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Quee, P. J., B. Z. Alizadeh, A. Aleman, and E. R. van den Heuvel. "Cognitive subtypes in non-affected siblings of schizophrenia patients: characteristics and profile congruency with affected family members." Psychological Medicine 44, no. 2 (May 9, 2013): 395–405. http://dx.doi.org/10.1017/s0033291713000809.
Повний текст джерелаАнотація:
BackgroundAlthough cognitive subtypes have been suggested in schizophrenia patients, similar analyses have not been carried out in their non-affected siblings. Subtype classification may provide more insight into genetically driven variation in cognitive function. We investigated cognitive subtypes in siblings.MethodCluster analyses were performed in 654 non-affected siblings, on a cognitive battery that included tests of attention, intellectual function and episodic memory. Resulting subtypes in the siblings were analyzed for cognitive, demographic and clinical characteristics and compared with those of their probands.ResultsThree sibling subtypes of cognitive function were distinguished: ‘normal’, ‘mixed’ and ‘impaired’. Normal profile siblings (n = 192) were unimpaired on cognitive tests, in contrast to their proband (n = 184). Mixed profile siblings (n = 228) and their probands (n = 222) had a more similar performance pattern. Impaired profile siblings had poorer functional outcomes (n = 234) and their profile was almost identical to that of their proband (n = 223). Probands with cognitively impaired siblings could be distinguished from other schizophrenia patients by their own cognitive performance. They also had poorer clinical characteristics, including achievement of symptomatic remission.ConclusionsUnaffected siblings of patients with schizophrenia are heterogeneous with respect to cognitive function. The poorer the cognitive profile of the sibling, the higher the level of correspondence with the proband. The sibling's cognitive subtype was predictive for disease course in the proband. Distinguishing cognitive subtypes of unaffected siblings may be of relevance for genetic studies.
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Andrejeva, Nadeshda, Maren Knebel, Vasco Dos Santos, Janna Schmidt, Christina Josefa Herold, Ruxandra Tudoran, Petra Wetzel, et al. "Neurocognitive Deficits and Effects of Cognitive Reserve in Mild Cognitive Impairment." Dementia and Geriatric Cognitive Disorders 41, no. 3-4 (2016): 199–209. http://dx.doi.org/10.1159/000443791.
Повний текст джерелаАнотація:
Background/Aims: Mild cognitive impairment (MCI) is a frequent syndrome in the older population, which involves an increased risk to develop Alzheimer's disease (AD). The latter can be modified by the cognitive reserve, which can be operationalized by the length of school education. MCI can be differentiated into four subtypes according to the cognitive domains involved: amnestic MCI, multiple-domain amnestic MCI, non-amnestic MCI and multiple-domain non-amnestic MCI. While neurocognitive deficits are a constituent of the diagnosis of these subtypes, the question of how they refer to the cognitive reserve still needs to be clarified. Methods: We examined neuropsychological deficits in healthy controls, patients with MCI and patients with mild AD (n = 485) derived from a memory clinic. To reduce the number of neuropsychological variables, a factor analysis with varimax rotation was calculated. In a second step, diagnostic groups including MCI subtypes were compared with respect to their clinical and neuropsychological characteristics including cognitive reserve. Results: Most MCI patients showed the amnestic multiple-domain subtype followed by the pure amnestic subtype, while the non-amnestic subtypes were rare. The amnestic subtype displayed a significantly higher level of cognitive reserve and higher MMSE scores than the amnestic multiple-domain subtype, which was in most cases characterized by additional psychomotor and executive deficits. Conclusions: These findings confirm earlier reports revealing that the amnestic multiple-domain subtype is the most frequent one and indicating that a high cognitive reserve may primarily prevent psychomotor and executive deficits in MCI.
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ten Kate, Mara, Ellen Dicks, Pieter Jelle Visser, Wiesje M. van der Flier, Charlotte E. Teunissen, Frederik Barkhof, Philip Scheltens, and Betty M. Tijms. "Atrophy subtypes in prodromal Alzheimer’s disease are associated with cognitive decline." Brain 141, no. 12 (October 22, 2018): 3443–56. http://dx.doi.org/10.1093/brain/awy264.
Повний текст джерелаАнотація:
Abstract Alzheimer’s disease is a heterogeneous disorder. Understanding the biological basis for this heterogeneity is key for developing personalized medicine. We identified atrophy subtypes in Alzheimer’s disease dementia and tested whether these subtypes are already present in prodromal Alzheimer’s disease and could explain interindividual differences in cognitive decline. First we retrospectively identified atrophy subtypes from structural MRI with a data-driven cluster analysis in three datasets of patients with Alzheimer’s disease dementia: discovery data (dataset 1: n = 299, age = 67 ± 8, 50% female), and two independent external validation datasets (dataset 2: n = 181, age = 66 ± 7, 52% female; dataset 3: n = 227, age = 74 ± 8, 44% female). Subtypes were compared on clinical, cognitive and biological characteristics. Next, we classified prodromal Alzheimer’s disease participants (n = 603, age = 72 ± 8, 43% female) according to the best matching subtype to their atrophy pattern, and we tested whether subtypes showed cognitive decline in specific domains. In all Alzheimer’s disease dementia datasets we consistently identified four atrophy subtypes: (i) medial-temporal predominant atrophy with worst memory and language function, older age, lowest CSF tau levels and highest amount of vascular lesions; (ii) parieto-occipital atrophy with poor executive/attention and visuospatial functioning and high CSF tau; (iii) mild atrophy with best cognitive performance, young age, but highest CSF tau levels; and (iv) diffuse cortical atrophy with intermediate clinical, cognitive and biological features. Prodromal Alzheimer’s disease participants classified into one of these subtypes showed similar subtype characteristics at baseline as Alzheimer’s disease dementia subtypes. Compared across subtypes in prodromal Alzheimer’s disease, the medial-temporal subtype showed fastest decline in memory and language over time; the parieto-occipital subtype declined fastest on executive/attention domain; the diffuse subtype in visuospatial functioning; and the mild subtype showed intermediate decline in all domains. Robust atrophy subtypes exist in Alzheimer’s disease with distinct clinical and biological disease expression. Here we observe that these subtypes can already be detected in prodromal Alzheimer’s disease, and that these may inform on expected trajectories of cognitive decline.
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Brazo, P., R. M. Marié, I. Halbecq, K. Benali, L. Segard, P. Delamillieure, S. Langlois-Théry, et al. "Cognitive patterns in subtypes of schizophrenia." European Psychiatry 17, no. 3 (May 2002): 155–62. http://dx.doi.org/10.1016/s0924-9338(02)00648-x.
Повний текст джерелаАнотація:
SummaryAimBecause of the heterogeneity of schizophrenia, this study researched different cognitive patterns in distinct subtypes of schizophrenic patients.MethodsThirty-five Diagnostic and Statistical Manual IV (DSM IV) schizophrenic patients and 35 healthy controls were included. Patients were categorized into deficit, disorganized and positive subtypes with the schedule for the deficit syndrome (SDS) and the positive and negative syndrome scale (PANSS). Executive/attentional functions were assessed with the modified card sorting test (MCST), a test of verbal fluency, the trail making test (TMT) and the Stroop color-word test (Stroop test). Episodic memory was explored through the California verbal learning test (CVLT).ResultsThe positive subtype had some executive/attentional (fluency and Stroop tests) and mnesic performances in the normal range, suggesting the preservation of good cognitive skills. In contrast, the deficit and disorganized subtypes had major mnesic and executive/attentional dysfunctions compared to healthy subjects. The deficit subtype compared to the control group performed predominantly worse on the MCST and fluency, whereas the disorganized subtype had the lowest scores on the TMT and the Stroop test.ConclusionThis study showed distinct cognitive patterns in deficit, disorganized and positive patients in comparison with the controls, suggesting a heterogeneous cognitive dysfunction in schizophrenia.
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Edmonds, Emily C., Alexandra J. Weigand, Sean N. Hatton, Anisa J. Marshall, Kelsey R. Thomas, Daniela A. Ayala, Mark W. Bondi, and Carrie R. McDonald. "Patterns of longitudinal cortical atrophy over 3 years in empirically derived MCI subtypes." Neurology 94, no. 24 (May 11, 2020): e2532-e2544. http://dx.doi.org/10.1212/wnl.0000000000009462.
