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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Mild Parkinsonian Signs in a Hospital-based Cohort of Mild Cognitive Impairment Types: A Cross-sectional Study
Cecilia Camarda1, Paola Torelli2, Carmela Pipia3
1Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.
Background:
Mild Parkinsonian Signs (MPS) have been associated with Mild Cognitive Impairment (MCI) types with conflicting results.
Objective:
To investigate the association of individual MPS with different MCI types using logistic ridge regression analysis, and to evaluate for each MCI type, the association of MPS with caudate atrophy, global cerebral atrophy, and the topographical location of White Matter Hyperintensities (WMH), and lacunes.
Methods:
A cross-sectional study was performed among 1,168 subjects with different types of MCI aged 45-97 (70,52 ± 9,41) years, who underwent brain MRI. WMH were assessed through two visual rating scales. The number and location of lacunes were also rated. Atrophy of the caudate nuclei and global cerebral atrophy were assessed through the bicaudate ratio, and the lateral ventricles to brain ratio, respectively. Apolipoprotein E (APOE) genotypes were also assessed. Using the items of the motor section of the Unified Parkinson's Disease Rating Scale, tremor, rigidity, bradykinesia, and gait/balance/axial dysfunction were evaluated.
Results:
Bradykinesia, and gait/balance/axial dysfunction were the MPS more frequently encountered followed by rigidity, and tremor. MPS were present in both amnestic and non-amnestic MCI types, and were associated with WMH, lacunes, bicaudate ratio, and lateral ventricles to brain ratio.
Conclusion:
MPS are present in both amnestic and non-amnestic MCI types, particularly in those multiple domain, and carrying the APOE ε4 allele. Cortical and subcortical vascular and atrophic processes contribute to MPS. Long prospective studies are needed to disentangle the contribution of MPS to the conversion from MCI to dementia.
Insights
Mild Parkinsonian Signs (MPS) are common in Mild Cognitive Impairment (MCI) and linked to brain changes like white matter hyperintensities and atrophy. These signs may indicate increased risk for dementia progression.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- Mild Parkinsonian Signs (MPS) have shown conflicting associations with Mild Cognitive Impairment (MCI) subtypes.
- Understanding this relationship is crucial for early diagnosis and intervention in cognitive decline.
Purpose of the Study:
- To investigate the association between individual MPS and different MCI types.
- To evaluate the link between MPS and specific neuroimaging markers including caudate atrophy, global cerebral atrophy, White Matter Hyperintensities (WMH), and lacunes in MCI patients.
Main Methods:
- A cross-sectional study of 1,168 MCI patients (aged 45-97) utilizing brain MRI.
- Assessment of MPS using the Unified Parkinson's Disease Rating Scale motor section (tremor, rigidity, bradykinesia, gait/balance/axial dysfunction).
- Evaluation of WMH, lacunes, caudate atrophy (bicaudate ratio), and global cerebral atrophy (ventricles to brain ratio). Apolipoprotein E (APOE) genotyping was also performed.
Main Results:
- Bradykinesia and gait/balance/axial dysfunction were the most frequent MPS observed.
- MPS were present in both amnestic and non-amnestic MCI subtypes.
- MPS were significantly associated with WMH, lacunes, caudate atrophy, and global cerebral atrophy.
Conclusions:
- MPS are prevalent in both amnestic and non-amnestic MCI, especially in multiple-domain MCI and in individuals with the APOE ε4 allele.
- Vascular and atrophic brain processes (cortical and subcortical) contribute to the development of MPS in MCI.
- Further longitudinal studies are necessary to clarify the role of MPS in the progression from MCI to dementia.
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