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Lookup NU author(s): Dr Laura WrightORCiD, Dr Paul Donaghy, Professor David BurnORCiD, Professor John-Paul TaylorORCiD, Professor John O'Brien, Professor Alison Yarnall, Professor Fiona MatthewsORCiD, Dr Michael FirbankORCiD, Professor Alan ThomasORCiD, Dr Rachael LawsonORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Introduction: Neuropsychiatric symptoms (NPS) in Lewy body dementias (LBD) occur frequently andearly in disease progression. Such symptoms are associated with worse quality of life, caregiverburden and functional limitations. Limited evidence exists, however, outlining the longitudinalrelationship between NPS and cognitive decline in prodromal LBD.Methods: 123 participants were derived from three cohort studies. Patients with mild cognitiveimpairment relating to probable dementia with Lewy bodies (MCI-LB, n=67) and Parkinson’s disease(PD-MCI, n=56) completed comprehensive cognitive and neuropsychiatric assessment and werefollowed up longitudinally. Linear regression and mixed effects models assessed the relationshipbetween baseline NPS and cognition at baseline and over time.Results: In MCI-LB, overall NPS burden was associated with declines over time in executive function(p=0.026) and processing speed (p=0.028) and baseline aberrant motor behaviour was associatedwith declines in attention (p<0.025). Anxiety was significantly associated with poorer visuospatialfunctioning (p=0.016) at baseline and poorer attention both at baseline (p=0.017) and across timepoints (p=0.024). In PD-MCI, psychosis was associated with poorer executive functioning at baseline(p=0.008) and across time points (p=0.002) but had no association with changes longitudinally.Conclusions: Core neuropsychiatric components of LBD are not strongly associated with cognition inprodromal disease. This may suggest that neuropathological mechanisms underlying NPS maynot be the same as those underlying cognitive impairment. Non-core NPS, however, may bemore directly associated with cognitive change. Future studies utilising neuroimagingtechniques are needed to explore the neuropathological basis of NPS in prodromal LBD.
Author(s): Wright LM, Donaghy PC, Burn DJ, Taylor JP, O'Brien JT, Yarnall AJ, Matthews FE, Firbank MJ, Thomas AJ, Lawson RA
Publication type: Article
Publication status: Published
Journal: Parkinsonism and Related Disorders
Year: 2023
Volume: 113
Print publication date: 01/08/2023
Online publication date: 08/07/2023
Acceptance date: 07/07/2023
Date deposited: 10/07/2023
ISSN (print): 1353-8020
ISSN (electronic): 1873-5126
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.parkreldis.2023.105762
DOI: 10.1016/j.parkreldis.2023.105762
Data Access Statement: Data may be available upon reasonable request to the corresponding author or through the Medical Research Council Dementias Platform UK, study references: 'LewyPro', 'SUPErB' and 'ICICLE-PD’'
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