Повний текст джерелаАнотація:
ObjectiveWe previously identified 4 empirically derived mild cognitive impairment (MCI) subtypes via cluster analysis within the Alzheimer's Disease Neuroimaging Initiative (ADNI) and demonstrated high correspondence between patterns of cortical thinning at baseline and each cognitive subtype. We aimed to determine whether our MCI subtypes demonstrate unique longitudinal atrophy patterns.MethodsADNI participants (295 with MCI and 134 cognitively normal [CN]) underwent annual structural MRI and neuropsychological assessments. General linear modeling compared vertex-wise differences in cortical atrophy rates between each MCI subtype and the CN group. Linear mixed models examined trajectories of cortical atrophy over 3 years within lobar regions of interest.ResultsCompared to the CN group, those with amnestic MCI (memory deficit) initially demonstrated greater atrophy rates within medial temporal lobe regions that became more widespread over time. Those with dysnomic/amnestic MCI (naming/memory deficits) showed greater atrophy rates largely localized to temporal lobe regions. The mixed MCI (impairment in all cognitive domains) group showed greater atrophy rates in widespread regions at all time points. The cluster-derived normal group, who had intact neuropsychological performance and normal cortical thickness at baseline despite their MCI diagnosis via conventional diagnostic criteria, continued to show normal cognition and minimal cortical atrophy over 3 years.ConclusionsADNI's purported amnestic MCI sample produced more refined cognitive subtypes with unique longitudinal cortical atrophy rates. These novel MCI subtypes reliably reflect underlying atrophy, reduce false-positive diagnostic errors, and improve prediction of clinical course. Such improvements have implications for the selection of participants for clinical trials and for providing more precise risk assessment for individuals diagnosed with MCI.
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Zhang, TianHong, XiaoChen Tang, HuiJun Li, Kristen A. Woodberry, Emily R. Kline, LiHua Xu, HuiRu Cui, et al. "Clinical subtypes that predict conversion to psychosis: A canonical correlation analysis study from the ShangHai At Risk for Psychosis program." Australian & New Zealand Journal of Psychiatry 54, no. 5 (September 5, 2019): 482–95. http://dx.doi.org/10.1177/0004867419872248.
Повний текст джерелаАнотація:
Objective: Since only 30% or fewer of individuals at clinical high risk convert to psychosis within 2 years, efforts are underway to refine risk identification strategies to increase their predictive power. The clinical high risk is a heterogeneous syndrome presenting with highly variable clinical symptoms and cognitive dysfunctions. This study investigated whether subtypes defined by baseline clinical and cognitive features improve the prediction of psychosis. Method: Four hundred clinical high-risk subjects from the ongoing ShangHai At Risk for Psychosis program were enrolled in a prospective cohort study. Canonical correlation analysis was applied to 289 clinical high-risk subjects with completed Structured Interview for Prodromal Syndromes and cognitive battery tests at baseline, and at least 1-year follow-up. Canonical variates were generated by canonical correlation analysis and then used for hierarchical cluster analysis to produce subtypes. Kaplan–Meier survival curves were constructed from the three subtypes to test their utility further in predicting psychosis. Results: Canonical correlation analysis determined two linear combinations: (1) negative symptom and functional deterioration-related cognitive features, and (2) Positive symptoms and emotional disorganization-related cognitive features. Cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, comprising 14.2% (subtype 1, n = 41), 37.4% (subtype 2, n = 108) and 48.4% (subtype 3, n = 140) of the sample, and each with distinctive features of clinical and cognitive performance. Those with subtype 1, which is characterized by extensive negative symptoms and cognitive deficits, appear to have the highest risk for psychosis. The conversion risk for subtypes 1–3 are 39.0%, 11.1% and 18.6%, respectively. Conclusion: Our results define important subtypes within clinical high-risk syndromes that highlight clinical symptoms and cognitive features that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in clinical and cognitive characteristics as well as in the risk of conversion to psychosis.
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Clark, Lindsay R., Lisa Delano-Wood, David J. Libon, Carrie R. McDonald, Daniel A. Nation, Katherine J. Bangen, Amy J. Jak, Rhoda Au, David P. Salmon, and Mark W. Bondi. "Are Empirically-Derived Subtypes of Mild Cognitive Impairment Consistent with Conventional Subtypes?" Journal of the International Neuropsychological Society 19, no. 6 (April 3, 2013): 635–45. http://dx.doi.org/10.1017/s1355617713000313.
Повний текст джерелаАнотація:
AbstractGiven the importance of identifying dementia prodromes for future treatment efforts, we examined two methods of diagnosing mild cognitive impairment (MCI) and determined whether empirically-derived MCI subtypes of these diagnostic methods were consistent with one another as well as with conventional MCI subtypes (i.e., amnestic, non-amnestic, single-domain, multi-domain). Participants were diagnosed with MCI using either conventional Petersen/Winblad criteria (n = 134; >1.5 SDs below normal on one test within a cognitive domain) or comprehensive neuropsychological criteria developed by Jak et al. (2009) (n = 80; >1 SD below normal on two tests within a domain), and the resulting samples were examined via hierarchical cluster and discriminant function analyses. Results showed that neuropsychological profiles varied depending on the criteria used to define MCI. Both criteria revealed an Amnestic subtype, consistent with prodromal Alzheimer's disease (AD), and a Mixed subtype that may capture individuals in advanced stages of MCI. The comprehensive criteria uniquely yielded Dysexecutive and Visuospatial subtypes, whereas the conventional criteria produced a subtype that performed within normal limits, suggesting its susceptibility to false positive diagnostic errors. Whether these empirically-derived MCI subtypes correspond to dissociable neuropathologic substrates and represent reliable prodromes of dementia will require additional follow-up. (JINS, 2013, 19, 1–11)
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Zhao, Qiannan, Jiao Li, Yuan Xiao, Hengyi Cao, Xiao Wang, Wenjing Zhang, Siyi Li, Wei Liao, Qiyong Gong, and Su Lui. "Distinct neuroanatomic subtypes in antipsychotic-treated patients with schizophrenia classified by the predefined classification in a never-treated sample." Psychoradiology 1, no. 4 (December 2021): 212–24. http://dx.doi.org/10.1093/psyrad/kkab018.
Повний текст джерелаАнотація:
Abstract Background Distinct neuroanatomic subtypes have been identified in never-treated patients with schizophrenia based on cerebral structural abnormalities, but whether antipsychotic-treated patients would be stratified under the guidance of such previously formed classification remains unclear. Objective The present study aimed to investigate alterations of brain structures in antipsychotic-treated patients with schizophrenia based on a predefined morphological classification and their relationships with cognitive performance. Methods Cortical thickness, surface area, and subcortical volume were extracted from 147 antipsychotic-treated patients with schizophrenia using structural magnetic resonance imaging for classification. The Brief Assessment of Cognition in Schizophrenia (BACS) and Positive and Negative Syndrome Scale (PANSS) were used to assess cognition and symptoms. Results Antipsychotic-treated patients were categorized into three subtypes with distinct patterns of brain morphological alterations. Subtypes 1 and 2 were characterized by widespread deficits in cortical thickness but relatively limited deficits in surface area. In contrast, subtype 3 demonstrated cortical thickening mainly in parietal-occipital regions and widespread deficits in surface area. All three subgroups demonstrated cognitive deficits compared with healthy controls. Significant associations between neuroanatomic and cognitive abnormalities were only observed in subtype 1, where cortical thinning in the left lingual gyrus was conversely related to symbol coding performance. Conclusions Similar to drug-naïve patients, neuroanatomic heterogeneity exists in antipsychotic-treated patients, with disparate associations with cognition. These findings promote our understanding of relationships between neuroanatomic abnormalities and cognitive performance in the context of heterogeneity. Moreover, these results suggest that neurobiological heterogeneity needs to be considered in cognitive research in schizophrenia.
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Michaud, Tzeyu L., Dejun Su, Mohammad Siahpush, and Daniel L. Murman. "The Risk of Incident Mild Cognitive Impairment and Progression to Dementia Considering Mild Cognitive Impairment Subtypes." Dementia and Geriatric Cognitive Disorders Extra 7, no. 1 (February 2, 2017): 15–29. http://dx.doi.org/10.1159/000452486.
