Nicolas Auzou1, Kathy Dujardin2, Roberta Biundo3, Alexandra Foubert-Samier4, Caroline Barth5, Fanny Duval6, François Tison4, Luc Defebvre2, Angelo Antonini3, Wassilios G Meissner7. 1. Service de Neurologie, CHU de Bordeaux, Bordeaux, France; Univ. de Bordeaux, Laboratoire de Psychologie, Santé et Qualité de Vie, EA4139, Bordeaux, France. 2. Service de Neurologie et Pathologies du Mouvement, CHRU de Lille, France; Inserm U1171, Troubles cognitifs dégénératifs et vasculaires, Université de Lille, Lille, France. 3. Parkinson and Movement Disorders Unit, Fondazione Ospedale San Camillo, Venice, Italy. 4. Service de Neurologie, CHU de Bordeaux, Bordeaux, France; Centre de référence atrophie multisystématisée, CHU de Bordeaux, Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France. 5. Centre de référence atrophie multisystématisée, CHU de Bordeaux, Bordeaux, France. 6. Service de Neurologie, CHU de Bordeaux, Bordeaux, France. 7. Service de Neurologie, CHU de Bordeaux, Bordeaux, France; Centre de référence atrophie multisystématisée, CHU de Bordeaux, Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France. Electronic address: wassilios.meissner@chu-bordeaux.fr.
Abstract
INTRODUCTION: Dementia is an exclusion criterion in current consensus diagnostic criteria, while growing evidence suggests the occurrence of cognitive dysfunction and even dementia in multiple system atrophy (MSA) patients. The main goal of this study was to determine if Movement Disorder Society (MDS) Parkinson's disease dementia (PDD) LEVEL-1 criteria are useful in screening for dementia in MSA patients compared to full cognitive testing (LEVEL-2 criteria). METHODS: In this retrospective study, MDS diagnostic criteria for PDD were applied in 111 MSA patients from three centres. LEVEL-1 evaluation (short screening test) was compared to LEVEL-2 examination (extensive neuropsychological gold standard assessment). Sensitivity, specificity, positive and negative predictive values were calculated for LEVEL-1 compared to LEVEL-2. Two Mini Mental State Examination (MMSE) cut-off scores were evaluated (<26 according to MDS procedures for the diagnosis of PDD and <27 which has proven more sensitive in a recent study proposing a short procedure for PDD screening). RESULTS: According to these criteria, 11.7% of MSA patients were demented on LEVEL-2 examination. LEVEL-1 examination showed strong specificity (96.9%) and negative predictive value (94.1%), while sensitivity (53.8%) and positive predictive (70%) value were moderate compared to LEVEL-2 evaluation. Sensitivity increased to 84.6% when using a MMSE threshold <27 for LEVEL-1. Executive dysfunction was the main prevalent finding (52% of all patients), while impairment of memory (15%), language (14%) and visuospatial functions was less frequent (13%). CONCLUSION: Our findings suggest that the MDS PDD short screening test may be useful for the diagnosis of MSA dementia.
INTRODUCTION:Dementia is an exclusion criterion in current consensus diagnostic criteria, while growing evidence suggests the occurrence of cognitive dysfunction and even dementia in multiple system atrophy (MSA) patients. The main goal of this study was to determine if Movement Disorder Society (MDS) Parkinson's disease dementia (PDD) LEVEL-1 criteria are useful in screening for dementia in MSA patients compared to full cognitive testing (LEVEL-2 criteria). METHODS: In this retrospective study, MDS diagnostic criteria for PDD were applied in 111 MSA patients from three centres. LEVEL-1 evaluation (short screening test) was compared to LEVEL-2 examination (extensive neuropsychological gold standard assessment). Sensitivity, specificity, positive and negative predictive values were calculated for LEVEL-1 compared to LEVEL-2. Two Mini Mental State Examination (MMSE) cut-off scores were evaluated (<26 according to MDS procedures for the diagnosis of PDD and <27 which has proven more sensitive in a recent study proposing a short procedure for PDD screening). RESULTS: According to these criteria, 11.7% of MSA patients were demented on LEVEL-2 examination. LEVEL-1 examination showed strong specificity (96.9%) and negative predictive value (94.1%), while sensitivity (53.8%) and positive predictive (70%) value were moderate compared to LEVEL-2 evaluation. Sensitivity increased to 84.6% when using a MMSE threshold <27 for LEVEL-1. Executive dysfunction was the main prevalent finding (52% of all patients), while impairment of memory (15%), language (14%) and visuospatial functions was less frequent (13%). CONCLUSION: Our findings suggest that the MDSPDD short screening test may be useful for the diagnosis of MSA dementia.
Authors: Francesca Caso; Elisa Canu; Milica Jecmenica Lukic; Igor N Petrovic; Andrea Fontana; Ivan Nikolic; Vladimir S Kostic; Massimo Filippi; Federica Agosta Journal: J Neurol Date: 2019-09-26 Impact factor: 4.849
Authors: Iva Stankovic; Alessandra Fanciulli; Vladimir S Kostic; Florian Krismer; Wassilios G Meissner; Jose Alberto Palma; Jalesh N Panicker; Klaus Seppi; Gregor K Wenning Journal: Mov Disord Clin Pract Date: 2021-03-10