Kyla-Louise Horne1,2,3,4, Michael R MacAskill1,2, Daniel J Myall1,3, Leslie Livingston1,2, Sophie Grenfell1, Maddie J Pascoe1, Bob Young1, Reza Shoorangiz1,3,5, Tracy R Melzer1,2,3, Toni L Pitcher1,2,3, Tim J Anderson1,2,3,6, John C Dalrymple-Alford1,2,3,4. 1. New Zealand Brain Research Institute Christchurch New Zealand. 2. Department of Medicine University of Otago Christchurch New Zealand. 3. Brain Research New Zealand Rangahau Roro Aotearoa Centre of Research Excellence Christchurch New Zealand. 4. School of Psychology, Speech and Hearing University of Canterbury Christchurch New Zealand. 5. Department of Electrical and Computer Engineering University of Canterbury Christchurch New Zealand. 6. Department of Neurology Christchurch Hospital Christchurch New Zealand.
Abstract
BACKGROUND: Neuropsychiatric symptoms in Parkinson's disease (PD) may increase dementia (PDD) risk. The predictive value of these symptoms, however, has not been compared to clinical and demographic predictors of future PDD. OBJECTIVES: Determine if neuropsychiatric symptoms are useful markers of PDD risk. METHODS: 328 PD participants completed baseline neuropsychiatric and MDS-Task Force-Level II assessments. Of these, 202 non-demented individuals were followed-up over a four-years period to detect conversion to PDD; 51 developed PDD. ROC analysis tested associations between baseline neuropsychiatric symptoms and future PDD. The probability of developing PDD was also modeled as a function of neuropsychiatric inventory (NPI)-total score, PD Questionnaire (PDQ)-hallucinations, PDQ-anxiety, and contrasted to cognitive ability, age, and motor function. Leave-one-out information criterion was used to evaluate which models provided useful information when predicting future PDD. RESULTS: The PDD group experienced greater levels of neuropsychiatric symptoms compared to the non-PDD groups at baseline. Few differences were found between the PD-MCI and PD-N groups. Six neuropsychiatric measures were significantly, but weakly, associated with future PDD. The strongest was NPI-total score: AUC = 0.66 [0.57-0.75]. There was, however, no evidence it contained useful out-of-sample predictive information of future PDD (delta ELPD = 1.8 (SD 2.5)); Similar results held for PDQ-hallucinations and PDQ-anxiety. In contrast, cognitive ability (delta ELPD = 36 (SD 8)) and age (delta ELPD = 11 (SD 5)) provided useful predictive information of future PDD. CONCLUSIONS: Cognitive ability and age strongly out-performed neuropsychiatric measures as markers of developing PDD within 4 years. Therefore, neuropsychiatric symptoms do not appear to be useful markers of PDD risk.
BACKGROUND: Neuropsychiatric symptoms in Parkinson's disease (PD) may increase dementia (PDD) risk. The predictive value of these symptoms, however, has not been compared to clinical and demographic predictors of future PDD. OBJECTIVES: Determine if neuropsychiatric symptoms are useful markers of PDD risk. METHODS: 328 PD participants completed baseline neuropsychiatric and MDS-Task Force-Level II assessments. Of these, 202 non-demented individuals were followed-up over a four-years period to detect conversion to PDD; 51 developed PDD. ROC analysis tested associations between baseline neuropsychiatric symptoms and future PDD. The probability of developing PDD was also modeled as a function of neuropsychiatric inventory (NPI)-total score, PD Questionnaire (PDQ)-hallucinations, PDQ-anxiety, and contrasted to cognitive ability, age, and motor function. Leave-one-out information criterion was used to evaluate which models provided useful information when predicting future PDD. RESULTS: The PDD group experienced greater levels of neuropsychiatric symptoms compared to the non-PDD groups at baseline. Few differences were found between the PD-MCI and PD-N groups. Six neuropsychiatric measures were significantly, but weakly, associated with future PDD. The strongest was NPI-total score: AUC = 0.66 [0.57-0.75]. There was, however, no evidence it contained useful out-of-sample predictive information of future PDD (delta ELPD = 1.8 (SD 2.5)); Similar results held for PDQ-hallucinations and PDQ-anxiety. In contrast, cognitive ability (delta ELPD = 36 (SD 8)) and age (delta ELPD = 11 (SD 5)) provided useful predictive information of future PDD. CONCLUSIONS: Cognitive ability and age strongly out-performed neuropsychiatric measures as markers of developing PDD within 4 years. Therefore, neuropsychiatric symptoms do not appear to be useful markers of PDD risk.
Authors: Jeroen Hoogland; Judith A Boel; Rob M A de Bie; Ronald B Geskus; Ben A Schmand; John C Dalrymple-Alford; Connie Marras; Charles H Adler; Jennifer G Goldman; Alexander I Tröster; David J Burn; Irene Litvan; Gert J Geurtsen Journal: Mov Disord Date: 2017-06-12 Impact factor: 10.338
Authors: Christopher G Goetz; Barbara C Tilley; Stephanie R Shaftman; Glenn T Stebbins; Stanley Fahn; Pablo Martinez-Martin; Werner Poewe; Cristina Sampaio; Matthew B Stern; Richard Dodel; Bruno Dubois; Robert Holloway; Joseph Jankovic; Jaime Kulisevsky; Anthony E Lang; Andrew Lees; Sue Leurgans; Peter A LeWitt; David Nyenhuis; C Warren Olanow; Olivier Rascol; Anette Schrag; Jeanne A Teresi; Jacobus J van Hilten; Nancy LaPelle Journal: Mov Disord Date: 2008-11-15 Impact factor: 10.338
Authors: Murat Emre; Dag Aarsland; Richard Brown; David J Burn; Charles Duyckaerts; Yoshikino Mizuno; Gerald Anthony Broe; Jeffrey Cummings; Dennis W Dickson; Serge Gauthier; Jennifer Goldman; Christopher Goetz; Amos Korczyn; Andrew Lees; Richard Levy; Irene Litvan; Ian McKeith; Warren Olanow; Werner Poewe; Niall Quinn; Christina Sampaio; Eduardo Tolosa; Bruno Dubois Journal: Mov Disord Date: 2007-09-15 Impact factor: 10.338