Giuseppe Tosto1,2, Sarah E Monsell3, Stephen E Hawes3,4, Giuseppe Bruno5, Richard Mayeux1,2,6. 1. The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA. 2. Sergievsky Center, College of Physiciansand Surgeons, Columbia University New York, NY, USA. 3. National Alzheimer's Coordinating Center, University of Washington, WA, USA. 4. Department of Epidemiology, University of Washington, WA, USA. 5. Department of Neurology and Psychiatry, University "Sapienza", Rome, Italy. 6. Department of Neurology, College of Physiciansand Surgeons, Columbia University and the New York, Presbyterian Hospital, New York, NY, USA.
Abstract
BACKGROUND: Extrapyramidal signs (EPS) are frequent in Alzheimer's disease (AD) and core manifestation of related diseases, i.e., dementia with Lewy bodies and Parkinson's disease; furthermore, Lewy bodies and AD-type pathology occur in all three conditions. OBJECTIVE: To identify clusters of EPS progression over time and their clinical and neuropathological correlates. METHODS: 3,502 AD patients with longitudinal assessment from the National Alzheimer's Coordinating Center database were included; 394 provided neuropathological data. k-means algorithm was employed to identify clusters of EPS progression and those were compared in terms of cognitive profile, neuropsychiatric features and neuropathological findings. RESULTS: Three clusters of EPS progression were identified: no/low (n = 1,583), medium (n = 1,259), and high (n = 660) EPS burden. Compared to those with no/low and medium EPS, those with high EPS had greater cognitive and neuropsychiatric impairment, specifically hallucinations. Despite similar AD-pathology across the three clusters, the high EPS cluster had a significantly number of subjects diagnosed with dementia with Lewy bodies. CONCLUSIONS: Cluster analysis of EPS progression over time identified different subgroups of AD patients with distinct clinical and neuropathological features.
BACKGROUND: Extrapyramidal signs (EPS) are frequent in Alzheimer's disease (AD) and core manifestation of related diseases, i.e., dementia with Lewy bodies and Parkinson's disease; furthermore, Lewy bodies and AD-type pathology occur in all three conditions. OBJECTIVE: To identify clusters of EPS progression over time and their clinical and neuropathological correlates. METHODS: 3,502 ADpatients with longitudinal assessment from the National Alzheimer's Coordinating Center database were included; 394 provided neuropathological data. k-means algorithm was employed to identify clusters of EPS progression and those were compared in terms of cognitive profile, neuropsychiatric features and neuropathological findings. RESULTS: Three clusters of EPS progression were identified: no/low (n = 1,583), medium (n = 1,259), and high (n = 660) EPS burden. Compared to those with no/low and medium EPS, those with high EPS had greater cognitive and neuropsychiatric impairment, specifically hallucinations. Despite similar AD-pathology across the three clusters, the high EPS cluster had a significantly number of subjects diagnosed with dementia with Lewy bodies. CONCLUSIONS: Cluster analysis of EPS progression over time identified different subgroups of ADpatients with distinct clinical and neuropathological features.
Authors: J S Paulsen; D P Salmon; L J Thal; R Romero; C Weisstein-Jenkins; D Galasko; C R Hofstetter; R Thomas; I Grant; D V Jeste Journal: Neurology Date: 2000-05-23 Impact factor: 9.910
Authors: L Hansen; D Salmon; D Galasko; E Masliah; R Katzman; R DeTeresa; L Thal; M M Pay; R Hofstetter; M Klauber Journal: Neurology Date: 1990-01 Impact factor: 9.910
Authors: D I Kaufer; J L Cummings; P Ketchel; V Smith; A MacMillan; T Shelley; O L Lopez; S T DeKosky Journal: J Neuropsychiatry Clin Neurosci Date: 2000 Impact factor: 2.198
Authors: Jon B Toledo; Nigel J Cairns; Xiao Da; Kewei Chen; Deborah Carter; Adam Fleisher; Erin Householder; Napatkamon Ayutyanont; Auttawut Roontiva; Robert J Bauer; Paul Eisen; Leslie M Shaw; Christos Davatzikos; Michael W Weiner; Eric M Reiman; John C Morris; John Q Trojanowski Journal: Acta Neuropathol Commun Date: 2013-10-09 Impact factor: 7.801
Authors: Hany Alashwal; Mohamed El Halaby; Jacob J Crouse; Areeg Abdalla; Ahmed A Moustafa Journal: Front Comput Neurosci Date: 2019-05-24 Impact factor: 2.380