scholarly journals Management of Neuropsychiatric Symptoms in Neurocognitive Disorders

2017 ◽  
Vol 15 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Benalfew Legesse ◽  
Baktash Babadi ◽  
Brent Forester
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Neurocognitive Disorders

scholarly journals Neuropsychiatric Symptoms in Mild Cognitive Impairment

2017 ◽  
Vol 62 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Damien Gallagher ◽  
Corinne E. Fischer ◽  
Andrea Iaboni
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Later Life ◽  
Neurocognitive Disorders ◽  
Prognostic Indicators ◽  
Neurocognitive Disorder ◽  
Clinical Stages ◽  
Before And After

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.

scholarly journals Investigating the clinical utility of biomarkers and other novel tests in younger onset neurocognitive disorders: the BeYOND study, protocol for a longitudinal clinical study in a real-world setting.

2021 ◽  
Author(s):  
Samantha M Loi ◽  
Dhamidhu Eratne ◽  
Claire Cadwallader ◽  
Parsa M Ravanfar ◽  
Carolyn Chadunow ◽  
...  
Keyword(s):  
Mental Health ◽  
Real World ◽  
Clinical Utility ◽  
Age Of Onset ◽  
Neuropsychiatric Symptoms ◽  
Diagnostic Delay ◽  
Well Being ◽  
Neurocognitive Disorders ◽  
Csf Biomarkers ◽  
Novel Biomarkers

Background: Younger-onset dementia (YOD) can be challenging to diagnose due to its younger age of onset, heterogeneous aetiologies and broad range of presentations. Misdiagnosis is common with psychiatric conditions often diagnosed initially and diagnostic delay of five years is common. More information is needed to better understand and diagnose YOD, including the nature of symptom onset, progression of the disease, the relationship between cognition and functional outcomes for patients and carers, imaging changes and novel biomarkers. This paper reports on the background behind the Investigating the clinical utility of biomarkers and other novel tests in younger-onset neurocognitive disorders, the BeYOND study, and its methodology. Methods: BeYOND is a clinically-oriented real-world longitudinal study that follows younger people presenting with an onset of neuropsychiatric symptoms at 65 years or less. We aim to collect information on participants' cognition, neuroimaging, mental health, and blood and cerebrospinal fluid (CSF) biomarkers at 18-month time-points over 3 years. We also aim to collect information regarding the experience of carers and/or family of participants. Conclusion: Serial assessment of symptomatology, cognition, imaging, and blood and CSF biomarkers will be correlated with eventual diagnosis to determine the usefulness of these measures in determining a confident diagnosis. In addition, repeat measurements of the mental health and well-being of the participant and that of their carers/family while they traverse their diagnostic journey will provide important information about service provision and how they can be better supported.

Specific Cognitive–Psychopathological Phenotypes in Patients With Early Stages of Subcortical Vascular Neurocognitive Disorders: A Hospital-Based Case–Control Study

2018 ◽  
Vol 31 (5) ◽  
pp. 256-264 ◽  
Author(s):  
Oleg A. Levada ◽  
Alexandra S. Troyan ◽  
Nataliya V. Cherednichenko
Keyword(s):  
Case Control Study ◽  
Early Stage ◽  
Neuropsychiatric Symptoms ◽  
Executive Dysfunction ◽  
Nonparametric Tests ◽  
Neurocognitive Disorders ◽  
Neuropsychiatric Inventory ◽  
Cognitively Normal ◽  
Additional Information ◽  
Control Study

Background: Diagnosis of subcortical vascular neurocognitive disorders’ (ScVNCDs) is currently based on neuropsychological and neuroimaging approaches; nevertheless, clinical features, apart from cognitive impairments (CI), may provide additional information about ScVNCD phenotypes. We aimed to determine whether CI and neuropsychiatric symptoms (NPS) form such clinical phenotypes in the mild and early stage of major ScVNCD. Methods: Our sample included 88 cognitively normal elderly individuals, 100 patients with mild ScVNCD, and 60 patients with early major ScVNCD. All participants had neuropsychological, neuropsychiatric, neurological, and functional evaluations. The prevalence of NPS was based on the neuropsychiatric inventory. The statistical analyses included parametric and nonparametric tests and multivariate regression. Results: The severity of executive dysfunction increased through stages of ScVNCD progression ( P < .0001). The NPS with significant predictive value for mild ScVNCD membership was depression (odds ratio [OR] = 7.4), whereas for early major ScVNCD were depression (OR = 5.5) and apathy (OR = 7.6). Those distinguishing NPS and impairments of executive tests’ performance significantly correlated ( P < .05) in patients with mild/major ScVNCD. Conclusion: Significant correlation between pathognomonic cognitive and NPS in compared groups suggest that dysexecutive-depressive syndrome can be the main phenotype in mild ScVNCD, while dysexecutive-depressive-apathetic syndrome in the early stage of major ScVNCD. Obtained cognitive–psychopathological phenotypes may allow a better comprehension of the ScVNCD pathophysiology and improve the diagnostic and therapeutic approach.

