Background: Lewy body disease is a spectrum of disorders related to Parkinson’s disease and to Alzheimer’s disease. 10-25% patients with dementia are affected by Lewy body disease and 25-40% of patients with Parkinson’s Disease are affected also by dementia (PPD). Features of Lewy body disease (LBD) include fluctuating cognition, visual hallucinations, and parkinsonism, but the diagnosis cannot be made if parkinsonian symptoms developed more than 1 year prior to the onset of dementia. A key question is whether this is a meaningful distinction between different clinical entities and if it is possible to distinguish them by using electrophysiological recordings, as diffuse cortical Lewy bodies are the main substrate of dementia. Our previous findings on fluctuating cognition and correlated alterations of the electrocortical arousal in Alzheimer’s disease and LBD will be used to establish if it is possible to distinguish PPD patients from LBD patients.
Materials and Methods: The study population consisted of 30 patients affected by idiopatic Parkinson’s disease, according to brain bank criteria and dementia, DSM IV criteria, and 30 patients affected by Lewy body disease according to the consensus criteria. Both groups were matched by age, sex, and education. They underwent neuropsychological evaluations, MMSE, Mattis Dementia Rating scale (CDR), Neuropsychiatric Inventory (NPI), QEEG, brain mapping, and CSA.
Results: There are no significant differences in the two patient groups for MMSE and DRS scores, for the duration of onset of dementia. The two groups differ significantly for UPDRS motor subscale score, L-Dopa dosage. The NPI evaluation reveals that symptoms like hallucinations, apathy, irritability and aberrant motor behavior were predominant in LBD patients, whereas sleep disturbances were significantly reported in patients with PDD. Neurophysiological recordings show a dominant EEG frequency variability, with low amplitude in the LBD group, whereas the PDD patient recordings were characterized by a stable dominant EEG frequency with predominant slow frequencies.
Conclusion: The presence of variability in the dominant EEG frequency can differentiate PDD from LBD patients.
Back to S014 Psychopathology with Parkinson's Disease vs. Parkinson's Disease with Psychopathology
Back to The Eleventh International Congress