Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with de novo Parkinson's disease.


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
01 2019
Historique:
received: 10 01 2018
accepted: 02 08 2018
pubmed: 10 8 2018
medline: 4 6 2019
entrez: 10 8 2018
Statut: ppublish

Résumé

The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in the initial phase. Whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD was addressed. Neuropsychological tests of 40 iNPH subjects with early symptoms resembling parkinsonism were retrospectively evaluated together with 47 de novoPD patients (dnPD). Only neuropsychological tests performed within 1 year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD was also compared with a sample of 70 normal controls. A clear difference in the cognitive profile of iNPH, dnPD patients and normal controls was shown. 65% of iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only 25.5% of the dnPD patients presented an executive dysfunction. 35% of iNPH and 74.5% of PD patients performed within the normal range (P < 0.05). Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism.

Sections du résumé

BACKGROUND AND PURPOSE
The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in the initial phase. Whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD was addressed.
METHODS
Neuropsychological tests of 40 iNPH subjects with early symptoms resembling parkinsonism were retrospectively evaluated together with 47 de novoPD patients (dnPD). Only neuropsychological tests performed within 1 year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD was also compared with a sample of 70 normal controls.
RESULTS
A clear difference in the cognitive profile of iNPH, dnPD patients and normal controls was shown. 65% of iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only 25.5% of the dnPD patients presented an executive dysfunction. 35% of iNPH and 74.5% of PD patients performed within the normal range (P < 0.05).
CONCLUSION
Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism.

Identifiants

pubmed: 30091839
doi: 10.1111/ene.13766
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

74-79

Informations de copyright

© 2018 EAN.

Auteurs

M Picascia (M)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

N G Pozzi (NG)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

M Todisco (M)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

B Minafra (B)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

E Sinforiani (E)

Alzheimer's Disease Assessment Unit/Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy.

R Zangaglia (R)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

R Ceravolo (R)

Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

C Pacchetti (C)

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.

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