Behavioral Symptoms as Predictor Factor of Disease Progression Across Different Neurocognitive Disorders. A Longitudinal Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S665-S665
Author(s):  
H. Santamaría García ◽  
J.M. Santacruz Escudero ◽  
D. Matallana ◽  
A. Ibañez
Keyword(s):  
Disease Progression ◽  
Neuropsychiatric Symptoms ◽  
Neurocognitive Disorders ◽  
Functional Dependency ◽  
Behavioral Symptoms ◽  
Future Research ◽  
Functional Impairments ◽  
Alzheimer Dementia ◽  
T1 And T2 ◽  
Predict Disease Progression

BackgroundPrevious works highlight the importance of neurocognitive symptoms over cognitive and functional dependency in neurocognitive disorders. However, little is known regarding to what extent presence of neuropsychiatric symptoms predicts disease progression, cognitive and functional impairments in behavioral variant frontotemporal dementia (bvFTD) and in Alzheimer dementia.MethodsWe performed two different evaluations (T1 and T2) with 3 years of difference in a group of bvFTD (n = 18), AD (n = 20) and controls (n = 22). Neuropsychological, clinical and cognitive correlates were measured in each time T1 and T2. By using different multiple regression models, we explored if behavioral symptoms (measured by Columbia, Yesavage at T1) predict disease progression as measured by changes over T1 and T2 in cognitive (MoCA, IFS, and clock figure) and functional dependency (Lawton).ResultsBehavioral symptoms, in particular depression, psychosis, apathy and disihinibition were factors able to predict cognitive and functional progression in bvFTD. By contrast, regression model revealed that depression and insomnia were behavioral factors able to predict progression in AD.ConclusionNeuropsychiatric symptoms are crucial to predict disease progression in bvFTD and AD patients in differentiated ways. Our results suggest tha tracking early behavioral symptoms in neurocognitive disorders playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neurocognitive disorders and language: The impact of cognitive decline and neuropsychiatric symptoms on the language performance

2019 ◽  
Vol 29 ◽  
pp. S453-S454
Author(s):  
M. Králová ◽  
Ľ. Izáková ◽  
B. Mészáros Hideghéty ◽  
M. Hajdúk ◽  
J. Marková ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Neurocognitive Disorders ◽  
Language Performance ◽  
The Impact

scholarly journals Correlations between facial expressivity and apathy in elderly people with Neurocognitive Disorders (Preprint)

2020 ◽  
Author(s):  
Radia Zeghari ◽  
Alexandra König ◽  
Rachid Guerchouche ◽  
Garima Sharma ◽  
Jyoti Joshi ◽  
...  
Keyword(s):  
Computer Vision ◽  
Neuropsychiatric Symptoms ◽  
Neurocognitive Disorders ◽  
Elderly Subjects ◽  
Average Intensity ◽  
Clinical Scales ◽  
Facial Movements ◽  
Partial Correlations ◽  
Tablet Device ◽  
Facial Expressivity

BACKGROUND Neurocognitive disorders are often accompanied by behavioral symptoms such as anxiety, depression, and/or apathy. These symptoms can occur very early in the disease progression, and are often difficult to detect and quantify in non-specialized clinical settings. We focus in this study on apathy, one of the most common and debilitating neuropsychiatric symptoms in neurocognitive disorders. Specifically, we investigated whether facial expressivity extracted trough computer vision software correlates with the severity of apathy symptoms in elderly subjects with neurocognitive disorders. OBJECTIVE Specifically, we investigated whether facial expressivity extracted trough computer vision software correlates with the severity of apathy symptoms in elderly subjects with neurocognitive disorders. METHODS 63 subjects (38 females and 25 males) with neurocognitive disorder participated in the study. Apathy was assessed using the Apathy Inventory (AI), a scale which comprises three domains of apathy: loss of interest, loss of initiation and emotional blunting. The higher the scales score, the more severe the apathy symptoms. Participants were asked to recall a positive and a negative event of their life, while their voice and face were recorded through a tablet device. Action Units (AU), which are basic facial movements, were extracted using OpenFace 2.0. 17 AUs (intensity and presence) for each frame of the video were extracted in both positive and negative storytelling. Average intensity and frequency of AU activation were calculated for each participant in each video. Partial correlations (controlling for the level of depression and cognitive impairment) were performed between these indexes and AI subscales. RESULTS Results showed that AU intensity and frequency were negatively correlated with apathy scales scores, in particular with the emotional blunting component. The more severe the apathy symptoms, the less expressivity was displayed from participants while recalling an emotional event in specific emotional and non-emotional AUs. Different AUs showed significant correlations depending on gender of the participant and the task (positive vs negative story), suggesting the importance to assess independently male and female participants. CONCLUSIONS Our study suggest the interest of employing computer vision based facial analysis to quantify facial expressivity and assess the severity of apathy symptoms in subjects with Neurocognitive Disorders. This may thus represent a useful tool for a preliminary apathy assessment in non-specialized settings, and could be used to complement classical clinical scales. Future studies including larger samples should confirm the clinical relevance of this kind on instrument. CLINICALTRIAL N/A

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