scholarly journals Measuring neuropsychiatric symptoms in patients with early cognitive decline using speech analysis

2021 ◽  
pp. 1-41
Author(s):  
Alexandra König ◽  
Elisa Mallick ◽  
Johannes Tröger ◽  
Nicklas Linz ◽  
Radia Zeghari ◽  
...  
2011 ◽  
Vol 31 (11) ◽  
pp. 2199-2208 ◽  
Author(s):  
Meike Heeren ◽  
Karin Weissenborn ◽  
Dimitrios Arvanitis ◽  
Martin Bokemeyer ◽  
Annemarie Goldbecker ◽  
...  

Patients with hepatitis C virus (HCV) infection frequently show neuropsychiatric symptoms. This study aims to help clarify the neurochemical mechanisms behind these symptoms and to add further proof to the hypothesis that HCV may affect brain function. Therefore, 15 patients who reported increasing chronic fatigue, mood alterations, and/or cognitive decline since their HCV infection underwent neurologic and neuropsychological examination, magnetic resonance imaging, 18F-fluoro-deoxy-glucose positron emission tomography of the brain, and single photon emission tomography of striatal dopamine and midbrain serotonin transporter (SERT) availability. None of the patients had liver cirrhosis. Patients’ data were compared with data of age-matched controls. In addition, regression analysis was performed between cognitive deficits, and mood and fatigue scores as dependent variables, and cerebral glucose metabolism, dopamine, or SERT availability as predictors. Patients showed significant cognitive deficits, significantly decreased striatal dopamine and midbrain SERT availability, and significantly reduced glucose metabolism in the limbic association cortex, and in the frontal, parietal, and superior temporal cortices, all of which correlated with dopamine transporter availability and psychometric results. Thus, the study provides further evidence of central nervous system affection in HCV-afflicted patients with neuropsychiatric symptoms. Data indicate alteration of dopaminergic neurotransmission as a possible mechanism of cognitive decline.


2020 ◽  
Vol 28 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Muhammad Haroon Burhanullah ◽  
JoAnn T. Tschanz ◽  
Matthew E. Peters ◽  
Jeannie-Marie Leoutsakos ◽  
Joshua Matyi ◽  
...  

Author(s):  
Bruno Kusznir Vitturi ◽  
Enrico Stefano Suriano ◽  
Ana Beatriz Pereira de Sousa ◽  
Dawton Yukito Torigoe

ABSTRACT:Background:Little is known about the potential systemic effects of ankylosing spondylitis (AS) on the nervous system. We designed a study aiming to assess the frequency and clinical predictors of cognitive impairment in AS patients.Methods:We carried out a cross-sectional case–control study composed of consecutive patients with AS. Trained and blinded interviewers registered clinical-epidemiological data and applied a standardized neurological assessment for each subject of the study. At baseline, functional limitations were characterized using the Health Assessment Questionnaire. Cognitive impairment was evaluated with the Brief Cognitive Screening Battery, the Montreal Cognitive Assessment, and the Clinical Dementia Rating, while neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale. Healthy controls were matched for age, educational attainment, sex, and comorbidities. We compared the neurological outcomes between case and controls, and we determined the clinical predictors of cognitive decline.Results:We included 40 patients (mean: 49.3 years) with AS and 40 healthy controls (mean: 48.8 years) in our study. In Brief Cognitive Screening Battery, patients with AS presented a statistically significant poor performance in the clock drawing test and in the verbal fluency. The mean Montreal Cognitive Assessment (MoCA) scores were significantly lower in AS subjects compared to the control group. Also, the prevalence of subjects classified as cognitively impaired according to MoCA was significantly higher in the AS group (90.0% vs. 57.5%, p = 0.02). Moreover, neuropsychiatric symptoms were more prevalent in AS patients. Worse functional limitations were associated with poor cognitive performance as well.Conclusions:Patients with AS might be more vulnerable to cognitive decline.


2020 ◽  
Vol 16 (S6) ◽  
Author(s):  
Audun Osland Vik‐Mo ◽  
Lasse Melvær Giil ◽  
Clive Ballard ◽  
Dag Aarsland

2017 ◽  
Vol 62 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Damien Gallagher ◽  
Corinne E. Fischer ◽  
Andrea Iaboni

Objective: Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care. Method: The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders. Results: NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline. Conclusions: NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.


2017 ◽  
Vol 30 (1) ◽  
pp. 103-113 ◽  
Author(s):  
N. Siafarikas ◽  
G. Selbaek ◽  
T. Fladby ◽  
J. Šaltytė Benth ◽  
E. Auning ◽  
...  