Повний текст джерелаАнотація:
Background: It remains unclear how demographic and clinical characteristics are related to the risk of incident mild cognitive impairment (MCI) by its subtypes. Moreover, the contribution of the subtypes of incident MCI to the progression to dementia remains puzzling. Methods: We used data collected by the National Alzheimer Coordinating Center. Our analysis sample included cognitively normal subjects at baseline. The associations were examined using competing-risks survival regression models and Cox proportional hazards models. Results: About 16.3% of subjects developed incident MCI of whom 15.8% progressed to Alzheimer disease (overall mean follow-up of 4.3 years). The risk of incident amnestic MCI (aMCI) was greater in subjects with 1 copy (subhazard ratio [SHR]: 1.23; 95% CI: 1.00–1.50) or 2 copies (SHR: 2.14; 95% CI: 1.49–3.05) of the APOE ε4 allele than in those who had no ε4 allele. Multiple-domain aMCI patients were more likely to progress to dementia than single-domain aMCI patients (hazard ratio: 2.14; 95% CI: 1.28–3.58). Conclusions: Cognitively normal subjects with an APOE ε4 allele had a higher likelihood of developing aMCI and the MCI subtype was associated with the dementia subtype. Our findings provide important information about practical indicators for the prediction of cognitive decline.
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Diniz, Breno Satler, Paula Villela Nunes, Monica S. Yassuda, Fernanda S. Pereira, Mariana K. Flaks, Luciane F. Viola, Marcia Radanovic, et al. "Mild cognitive impairment: cognitive screening or neuropsychological assessment?" Revista Brasileira de Psiquiatria 30, no. 4 (December 2008): 316–21. http://dx.doi.org/10.1590/s1516-44462008000400003.
Повний текст джерелаАнотація:
OBJECTIVE: To describe the neuropsychological profile of mild cognitive impairment subtypes (amnestic, non-amnestic and multiple-domain) of a clinical sample. We further address the diagnostic properties of the Mini-Mental State Examination and the Cambridge Cognitive Examination for the identification of the different mild cognitive impairment subtypes in clinical practice. METHOD: Cross-sectional clinical and neuropsychological evaluation of 249 elderly patients attending a memory clinic at a university hospital in Sao Paulo, Brazil. RESULTS: The performance of patients with mild cognitive impairment was heterogeneous across the different subtests of the neuropsychological battery, with a trend towards an overall worse performance for amnestic (particularly multiple domain) mild cognitive impairment as compared to non-amnestic subtypes. Screening tests for dementia (Mini-Mental State Examination and Cambridge Cognitive Examination) adequately discriminated cases of mild Alzheimer's disease from controls, but they were not accurate to discriminate patients with mild cognitive impairment (all subtypes) from control subjects. CONCLUSIONS: The discrimination of mild cognitive impairment subtypes was possible only with the aid of a comprehensive neuropsychological assessment. It is necessary to develop new strategies for mild cognitive impairment screening in clinical practice.
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Göthlin, Mattias, Marie Eckerström, Sindre Rolstad, Anders Wallin, and Arto Nordlund. "Prognostic Accuracy of Mild Cognitive Impairment Subtypes at Different Cut-Off Levels." Dementia and Geriatric Cognitive Disorders 43, no. 5-6 (2017): 330–41. http://dx.doi.org/10.1159/000477341.
Повний текст джерелаАнотація:
Background/Aims: The prognostic accuracy of mild cognitive impairment (MCI) in clinical settings is debated, variable across criteria, cut-offs, subtypes, and follow-up time. We aimed to estimate the prognostic accuracy of MCI and the MCI subtypes for dementia using three different cut-off levels. Methods: Memory clinic patients were followed for 2 (n = 317, age 63.7 ± 7.8) and 4-6 (n = 168, age 62.6 ± 7.4) years. We used 2.0, 1.5, and 1.0 standard deviations (SD) below the mean of normal controls (n = 120, age 64.1 ± 6.6) to categorize MCI and the MCI subtypes. Prognostic accuracy for dementia syndrome at follow-up was estimated. Results: Amnestic multi-domain MCI (aMCI-md) significantly predicted dementia under all conditions, most markedly when speed/attention, language, or executive function was impaired alongside memory. For aMCI-md, sensitivity increased and specificity decreased when the cut-off was lowered from 2.0 to 1.5 and 1.0 SD. Non-subtyped MCI had a high sensitivity and a low specificity. Conclusion: Our results suggest that aMCI-md is the only viable subtype for predicting dementia for both follow-up times. Lowering the cut-off decreases the positive predictive value and increases the negative predictive value of aMCI-md. The results are important for understanding the clinical prognostic utility of MCI, and MCI as a non-progressive disorder.
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Zhang, TianHong, JunJie Wang, LiHua Xu, YanYan Wei, XiaoChen Tang, YeGang Hu, HuiRu Cui, et al. "Subtypes of Clinical High Risk for Psychosis that Predict Antipsychotic Effectiveness in Long-Term Remission." Pharmacopsychiatry 54, no. 01 (October 12, 2020): 23–30. http://dx.doi.org/10.1055/a-1252-2942.
Повний текст джерелаАнотація:
Abstract Introduction In a previous report, we used canonical correlation analysis to classify individuals with clinical high risk (CHR) of psychosis into the 3 subtypes: subtype-1, characterized by extensive negative symptoms and cognitive deficits, appeared to have the highest risk for conversion to psychosis; subtype-2, characterized by thought and behavioral disorganization, with moderate cognitive impairment; subtype-3, characterized by the mildest symptoms and cognitive deficits. The present study attempted to identify these subtypes’ response to antipsychotic (AP) treatment. Methods A total of 289 individuals with CHR were identified and followed up for 2 years. Individuals with CHR were classified by subtype. Use of APs was examined at 2-month, 1-year, and 2-year follow-up interviews that inquired after the subjects’ medication history since the first visit. The main outcome was remission, determined according to global assessment of function (GAF) score (i. e., functional outcome) and SIPS positive symptom score (symptomatic outcome) at the follow-up points. Results Among the 289 individuals with CHR included in the current analysis, 223 (77.2%) were treated using APs for at least 2 weeks during the follow-up period. Individuals with CHR tended to show significant improvement in both symptoms and function after 2 years, but subtypes exhibited significantly different trajectories. Subtype status can predict AP treatment outcome in terms of remission. The likelihood of remission differed significantly among the subtype groups. The remission rates for individuals with subtypes 1–3 treated using AP were 13.5%, 36.1%, and 67.0%, respectively. Discussion These subtypes may be of clinical value in AP treatment decision-making in the CHR population.
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Allali, Gilles, Emmeline I. Ayers, and Joe Verghese. "Motoric Cognitive Risk Syndrome Subtypes and Cognitive Profiles." Journals of Gerontology Series A: Biological Sciences and Medical Sciences 71, no. 3 (August 6, 2015): 378–84. http://dx.doi.org/10.1093/gerona/glv092.
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Forlenza, Orestes Vicente, Breno Satler Diniz, Paula Villela Nunes, Claudia Maia Memória, Monica Sanches Yassuda, and Wagner Farid Gattaz. "Diagnostic transitions in mild cognitive impairment subtypes." International Psychogeriatrics 21, no. 6 (August 20, 2009): 1088–95. http://dx.doi.org/10.1017/s1041610209990792.
Повний текст джерелаАнотація:
ABSTRACTBackground: At least for a subset of patients, the clinical diagnosis of mild cognitive impairment (MCI) may represent an intermediate stage between normal aging and dementia. Nevertheless, the patterns of transition of cognitive states between normal cognitive aging and MCI to dementia are not well established. In this study we address the pattern of transitions between cognitive states in patients with MCI and healthy controls, prior to the conversion to dementia.Methods: 139 subjects (78% women, mean age, 68.5 ± 6.1 years; mean educational level, 11.7 ± 5.4 years) were consecutively assessed in a memory clinic with a standardized clinical and neuropsychological protocol, and classified as cognitively healthy (normal controls) or with MCI (including subtypes) at baseline. These subjects underwent annual reassessments (mean duration of follow-up: 2.7 ± 1.1 years), in which cognitive state was ascertained independently of prior diagnoses. The pattern of transitions of the cognitive state was determined by Markov chain analysis.Results: The transitions from one cognitive state to another varied substantially between MCI subtypes. Single-domain MCI (amnestic and non-amnestic) more frequently returned to normal cognitive state upon follow-up (22.5% and 21%, respectively). Among subjects who progressed to Alzheimer's disease (AD), the most common diagnosis immediately prior conversion was multiple-domain MCI (85%).Conclusion: The clinical diagnosis of MCI and its subtypes yields groups of patients with heterogeneous patterns of transitions between one given cognitive state to another. The presence of more severe and widespread cognitive deficits, as indicated by the group of multiple-domain amnestic MCI may be a better predictor of AD than single-domain amnestic or non-amnestic deficits. These higher-risk individuals could probably be the best candidates for the development of preventive strategies and early treatment for the disease.
