Profiling people with Parkinson's disease at risk of cognitive decline: Insights from PPMI and ICICLE-PD data.

IF 4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2024-08-05 eCollection Date: 2024-07-01 DOI:10.1002/dad2.12625
Dana Pourzinal, Rachael A Lawson, Alison J Yarnall, Caroline H Williams-Gray, Roger A Barker, Jihyun Yang, Katie L McMahon, John D O'Sullivan, Gerard J Byrne, Nadeeka N Dissanayaka
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Abstract

Introduction: A subset of people with Parkinson's disease (PD) develop dementia faster than others. We aimed to profile PD cognitive subtypes at risk of dementia based on their rate of cognitive decline.

Method: Latent class mixed models stratified subtypes in Parkinson's Progression Markers Initiative (PPMI) (= 770) and ICICLE-PD (= 212) datasets based on their decline in the Montreal Cognitive Assessment over at least 4 years. Baseline demographic and cognitive data at diagnosis were compared between subtypes to determine their clinical profile.

Results: Four subtypes were identified: two with stable cognition, one with steady decline, and one with rapid decline. Performance on Judgement of Line Orientation, but not category fluency, was associated with a steady decline in the PPMI dataset, and deficits in category fluency, but not visuospatial function, were associated with a steady decline in the ICICLE-PD dataset.

Discussion: People with PD susceptible to cognitive decline demonstrate unique clinical profiles at diagnosis, although this differed between cohorts.

Highlights: Four cognitive subtypes were revealed in two Parkinson's disease samples.Unique profiles of cognitive impairment were related to cognitive decline.Judgement of Line Orientation/category fluency predictive of steady decline.Global deficits related to rapid cognitive decline and increased dementia risk.

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帕金森病患者认知能力下降风险分析:从 PPMI 和 ICICLE-PD 数据中获得的启示。
导言:帕金森病(Parkinson's disease,PD)患者中的一部分人比其他人更快患上痴呆症。我们的目的是根据帕金森病患者认知能力下降的速度,对有痴呆风险的帕金森病认知亚型进行分析:潜类混合模型根据患者在蒙特利尔认知评估(Montreal Cognitive Assessment)中至少4年的衰退情况,对帕金森病进展标志物倡议(PPMI)(N = 770)和ICICLE-PD(N = 212)数据集中的亚型进行分层。对不同亚型患者诊断时的人口统计学基线和认知数据进行比较,以确定其临床特征:结果:确定了四个亚型:两个认知能力稳定,一个稳步下降,一个快速下降。在PPMI数据集中,线方向判断的表现(而非类别流畅性)与持续下降有关;在ICICLE-PD数据集中,类别流畅性的缺陷(而非视觉空间功能)与持续下降有关:讨论:容易出现认知功能下降的帕金森病患者在确诊时会表现出独特的临床特征,尽管不同组群之间存在差异:在两个帕金森病样本中发现了四种认知亚型。认知障碍的独特特征与认知能力下降有关。线性定向判断/分类流畅性预测能力持续下降。
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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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