Title | Progression of Extrapyramidal Signs in Alzheimer's Disease: Clinical and Neuropathological Correlates. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Tosto, G, Monsell, SE, Hawes, SE, Bruno, G, Mayeux, R |
Journal | J Alzheimers Dis |
Volume | 49 |
Issue | 4 |
Pagination | 1085-93 |
Date Published | 2016 |
ISSN | 1875-8908 |
Keywords | Aged, Algorithms, Alzheimer Disease, Cluster Analysis, Databases, Factual, Disease Progression, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Severity of Illness Index |
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. |
DOI | 10.3233/JAD-150244 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 26599050 |
PubMed Central ID | PMC4779642 |
Grant List | P30 AG013854 / AG / NIA NIH HHS / United States P30 AG010124 / AG / NIA NIH HHS / United States P50 AG023501 / AG / NIA NIH HHS / United States P50 AG005142 / AG / NIA NIH HHS / United States P50 AG005131 / AG / NIA NIH HHS / United States P30 AG010133 / AG / NIA NIH HHS / United States P50 AG016574 / AG / NIA NIH HHS / United States P50 AG005146 / AG / NIA NIH HHS / United States P30 AG035982 / AG / NIA NIH HHS / United States P50 AG008702 / AG / NIA NIH HHS / United States U01 AG016976 / AG / NIA NIH HHS / United States P30 AG008051 / AG / NIA NIH HHS / United States P50 AG005681 / AG / NIA NIH HHS / United States P30 AG013846 / AG / NIA NIH HHS / United States P01 AG007232 / AG / NIA NIH HHS / United States P50 AG005136 / AG / NIA NIH HHS / United States P30 AG012300 / AG / NIA NIH HHS / United States P50 AG016573 / AG / NIA NIH HHS / United States P50 AG016570 / AG / NIA NIH HHS / United States P50 AG005134 / AG / NIA NIH HHS / United States P30 AG008017 / AG / NIA NIH HHS / United States P30 AG010161 / AG / NIA NIH HHS / United States P50 AG025688 / AG / NIA NIH HHS / United States P50 AG005133 / AG / NIA NIH HHS / United States R01 AG041797 / AG / NIA NIH HHS / United States P01 AG004953 / AG / NIA NIH HHS / United States P50 AG005138 / AG / NIA NIH HHS / United States P30 AG010129 / AG / NIA NIH HHS / United States P30 AG019610 / AG / NIA NIH HHS / United States P01 AG009525 / AG / NIA NIH HHS / United States P30 AG028383 / AG / NIA NIH HHS / United States P50 AG033514 / AG / NIA NIH HHS / United States |