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Lee, Sun Hyung, Jun Ho Lee, Min Soo Byun, Dahyun Yi, Gijung Jung, Jee Eun Park, and Dong Young Lee. "Comparison of Amyloid Positivity Rate and Accumulation Pattern between Amnestic and Non-Amnestic Type Mild Cognitive Impairment." Psychiatry Investigation 17, no. 6 (June 15, 2020): 603–7. http://dx.doi.org/10.30773/pi.2020.0063.
Повний текст джерелаАнотація:
Objective We aimed to compare cerebral beta-amyloid protein (Aβ) positivity rate and amyloid accumulation pattern on amyloid positron emission tomography (PET) between mild cognitive impairment (MCI) subtypes, i.e. amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI).Methods The study participants were 34 naMCI patients and age-, sex- and education-matched 68 aMCI patients (1:2 ratio) who visited the Dementia and Age-Associated Cognitive Decline Clinic of the Seoul National University Hospital. All participants received comprehensive clinical and neuropsychological assessments and [<sup>18</sup>F] florbetaben PET.Results Aβ positivity rate of naMCI group (26.5%) was significantly lower than that of aMCI group (64.7%). Among Aβ positive individuals, there was no difference in Aβ accumulation pattern between naMCI and aMCI.Conclusion The findings suggest that MCI subtypes based on impaired cognitive domains have a differential association with brain Aβ deposition, a core pathology of AD. Amnestic subtype of MCI are more closely associated with cerebral Aβ deposition compared to nonamnestic subtype. In contrast, the pattern of amyloid deposition does not appear to have any difference between the subtypes.
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Huang, Qiumin, Xiaofang Jia, Jiguo Zhang, Feifei Huang, Huijun Wang, Bing Zhang, Liusen Wang, Hongru Jiang, and Zhihong Wang. "Diet–Cognition Associations Differ in Mild Cognitive Impairment Subtypes." Nutrients 13, no. 4 (April 17, 2021): 1341. http://dx.doi.org/10.3390/nu13041341.
Повний текст джерелаАнотація:
Cognitive function is not generally associated with diet, and there is debate over that association. Moreover, little is known about such associations with the specific cognitive domains and subtypes of mild cognitive impairment (MCI). We analyzed data of 4309 Chinese adults aged 55 and over from the Community-based Cohort Study on Nervous System Diseases from 2018–2019. Dietary habits were assessed at inclusion using a validated semi-quantitative food frequency questionnaire. Cognitive function of the participants was measured by using the Montreal Cognitive Assessment. Analyses were performed using multiple logistic regression and quantile regression with adjustment for socio-demographic, lifestyle, and health-related factors. Compared with normal cognition participants, those with a worse cognition state were characterized as being an older age and lower economic level. After adjustment for potential factors, participants with higher consumption of rice, legumes, fresh vegetables, fresh fruit, pork, poultry, fish, and nuts tended to have higher scores of global cognitive function and domains, and to have lower odds of MCI, while those with higher consumption levels of wheat and eggs had worse cognition, compared with the corresponding bottom consumption level of each food. Participants with a medium consumption level of beef or mutton had 57% (OR: 1.57, 95%CI: 1.07–2.32) higher odds of aMCI-SD, whereas they had 50% (OR: 0.50, 95%CI: 0.34–0.73) lower odds of naMCI-MD. Similarly, the highest consumption level of dairy was positively associated with the odds of aMCI-SD (OR:1.51, 95%CI:1.00–2.29), but inversely linked to the odds of naMCI-SD (OR: 0.60, 95%CI: 0.38–0.93) and naMCI-MD (OR: 0.49, 95%CI: 0.29–0.82). Most diet global cognitive benefits were observed to be associated with the preexisting higher consumption of rice, legumes, fresh vegetables, fresh fruit, meat, and nuts. In addition, the heterogeneity of associations between the consumption of certain foods and MCI subtypes was observed among Chinese adults aged over 55 years. These cross-sectional observations require validation in prospective studies.
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Lehrner, Johann, Heidemarie Zach, Doris Moser, Andreas Gleiß, Eduard Auff, Walter Pirker, and Gisela Pusswald. "Prevalence of Mild Cognitive Impairment Subtypes in Patients with Parkinson’s Disease – Comparison of two Modes of Classification." Zeitschrift für Neuropsychologie 25, no. 1 (January 2014): 49–63. http://dx.doi.org/10.1024/1016-264x/a000116.
Повний текст джерелаАнотація:
Early detection of dementia in Parkinson’s disease is becoming increasingly important. The goal of this study was to establish prevalence of mild cognitive impairment subtypes in Parkinson’s disease using two different modes of mild cognitive impairment classification. Categorizing patients into mild cognitive impairment subtypes according to the minimum mode of mild cognitive impairment classification revealed the following results: three patients (2.5 %) were categorized as cognitively healthy, whereas 117 patients (97.5 %) met the criteria for mild cognitive impairment. When categorizing patients according to the mean mode of mild cognitive impairment classification, 41.7 % of the patients were categorized as cognitively healthy, whereas 58.3 % met the criteria for mild cognitive impairment. Frequency of mild cognitive impairment varies substantially, depending on how impairment is defined.
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Valenza, Silvia, Lucia Paciaroni, Susy Paolini, Anna Rita Bonfigli, Mirko Di Rosa, Rosa Anna Rabini, Elena Tortato, Paolo Pelliccioni, and Giuseppe Pelliccioni. "Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects." Journal of Clinical Medicine 9, no. 7 (June 30, 2020): 2055. http://dx.doi.org/10.3390/jcm9072055.
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Background: Type 2 diabetes (T2D) is correlated to amnestic mild cognitive impairment (aMCI) and to non-amnestic mild cognitive impairment (naMCI). This study evaluated whether the T2D variable characterizes a peculiar cognitive profile in elderly patients. Moreover, it explores the association between glycated hemoglobin levels (HbA1c), T2D duration, insulin and oral hypoglycemic agent treatment, and cognition in elderly diabetic patients. Methods: Detailed neuropsychological battery was used to diagnose MCI subtypes. A total of 39 MCI subjects with T2D (T2D-MCI) and 37 MCI subjects without T2D (ND-MCI), matched for age, educational level, and Mini-Mental State Examination score, were included. Results: ND-MCI performed worse in memory and language domains than T2D-MCI. The amnestic subtype is more frequent among ND-MCI and non-amnestic subtype in T2D-MCI. In T2D-MCI, high HbA1c levels correlate with episodic memory (immediate recall) and T2D duration. Some indexes of episodic memory (immediate recall), attention, and visual-spatial ability correlate with insulin treatment. Conclusions: An association between T2D and non-amnestic MCI is suggested. In the T2D-MCI group, significant associations between insulin treatment and memory (immediate recall), complex figure copy, and attention were found.
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BANGEN, KATHERINE J., AMY J. JAK, DAWN M. SCHIEHSER, LISA DELANO-WOOD, ELIZABETH TUMINELLO, S. DUKE HAN, DEAN C. DELIS, and MARK W. BONDI. "Complex activities of daily living vary by mild cognitive impairment subtype." Journal of the International Neuropsychological Society 16, no. 4 (April 7, 2010): 630–39. http://dx.doi.org/10.1017/s1355617710000330.
