Effect of Deep Brain Stimulation on Parkinson’s Disease Dementia: A Systematic Review and Meta-Analysis

Patients in the early stages of Parkinson’s disease(PD) may have subtle cognitive deficits, while overt cognitive deficits are usually manifestations of late-stage PD. There is still a debate on the outcome of deep brain stimulation (DBS) on cognitive function of PD patients. This study aimed to investigate the effect of subthalamic nucleus(STN)-DBS on dementia of PD patients after surgery as compared to medical therapy and other procedures. We searched PubMed, Scopus, Cochrane library and Web of Science database in 22th October 2020. The words Deep Brain stimulation, Parkinson’s disease, dementia, and memory have been searched. Reviews, abstracts, case presentations and letters were excluded. Totally, 490 studies were screened after removing the duplicates. The screening results yielded 81 articles to be screened for eligibility. Finally, 6 studies were included in this meta-analysis for synthesis. Overall, 800 patients were included in this meta-analysis, using Mattis dementia rating scale (MDRS) along with descriptive data of the articles was extracted for assessment of global dementia. Our results indicated that STN-DBS group showed a larger cognitive decline than the best medical treatment(BMT). DBS diminished the score of Mattis dementia rating scale in PD patients more than BMT. The effect of STN-DBS vs. other procedures on dementia was not significant; our results showed that STN stimulation made no significant change in global dementia of PD patients in midterm compared to GPi, Pallidal stimulation and pallidotomy.

Performance of Mattis dementia rating scale-Chinese version in patients with mild cognitive impairment and Alzheimer’s disease

Background To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV). Methods The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale. Results The scores of DRS-CV were ranked in the order of NC > MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC. Conclusion The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.

Normative data for middle-aged Brazilians in the Mattis Dementia Rating Scale

ABSTRACT. Despite the advances in the diagnosis of dementia, neuropsychological assessment remains an important tool. The Mattis Dementia Rating Scale (DRS) was designed to evaluate people with suspected dementia and allows for the analysis of different cognitive domains. Considering the numerous cases of early-onset dementia, specific reference standards aimed at the middle-aged population are necessary. Objective: To provide normative data for the middle-aged Brazilian population in DRS and to investigate the influence of education level, age, sex, and intelligence quotient (IQ) on the results. Methods: Overall, 120 healthcare professionals and caregivers from a hospital, who were healthy, aged between 45 and 64 years, and had at least four years of formal education, were included in the study. They were equally divided into six groups. In each age group (45–54 and 55–64 years), there were three educational levels: 4–7, 8–11, and 12 or more (12+) years of formal education. The results are presented as mean values, standard deviations, and percentiles. Comparisons between groups were carried out for age, sex, and education level. Age, years of formal education, and IQ were also analyzed as continuous variables by Spearman's correlation. Results: Concerning education level, the comparison between groups showed differences in the results for the total scale and subscales, except for the Construction subscale. No differences were found for age and sex. Correlations observed for years of formal education and IQ were similar. No correlation was found for age. Conclusions: The present study contributes to the evaluation of dementia concerning people younger than 65 years of age and reinforces the importance of education in the interpretation of the scores.

Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease

Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.

Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease

Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.

Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease

Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.

Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease

Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.

Modeling the Cognitive Trajectory in CADASIL

Background: For developing future clinical trials in Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), it seems crucial to study the long-term changes of cognition. Objective: We aimed to study the global trajectory of cognition, measured by the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS), along the course of CADASIL. Methods: Follow-up data of 185 CADASIL patients, investigated at the French National Referral center CERVCO from 2003, were considered for analysis based on strict inclusion criteria. Assuming that the MMSE and the MDRS provide imprecise measures of cognition, the trajectory of a common cognitive latent process during follow-up was delineated using a multivariate latent process mixed model. After adjustment of this model for sex and education, the sensitivities of the two scales to cognitive change were compared. Results: Analysis of the cognitive trajectory over a time frame of 60 years of age showed a decrease of performances with aging, especially after age of 50 years. This decline was not altered by sex or education but patients who graduated from high school had a higher mean cognitive level at baseline. The sensitivities of MMSE and MDRS scales were similar and the two scales suffered from a ceiling effect and curvilinearity. Conclusion: These data support that cognitive decline is not linear and mainly occurs after the age of 50 years during the course of CADASIL. They also showed that MMSE and MDRS scales are hampered by major limitations for longitudinal studies.

A-035 What Make Them Tick? The Clock Drawing Test and Correlations Between Cognitive and Functional Abilities

Objective The Clock Drawing Test (CDT) is among the most researched cognitive measures and is frequently used to screen for neurocognitive disorders (NCDs). No study to date has investigated the relationship between qualitative errors on the CDT and independence in instrumental activities of daily living (IADLs) or discrete cognitive abilities. Therefore, this study sought to evaluate the correlations between qualitative errors on the CDT and IADL status as well as performance in individual cognitive domains. Method Data were retrospectively collected from patients seen at an outpatient clinic in eastern Massachusetts, including 16 healthy controls, 22 patients with mild NCD, and 35 patients with major NCD. Analyses were performed between qualitative errors on the CDT and patients’ scores on the Lawton IADL Scale, Mattis Dementia Rating Scale-2 (DRS-2), Digit Span Forward and Backward, Trail Making Test (TMT), and the Boston Naming Test (BNT). Results IADL scores were moderately correlated with CDT error types. DRS-2 scores were strongly correlated commission of qualitative errors. Strong to very strong correlations were observed between TMT parts A & B scores and all qualitative error types. BNT performance was strongly correlated with conceptual deficits and spatial/planning errors. Digit Span Forward and Backward scores showed low correlations with all CDT errors. Conclusions Functional status appears only moderately correlated with commission of various CDT errors; however, several cognitive measures showed high correlation with various CDT error types. These findings suggest that certain qualitative errors may be indicative of cognitive impairments warranting further workup. Clinical implications and future directions are discussed.

Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease

Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.