE by diagnosis interaction (F(1,53) = 9.34, p = 0.004). Mean FrSBe total for AD patients showed significant impairment across the range of dementia severity, whereas it was relatively preserved for DLB patients in the early stage of disease. The interaction term showed the same pattern for the executive dysfunction (F(1,53) = 7.62, p = 0.008), disinhibition (F(1,53) = 4.90, p = 0.031), and apathy (F(1,53) = 9.77, p = 0.003) subscales. CONCLUSION: Although frontal behavioral symptoms in AD patients were present regardless of stage of dementia, DLB patients showed significant frontal dysfunction only in later stages. Results suggest that frontal subcortical circuits associated with behaviors assessed by the FrSBe are affected early in AD but not until later stages in DLB. Assessing specific behaviors related to frontal systems, coupled with stage of cognitive decline, may aid in clinical differentiation of AD and DLB.
Authors:
Guerry M Peavy; David P Salmon; Steven D Edland; Steven Tam; Lawrence A Hansen; Eliezer Masliah; Douglas Galasko; Joanne M Hamilton
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-13
Journal Detail:
Title:  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry     Volume:  -     ISSN:  1545-7214     ISO Abbreviation:  Am J Geriatr Psychiatry     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-4-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosciences, University of California, San Diego, CA. Electronic address: gpeavy@ucsd.edu.
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