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AbstractThere is increasing consensus regarding the importance of operationally defining and measuring functional decline in mild cognitive impairment (MCI). However, few studies have directly examined functional abilities in MCI or its presumed subtypes and, to date, reported findings have been discrepant. Nondemented older adults (n = 120) were administered a comprehensive cognitive battery measuring multiple domains as well as a performance-based functional ability measure. Participants were characterized as either cognitively normal, amnestic MCI, or non-amnestic MCI. MCI individuals demonstrated decrements in instrumental activities of daily living (IADL) relative to their cognitively normal counterparts. Specifically, participants with amnestic MCI demonstrated significant decrements in financial management, whereas those with non-amnestic MCI showed poorer performance in abilities related to health and safety. Moreover, decreased functional abilities were associated with decrements in global cognitive functioning but not memory or executive functions in the MCI participants. Finally, logistic regression demonstrated that functional abilities accurately predicted MCI subtype. Results support the need for better delineation of functional decline in MCI. Given the implications of functional status for MCI diagnosis and treatment, the direct assessment of functional abilities is recommended. Results further suggest performance-based IADL assessment may have utility in distinguishing MCI subtypes. (JINS, 2010, 16, 630–639.)
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Brazo, P., I. Halbecq, R. M. Marié, L. Segard, P. Delamillieure, F. Thibaut, S. Langlois-Théry, et al. "Cognitive impairments in subtypes of schizophrenia." European Psychiatry 13, S4 (1998): 174s. http://dx.doi.org/10.1016/s0924-9338(99)80155-2.
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Moynihan, Jayne E., and Richard N. Gevirtz. "Respiratory and Cognitive Subtypes of Panic." Behavior Modification 25, no. 4 (September 2001): 555–83. http://dx.doi.org/10.1177/0145445501254005.
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AUGUST, GERALD J., and BARRY D. GARFINKEL. "Behavioral and Cognitive Subtypes of ADHD." Journal of the American Academy of Child & Adolescent Psychiatry 28, no. 5 (September 1989): 739–48. http://dx.doi.org/10.1097/00004583-198909000-00016.
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Panza, Francesco. "Hypertension and Mild Cognitive Impairment Subtypes." Archives of Neurology 65, no. 7 (July 1, 2008): 992. http://dx.doi.org/10.1001/archneur.65.7.992-c.
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Levin, Edward D. "Nicotinic receptor subtypes and cognitive function." Journal of Neurobiology 53, no. 4 (November 15, 2002): 633–40. http://dx.doi.org/10.1002/neu.10151.
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McCarthy, G., O. Fitzpatrick, D. O’Neill, D. Meagher, and D. Adamis. "Evaluation of psychomotor/motor disturbances in elderly medical inpatients." European Psychiatry 33, S1 (March 2016): S150. http://dx.doi.org/10.1016/j.eurpsy.2016.01.270.
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IntroductionTraditionally psychomotor subtypes have been investigated in patients with delirium in different settings and it has been found that those with hypoactive type is the largest proportion, often missed and with the worst outcomes.Aims and objectivesWe examined the psychomotor subtypes in an older age inpatients population, the effects that observed clinical variables have on psychomotor subtypes and their association with one year mortality.MethodsProspective study. Participants were assessed using the scales CAM, APACHE II, MoCA, Barthel Index and DRS-R98. Pre-existing dementia was diagnosed according to DSM-IV criteria. Psychomotor subtypes were evaluated using the two relevant items of DRS-R98. Mortality rates were investigated one year after admission day.ResultsThe sample consisted of 200 participants [mean age 81.1 ± 6.5; 50% female; pre-existing cognitive impairment in 126 (63%)]. Thirty-four (17%) were identified with delirium (CAM+). Motor subtypes of the entire sample was: none: 119 (59.5%), hypo: 37 (18.5%), mixed: 15 (7.5%) and hyper: 29 (14.5%). Hypoactive and mixed subtype were significantly more frequent to delirious patients than to those without delirium, and none subtype more often to those without delirium. There was no difference in the hyperactive subtype between those with and without delirium. Hypoactive subtype was significant associated with delirium and lower scores in MoCA (cognition), while mixed was associated mainly with delirium. Predictors for one-year mortality were lower MoCA scores and severity of illness.ConclusionsPsychomotor disturbances are not unique to delirium. Hypoactivity, this “silent epidemic” is also part of a deteriorated cognition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Russo, M., T. E. Van Rheenen, M. Shanahan, K. Mahon, M. M. Perez-Rodriguez, A. Cuesta-Diaz, E. Larsen, A. K. Malhotra, and K. E. Burdick. "Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings." Psychological Medicine 47, no. 16 (June 7, 2017): 2892–905. http://dx.doi.org/10.1017/s003329171700143x.
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BackgroundOur previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters.MethodsCluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71).ResultsThree cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs.ConclusionsThis study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.
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Lumba-Brown, Angela, Masaru Teramoto, O. Josh Bloom, David Brody, James Chesnutt, James R. Clugston, Michael Collins, et al. "Concussion Guidelines Step 2: Evidence for Subtype Classification." Neurosurgery 86, no. 1 (August 21, 2019): 2–13. http://dx.doi.org/10.1093/neuros/nyz332.
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Abstract BACKGROUND Concussion is a heterogeneous mild traumatic brain injury (mTBI) characterized by a variety of symptoms, clinical presentations, and recovery trajectories. By thematically classifying the most common concussive clinical presentations into concussion subtypes (cognitive, ocular-motor, headache/migraine, vestibular, and anxiety/mood) and associated conditions (cervical strain and sleep disturbance), we derive useful definitions amenable to future targeted treatments. OBJECTIVE To use evidence-based methodology to characterize the 5 concussion subtypes and 2 associated conditions and report their prevalence in acute concussion patients as compared to baseline or controls within 3 d of injury. METHODS A multidisciplinary expert workgroup was established to define the most common concussion subtypes and their associated conditions and select clinical questions related to prevalence and recovery. A literature search was conducted from January 1, 1990 to November 1, 2017. Two experts abstracted study characteristics and results independently for each article selected for inclusion. A third expert adjudicated disagreements. Separate meta-analyses were conducted to do the following: 1) examine the prevalence of each subtype/associated condition in concussion patients using a proportion, 2) assess subtype/associated conditions in concussion compared to baseline/uninjured controls using a prevalence ratio, and 3) compare the differences in symptom scores between concussion subtypes and uninjured/baseline controls using a standardized mean difference (SMD). RESULTS The most prevalent concussion subtypes for pediatric and adult populations were headache/migraine (0.52; 95% CI = 0.37, 0.67) and cognitive (0.40; 95% CI = 0.25, 0.55), respectively. In pediatric patients, the prevalence of the vestibular subtype was also high (0.50; 95% CI = 0.40, 0.60). Adult patients were 4.4, 2.9, and 1.7 times more likely to demonstrate cognitive, vestibular, and anxiety/mood subtypes, respectively, as compared with their controls (P < .05). Children and adults with concussion showed significantly more cognitive symptoms than their respective controls (SMD = 0.66 and 0.24; P < .001). Furthermore, ocular-motor in adult patients (SMD = 0.72; P < .001) and vestibular symptoms in both pediatric and adult patients (SMD = 0.18 and 0.36; P < .05) were significantly worse in concussion patients than in controls. CONCLUSION Five concussion subtypes with varying prevalence within 3 d following injury are commonly seen clinically and identifiable upon systematic literature review. Sleep disturbance, a concussion-associated condition, is also common. There was insufficient information available for analysis of cervical strain. A comprehensive acute concussion assessment defines and characterizes the injury and, therefore, should incorporate evaluations of all 5 subtypes and associated conditions.
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Wenzel, Julian, Shalaila S. Haas, Dominic B. Dwyer, Anne Ruef, Oemer Faruk Oeztuerk, Linda A. Antonucci, Sebastian von Saldern, et al. "Cognitive subtypes in recent onset psychosis: distinct neurobiological fingerprints?" Neuropsychopharmacology 46, no. 8 (March 15, 2021): 1475–83. http://dx.doi.org/10.1038/s41386-021-00963-1.