ABSTRACTBackground:Neuropsychiatric symptoms (NPS), such as depression, apathy, agitation, and psychotic symptoms are common in mild cognitive impairment (MCI) and dementia in Alzheimer's disease (AD). Subgroups of NPS have been reported. Yet the relationship of NPS and their subgroups to different stages of cognitive impairment is unclear. Most previous studies are based on small sample sizes and show conflicting results. We sought to examine the frequency of NPS and their subgroups in MCI and different stages of dementia in AD.Methods:This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4,571 patients, we included those with MCI or AD (MCI 817, mild AD 883, moderate–severe AD 441). To compare variables across groups ANOVA or χ2-test was applied. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items to identify subgroups of NPS.Results:The frequency of any NPS was 87.2% (AD 91.2%, MCI 79.5%; p < 0.001) and increased with increasing severity of cognitive decline. The most frequent NPS in MCI was depression. Apathy was the most frequent NPS in AD across different stages of severity. The factor analysis identified three subgroups in MCI and mild AD, and a fourth one in moderate–severe AD. We labelled the subgroups “depression,” “agitation,” “psychosis,” and “elation.”Conclusions:The frequency of NPS is high in MCI and AD and increases with the severity of cognitive decline. The subgroups of NPS were relatively consistent from MCI to moderate-severe AD. The subgroup elation appeared only in moderate-severe AD.


2020 ◽  
Author(s):  
Christopher Clark ◽  
Jonas Richiardi ◽  
Bénédicte Maréchal ◽  
Gene L. Bowman ◽  
Loïc Dayon ◽  
...  

Abstract BACKGROUND Neuroinflammation may contribute to psychiatric symptoms in older people, in particular in the context of Alzheimer’s disease (AD). Here, our objective was to determine systemic and central nervous system (CNS) inflammatory signatures associated with neuropsychiatric symptoms (NPS) in older subjects, and investigate their relationships with AD pathology and cognitive decline.METHODS We quantified a panel of inflammatory markers in both cerebrospinal fluid (CSF) and circulating blood serum in elderly subjects with normal cognition or with beginning cognitive decline. We further performed a comprehensive clinical assessment including longitudinal cognitive and neuropsychiatric evaluations and measured CSF biomarkers of core AD pathology. Multivariate analysis selected CSF and serum neuroinflammatory molecules associated with the presence of overall NPS and specific symptoms.RESULTS The presence of NPS was associated with distinct inflammatory markers profiles involving soluble intracellular cell adhesion molecule-1 (sICAM-1), C-reactive protein (CRP), Interleukin (IL) -8 and 10 kDa interferon-γ-induced protein (IP-10) in CSF; and Eotaxin-3, IL-6 and CRP in serum. Further analysis identified specific inflammatory marker signatures associated with anxiety, depression and disinhibition. Presenting NPS was associated with subsequent cognitive decline and this association was mediated by CSF sICAM-1.CONCLUSIONS These results suggest that NPS in older people are associated with distinct systemic and CNS inflammatory processes. Neuroinflammation may explain the link between NPS and more rapid clinical disease progression.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 282-282
Author(s):  
Douglas Hanes ◽  
Sean Clouston

Abstract Relationship status is thought to be associated with cognitive health in older adults, with married persons performing better on memory assessments than unmarried-cohabitating, single, divorced, and widowed persons. However, questions remain about whether relationship termination causes cognitive decline, is a result of it, or whether they share a cause; and the mechanisms by which such a relationship might operate. To address this gap in the literature, we hypothesized that relationship termination could affect cognition via the following five pathways: (1) post-termination depression; (2) loss of distributed-cognition partner; (3) cognitive depletion from caring for partner in declining and ultimately terminal health; (4) divorce to preserve assets to qualify for Medicaid to cover healthcare for cognitive decline; and (5) post-termination changes in neuropsychiatric symptoms alongside a pre-existing neurodegenerative condition that also causes cognitive decline. Using data from the 2000–2016 waves of the Health and Retirement Study (HRS; N = 23,393), we found that relationship termination, whether due to divorce or widowhood, was associated with cognitive decline. Using mixed-effects regression we found that the rate of cognitive decline increased after relationship termination (widowhood: □ = -0.587, p &lt;0.001; divorce: □ = -0.221, p &lt;0.001), supporting mechanism (5). Using HRS data for respondents and their spouses’ mental and physical health, health insurance, and activities of daily living, we also find support for mechanisms (1) and (3). Relationship termination is a critical juncture in a person’s life course that has multiple implications and may, ultimately, worsen patients’ conditions.


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