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AbstractIn schizophrenia, neurocognitive subtypes can be distinguished based on cognitive performance and they are associated with neuroanatomical alterations. We investigated the existence of cognitive subtypes in shortly medicated recent onset psychosis patients, their underlying gray matter volume patterns and clinical characteristics. We used a K-means algorithm to cluster 108 psychosis patients from the multi-site EU PRONIA (Prognostic tools for early psychosis management) study based on cognitive performance and validated the solution independently (N = 53). Cognitive subgroups and healthy controls (HC; n = 195) were classified based on gray matter volume (GMV) using Support Vector Machine classification. A cognitively spared (N = 67) and impaired (N = 41) subgroup were revealed and partially independently validated (Nspared = 40, Nimpaired = 13). Impaired patients showed significantly increased negative symptomatology (pfdr = 0.003), reduced cognitive performance (pfdr < 0.001) and general functioning (pfdr < 0.035) in comparison to spared patients. Neurocognitive deficits of the impaired subgroup persist in both discovery and validation sample across several domains, including verbal memory and processing speed. A GMV pattern (balanced accuracy = 60.1%, p = 0.01) separating impaired patients from HC revealed increases and decreases across several fronto-temporal-parietal brain areas, including basal ganglia and cerebellum. Cognitive and functional disturbances alongside brain morphological changes in the impaired subgroup are consistent with a neurodevelopmental origin of psychosis. Our findings emphasize the relevance of tailored intervention early in the course of psychosis for patients suffering from the likely stronger neurodevelopmental character of the disease.
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Rusz, Jan, Tereza Tykalova, Michal Novotny, David Zogala, Karel Sonka, Evzen Ruzicka, and Petr Dusek. "Defining Speech Subtypes in De Novo Parkinson Disease." Neurology 97, no. 21 (October 4, 2021): e2124-e2135. http://dx.doi.org/10.1212/wnl.0000000000012878.
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Background and ObjectivesPatterns of speech disorder in Parkinson disease (PD), which are highly variable across individual patients, have not been systematically studied. Our aim was to identify speech subtypes in treatment-naive patients with PD and to examine their response to long-term dopaminergic therapy.MethodsWe recorded speech data from a total of 111 participants with de novo PD; 83 of the participants completed the 12-month follow-up (69 patients with PD on stable dopaminergic medication and 14 untreated controls with PD). Unsupervised k-means cluster analysis was performed on 8 distinctive parameters of hypokinetic dysarthria examined with quantitative acoustic analysis.ResultsThree distinct speech subtypes with similar prevalence, symptom duration, and motor severity were detected: prosodic, phonatory-prosodic, and articulatory-prosodic. Besides monopitch and monoloudness, which were common in each subtype, speech impairment was more severe in the phonatory-prosodic subtype with predominant dysphonia and the articulatory-prosodic subtype with predominant imprecise consonant articulation than in the prosodic subtype. Clinically, the prosodic subtype was characterized by a prevalence of women and younger age, while articulatory-prosodic subtype was characterized by the prevalence of men, older age, greater severity of axial gait symptoms, and poorer cognitive performance. The phonatory-prosodic subtype clinically represented intermediate status in age with mostly men and preserved cognitive performance. While speech of untreated controls with PD deteriorated over 1 year (p = 0.02), long-term dopaminergic medication maintained stable speech impairment severity in the prosodic and articulatory-prosodic subtypes and improved speech performance in patients with the phonatory-prosodic subtype (p = 0.002).DiscussionDistinct speech phenotypes in de novo PD reflect divergent underlying mechanisms and allow prediction of response of speech impairment to levodopa therapy.Classification of EvidenceThis study provides Class II evidence that, in patients with newly diagnosed PD with speech impairment, speech phenotype is associated with levodopa responsiveness.
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BARBAREE, HOWARD E., MICHAEL C. SETO, RALPH C. SERIN, NANCY L. AMOS, and DENISE L. PRESTON. "Comparisons Between Sexual and Nonsexual Rapist Subtypes." Criminal Justice and Behavior 21, no. 1 (March 1994): 95–114. http://dx.doi.org/10.1177/0093854894021001007.
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Sixty incarcerated rapists were subtyped according to the Massachusetts Treatment Center Rapist Typology as either “nonsexual” (i.e., the opportunistic and vindictive subtypes) or “sexual” (i.e., the nonsadistic and sadistic subtypes). Subjects were then tested using the circumferential penile plethysmograph, assessing their erectile responses to verbal descriptions of consenting sex and rape. Additionally, the Psychopathy Checklist-Revised was scored for each subject, and institutional files were summarized and coded. The index offenses committed by the nonsexual subtypes were more violent and resulted in greater victim damage; the offenses of the men in the nonsexual subtypes were more likely to be impulsive; the men in the sexual subtypes were more socially isolated at the time of the offense. Relative sexual arousal to rape descriptions was greater among the sexual subtypes than among the nonsexual subtypes. These results are discussed in terms of two separate cognitive-behavioral processes leading to rape.
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Edmonds, Emily C., Alexandra J. Weigand, Kelsey R. Thomas, Joel Eppig, Lisa Delano-Wood, Douglas R. Galasko, David P. Salmon, and Mark W. Bondi. "Increasing Inaccuracy of Self-Reported Subjective Cognitive Complaints Over 24 Months in Empirically Derived Subtypes of Mild Cognitive Impairment." Journal of the International Neuropsychological Society 24, no. 8 (September 2018): 842–53. http://dx.doi.org/10.1017/s1355617718000486.
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AbstractObjectives: Although subjective cognitive complaints (SCC) are an integral component of the diagnostic criteria for mild cognitive impairment (MCI), previous findings indicate they may not accurately reflect cognitive ability. Within the Alzheimer’s Disease Neuroimaging Initiative, we investigated longitudinal change in the discrepancy between self- and informant-reported SCC across empirically derived subtypes of MCI and normal control (NC) participants. Methods: Data were obtained for 353 MCI participants and 122 “robust” NC participants. Participants were classified into three subtypes at baseline via cluster analysis: amnestic MCI, mixed MCI, and cluster-derived normal (CDN), a presumptive false-positive group who performed within normal limits on neuropsychological testing. SCC at baseline and two annual follow-up visits were assessed via the Everyday Cognition Questionnaire (ECog), and discrepancy scores between self- and informant-report were calculated. Analysis of change was conducted using analysis of covariance. Results: The amnestic and mixed MCI subtypes demonstrated increasing ECog discrepancy scores over time. This was driven by an increase in informant-reported SCC, which corresponded to participants’ objective cognitive decline, despite stable self-reported SCC. Increasing unawareness was associated with cerebrospinal fluid Alzheimer’s disease biomarker positivity and progression to Alzheimer’s disease. In contrast, CDN and NC groups over-reported cognitive difficulty and demonstrated normal cognition at all time points. Conclusions: MCI participants’ discrepancy scores indicate progressive underappreciation of their evolving cognitive deficits. Consistent over-reporting in the CDN and NC groups despite normal objective cognition suggests that self-reported SCC do not predict impending cognitive decline. Results demonstrate that self-reported SCC become increasingly misleading as objective cognitive impairment becomes more pronounced. (JINS, 2018, 24, 842–853)
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Aerts, Liesbeth, Megan Heffernan, Nicole A. Kochan, John D. Crawford, Brian Draper, Julian N. Trollor, Perminder S. Sachdev, and Henry Brodaty. "Effects of MCI subtype and reversion on progression to dementia in a community sample." Neurology 88, no. 23 (May 10, 2017): 2225–32. http://dx.doi.org/10.1212/wnl.0000000000004015.
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Objective:We sought to understand the trajectory of mild cognitive impairment (MCI) better by examining longitudinally different MCI subtypes and progression to dementia and reversion to normal cognition in a community sample.Methods:We evaluated the stability of MCI subtypes and risk of dementia over 4 biennial assessments as part of an ongoing prospective cohort study, the Sydney Memory and Ageing Study.Results:While prevalence of MCI and different MCI subtypes remains relatively stable across all assessments, reversion from MCI and transitions between different MCI subtypes were common. Up to 46.5% of participants classified with MCI at baseline reverted at some point during follow-up. The majority (83.8%) of participants with incident dementia were diagnosed with MCI 2 years prior to their dementia diagnosis. Both reverters and participants with stable MCI were at an increased risk of progression to dementia compared to those without MCI at baseline (HR 6.4, p = 0.02, and HR 24.7, p < 0.001, respectively); however, the risk of dementia in participants with MCI who did not revert was higher than in reverters (HR 2.5, p = 0.01). This effect was specific to amnestic subtypes (MCI reverters vs nonreverters: amnestic MCI HR 3.3, p = 0.006; nonamnestic MCI: HR 1.3, p = 0.67).Conclusion:Our findings indicate that the relevance of reversion for progression risk depends on the MCI subtype. Subtype specificity and longitudinal characterization are required for the reliable identification of individuals at high risk of developing dementia.
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Petridou, Evangelia. "Cognitive frailty: a brief review." Journal of Research and Practice on the Musculoskeletal System 4, no. 4 (December 1, 2020): 113–24. http://dx.doi.org/10.22540/jrpms-04-113.
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Frailty syndrome and cognitive decline, conditions linked with aging, jeopardize health status and promote an individual’s dependence on daily living activities. Various models include cognition in the assessment of frailty, but recently a new term has been proposed, called “Cognitive Frailty’’, originally presented as a probable outcome of frailty, but later it has been proposed to be an early sign of the syndrome. Cognitive frailty encompasses both the physical and the cognitive domain, explored as a unique entity, and includes two subtypes, the reversible and the potentially reversible cognitive frailty. Most studies examine cognition as another domain of frailty, using different methods for the assessment of both frailty and the status of cognition. In the present article, various definitions of the frailty syndrome and cognitive frailty as well as screening tools are reviewed. The link between cognitive impairment and frailty, and the common pathophysiological mechanisms such as neuropathological, vascular and metabolic factors, inflammation, hormones and nutrition are explored. Finally, this review presents the effects of multi-domain and single domain interventions, conducted in physical and/or cognitively frail populations that may be applied to the prevention and management of cognitive frailty.
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Liu, S., and Z. Li. "Identification of subtypes of Chinese schizophrenia patients before discharge: A cluster analysis." European Psychiatry 33, S1 (March 2016): s257. http://dx.doi.org/10.1016/j.eurpsy.2016.01.653.
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IntroductionPeople with schizophrenia is a highly heterogeneous group. Identifying subtypes of people with schizophrenia before discharge may help develop targeted discharge plans.ObjectivesTo explore possible subtypes among people with schizophrenia before discharge by their self-management ability, self-efficacy and cognitive function status.AimsTo identify possible subtypes among people with schizophrenia before discharge.MethodsTotally, 150 Chinese people with schizophrenia before discharged from a tertiary psychiatric hospital in Beijing were assessed by Self-management Instrument for People with Schizophrenia and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Cluster analysis using SPSS 20.0 package was performed to categorize subjects based on their scores.ResultsFour different types of subjects were revealed. Type I low cognition with no participation (n = 25), patients’ self-management ability, self-efficacy and cognitive function were very poor; type II medium cognition with blind confidence (n = 42), patients’ self-efficacy was good, while self-management ability was poor and cognitive function is medium; type III high cognition with high level skill (n = 46), patients’ cognitive function, self-management ability and self-efficacy were good; type IV low cognition with medium level skill (n = 37), patients’ cognition was very poor, while self-management ability and self-efficacy were medium. These four types of subjects had significant differences in long-term use of antipsychotics and primary caregivers’ education level (P < 0.05).ConclusionsThe finding of different subtypes of people with schizophrenia presenting in this sample may help health professionals give effective screening and targeted discharge measures which can further promote patients’ recovery and reduce readmission rates.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kristina Dziallas and Martin Borkovec. "Breaking down gender subtype perception." Technium Social Sciences Journal 10 (July 13, 2020): 579–610. http://dx.doi.org/10.47577/tssj.v10i1.1206.
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Gender stereotype research has identified many female and male subtypes, e.g. housewife, career woman, macho man, and wimp. Regarding their perception, several dimensions, such as Warmth, Competence, Traditionality, and Age, have been found to be meaningful in people’s cognitive organization of them. The present paper analyses gender subtype perception results obtained in an online questionnaire among English and Spanish participants who rated ten female and ten male subtypes on 15 scales. The subtypes were produced by the participants themselves in a prior study. The results are backed up by interview quotes of the same participants. Many of the findings conform to those of prior studies, e.g. the clear separation of female and male subtype clusters, while others are novel or contrary to previous research. Thus, the English male subtype mate is perceived both very masculine and feminine and the Spanish promiscuous female subtype guarra is seen as inherently different from the English equivalents.
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Baskin-Sommers, Arielle R., John J. Curtin, and Joseph P. Newman. "Altering the Cognitive-Affective Dysfunctions of Psychopathic and Externalizing Offender Subtypes With Cognitive Remediation." Clinical Psychological Science 3, no. 1 (January 2015): 45–57. http://dx.doi.org/10.1177/2167702614560744.
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Cognitive remediation is a treatment approach with the potential to translate basic science into more specific, mechanism-based interventions by targeting particular cognitive skills. The present study translated understanding of two well-defined cognitive-affective dysfunctions into novel deficit-matched interventions and evaluated whether cognitive remediation would demonstrate specific and generalizable change. Two antisocial subtypes, individuals with psychopathy and externalizing traits, are characterized by cognitive-affective problems that predispose them to engage in significant substance abuse and criminal behavior, culminating in incarceration. Whereas individuals with psychopathy fail to consider important contextual information, individuals with externalizing traits lack the capacity to regulate affective reactions. Training designed to remedy these subtype-specific deficits led to improvement on both trained and nontrained tasks. Such findings offer promise for changing neural and behavioral patterns, even for what many consider to be the most recalcitrant treatment population, and presage a new era of translating cognitive-affective science into increasingly specific and effective interventions.
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Wolk, David A., Julie C. Price, Judy A. Saxton, Beth E. Snitz, Jeffrey A. James, Oscar L. Lopez, Howard J. Aizenstein, et al. "Amyloid imaging in mild cognitive impairment subtypes." Annals of Neurology 65, no. 5 (May 2009): 557–68. http://dx.doi.org/10.1002/ana.21598.
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Westervelt, Holly James, Jared M. Bruce, William G. Coon, and Geoffrey Tremont. "Odor identification in mild cognitive impairment subtypes." Journal of Clinical and Experimental Neuropsychology 30, no. 2 (January 22, 2008): 151–56. http://dx.doi.org/10.1080/13803390701287408.
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Visser, Pieter Jelle. "MILD COGNITIVE IMPAIRMENT SUBTYPES AND VASCULAR DEMENTIA." Journal of the American Geriatrics Society 54, no. 12 (December 2006): 1966–67. http://dx.doi.org/10.1111/j.1532-5415.2006.00976.x.
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Montero-Odasso, Manuel, and Susan W. Muir. "SIMPLIFYING DETECTION OF MILD COGNITIVE IMPAIRMENT SUBTYPES." Journal of the American Geriatrics Society 58, no. 5 (May 2010): 992–94. http://dx.doi.org/10.1111/j.1532-5415.2010.02823.x.
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Davidson, M. "Deteriorating/no deteriorating cognitive subtypes within schizophrenia." European Psychiatry 23 (April 2008): S50. http://dx.doi.org/10.1016/j.eurpsy.2008.01.183.
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Silberman, Edward K., Herbert Weingartner, Steven D. Targum, and Selma Byrnes. "Cognitive functioning in biological subtypes of depression." Biological Psychiatry 20, no. 6 (June 1985): 654–61. http://dx.doi.org/10.1016/0006-3223(85)90100-3.
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Kwon, Oh Dae. "Subtypes and Treatment of Mild Cognitive Impairment." Korean Journal of Clinical Geriatrics 22, no. 2 (December 30, 2021): 61–66. http://dx.doi.org/10.15656/kjcg.2021.22.2.61.
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Jordan, Jennifer, Marie Crowe, Deborah Gillon, Cate McCall, Christopher Frampton, and Hamish Jamieson. "Reduced Pain Reports With Increasing Cognitive Impairment in Older Persons in New Zealand." American Journal of Alzheimer's Disease & Other Dementiasr 33, no. 7 (May 1, 2018): 463–70. http://dx.doi.org/10.1177/1533317518772685.
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Background: Conflicting findings prevail about pain in older persons with cognitive impairment. There is evidence of changed pain perception; however, pain is also underrecognized. Pain and cognitive impairment were examined in a national cohort of older persons assessed using the Home Care International Residential Assessment Instrument (interRAI-HC). Methods: Participants were 41 459 aged 65+ years receiving a mandated needs assessment to access publicly funded services. InterRAI-HC pain severity and Cognitive Performance Scale analyses covaried for age, gender, and ethnicity. Results: Milder pain prevalence increased with age, whereas daily severe-excruciating pain prevalence decreased with age. Daily severe-excruciating pain was reported by 18% of cognitively intact individuals decreasing to 8% in the severe cognitive impairment group. This relationship remained after covarying for age, sex, and ethnicity. Differences among dementia subtypes were found. Conclusion: Although severe pain reports decrease with increasing age and cognitive impairment, more nuanced research covarying for dementia severity and subtype is required.
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Eliassen, Carl F., Ivar Reinvang, Per Selnes, Ramune Grambaite, Tormod Fladby, and Erik Hessen. "Biomarkers in subtypes of mild cognitive impairment and subjective cognitive decline." Brain and Behavior 7, no. 9 (July 28, 2017): e00776. http://dx.doi.org/10.1002/brb3.776.
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Jacobson, Mark W., Linda McEvoy, and Christine Fennema-Notestine. "P1-192: Frequency of cognitive discrepancies in mild cognitive impairment subtypes." Alzheimer's & Dementia 4 (July 2008): T265. http://dx.doi.org/10.1016/j.jalz.2008.05.780.
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Collins, Kathleen, Brittany Rohl, Sarah Morgan, Edward D. Huey, Elan D. Louis, and Stephanie Cosentino. "Mild Cognitive Impairment Subtypes in a Cohort of Elderly Essential Tremor Cases." Journal of the International Neuropsychological Society 23, no. 5 (April 3, 2017): 390–99. http://dx.doi.org/10.1017/s1355617717000170.
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AbstractObjectivesIndividuals with essential tremor (ET) exhibit a range of cognitive deficits generally conceptualized as “dysexecutive” or “fronto-subcortical,” and thought to reflect disrupted cortico-cerebellar networks. In light of emerging evidence that ET increases risk for Alzheimer’s disease (AD), it is critical to more closely examine the nature of specific cognitive deficits in ET, with particular attention to amnestic deficits that may signal early AD.MethodsWe performed a cross-sectional analysis of baseline data from 128 ET cases (age 80.4±9.5 years) enrolled in a longitudinal, clinical-pathological study. Cases underwent a comprehensive battery of motor-free neuropsychological tests and a functional assessment to inform clinical diagnoses of normal cognition (ET-NC), mild cognitive impairment (MCI) (ET-MCI), or dementia (ET-D). ET-MCI was subdivided into subtypes including: amnestic single-domain (a-MCI), amnestic multi-domain (a-MCI+), non-amnestic single-domain (na-MCI), or non-amnestic multi-domain (na-MCI+).ResultsNinety-one (71.1%) cases were ET-NC, 24 (18.8%) were ET-MCI, and 13 (10.2%) were ET-D. Within MCI, the a-MCI+ subtype was the most common (13/24; 54.2%) followed by a-MCI (4/24; 16.7%), na-MCI+ (4/24; 16.7%), and na-MCI (3/24; 12.5%). Cases with amnestic MCI demonstrated lower recognition memoryZ-scores (−2.4±1.7) than non-amnestic groups (−0.9±1.2) (p=.042).ConclusionsAmnestic MCI, defined by impaired memory recall but associated with lower memory storage scores, was the most frequent MCI subtype in our study. Such impairment has not been explicitly discussed in the context of ET and may be an early hallmark of AD. Results have implications for the prognosis of specific cognitive deficits in ET. (JINS, 2017,23, 390–399)
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Yarnall, Alison Jane, Lynn Rochester, and David John Burn. "Mild cognitive impairment in Parkinson's disease." Age and Ageing 42, no. 5 (July 17, 2013): 567–76. http://dx.doi.org/10.1093/ageing/aft085.
Повний текст джерелаАнотація:
Abstract The concept of mild cognitive impairment (MCI) in the general population has received increased attention over recent years, and is associated with risk of progression to Alzheimer's disease. Within Parkinson's disease (PD), MCI (PD-MCI) is also now recognised to be relatively common, with certain subtypes predicting progression to Parkinson's disease dementia (PDD). Recently, criteria to better characterise PD-MCI and its subtypes have been produced by the Movement Disorder Society. In contrast to the population as a whole, where amnestic MCI is the most common subtype, non-amnestic PD-MCI dominates, with prominent executive and attention dysfunction. Although the pathophysiology of PD-MCI is poorly understood and encompasses both PD and non-PD pathology, it is most likely the result of a complex interaction between neurotransmitter dysfunction, synaptic pathology, protein aggregation and neuronal damage. Determining the factors that influence the progression of these pathologies in PD and the individuals at risk of ultimately developing PDD is critical for targeted intervention and drug discovery studies. Further work is required, however, to determine the significance of PD-MCI and also to validate the diagnostic criteria. This would be best delivered in the form of longitudinal studies in homogenous cohorts of PD participants, to allow prognostication and generalisation among the PD population. At the present time, no drug therapies are available for PD-MCI. Management includes screening for the disorder, excluding treatable causes of cognitive decline and cautious use of dopamine agonists and medications such as anticholinergics.
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Leahy, Christopher, Matthew Jones, Jennifer Thompson, and Christopher Kobylecki. "Evaluation of MDS-PSP diagnostic criteria in a combined behavioural neurology and atypical parkinsonism service." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 9 (August 12, 2022): e2.230. http://dx.doi.org/10.1136/jnnp-2022-abn2.8.
Повний текст джерелаАнотація:
BackgroundRecent diagnostic criteria for progressive supranuclear palsy (PSP) by the Movement Disorder Society (MDS) operationalise recently recognised subtypes, beyond the ‘classical’ Richardson phenotype (PSP-RS): predominant parkinsonism (PSP-P), predominant gait freezing (PSP-PGF), and frontal-cognitive- behavioural presentations (PSP-F).AimsTo evaluate the proportion of patients fulfilling MDS compared with previous NINDS-SPSP criteria; to establish the number of patients fulfilling operationalised subtypes criteria; and to explore the evolution of PSP subtypes.MethodsA retrospective case note review study of 201 patients clinically diagnosed with PSP in a combined behavioural neurology and movement disorders service over a 10-year period.ResultsOf 201 patients at first presentation, 187 met MDS-PSP criteria (157 probable, 8 possible, 22 sug- gestive) compared with 152 for NINDS-SPSP criteria. The number of probable PSP patients fulfilling opera- tionalised subtype criteria were: 125 PSP-RS, 111 PSP-P, 5 PSP-PGF, and 37 PSP-F. Notably, 100 patients met criteria for more than one subtype.ConclusionMDS criteria allowed earlier PSP diagnosis than NINDS-SPSP criteria and captured a range of phenotypic subtypes. Further analysis will address the issue of determining subtype predominance and will explore the natural history of PSP phenotypes, with particular reference to frontal-cognitive- behavioural presentations.
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Lonie, Jane A., Lucie L. Herrmann, Claire L. Donaghey, and Klaus P. Ebmeier. "Clinical referral patterns and cognitive profile in mild cognitive impairment." British Journal of Psychiatry 192, no. 1 (January 2008): 59–64. http://dx.doi.org/10.1192/bjp.bp.107.035642.
Повний текст джерелаАнотація:
BackgroundThere is current interest in exploring the different subtypes of mild cognitive impairment (MCI), in terms of both their epidemiology and their cognitive profile.AimsTo examine the frequency of MCI subtypes presenting to a memory clinic and to document detailed neuropsychological profiles of patients with the amnestic subtype.MethodConsecutive tertiary referrals (n = 187) were psychiatrically evaluated; 45 patients met criteria for amnestic mild cognitive impairment (aMCI). A subgroup of 33 patients with aMCI as well as 21 healthy controls took part in a thorough neuropsychological examination.ResultsOf the patients who were examined in greater neuropsychological detail, ten had pure aMCI (none with visual memory impairment only). Fifteen met criteria for non-amnestic MCI. Fifteen had normal neuropsychological profiles. Using more than one test increased sensitivity to detect episodic memory impairment.ConclusionsAmnestic MCI is an important diagnosis in secondary and tertiary memory clinics. There is scope to improve the efficacy and sensitivity of the clinical assessment of this impairment.