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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
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Clinical Manifestations.
Brenna Cholerton1, Gary W Beecham2, Christiane Reitz3
1Department of Pathology, Stanford University, Stanford, CA, USA.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
Summary
Neuropsychiatric symptoms (NPS) in dementia are linked to specific brain changes. Early psychosis/agitation (EPA) and late psychosis/agitation (LPA) show distinct associations with Alzheimer's disease (AD) neuropathology and other lesions.
Area of Science:
- Neuropathology
- Neuroscience
- Gerontology
Background:
- Neuropsychiatric symptoms (NPS) are common in Alzheimer's disease (AD) and related dementias.
- The timing and type of NPS may indicate different underlying pathologies and predict outcomes.
- Understanding these associations is crucial for managing dementia burden.
Purpose of the Study:
- To investigate the distinct associations between specific NPS clusters and neuropathologic lesions in dementia.
- To determine if Alzheimer's disease neuropathologic change (ADNC) interacts with other lesions to influence NPS subtypes.
- To explore the relationship between NPS timing, symptom clusters, and neuropathologic burden.
Main Methods:
- Utilized data from the National Alzheimer's Coordinating Center (NACC) neuropathology datasets.
- Assigned NPS subtypes (early psychosis/agitation [EPA], late psychosis/agitation [LPA], affective symptoms [AS]) using the Neuropsychiatric Inventory Questionnaire.
- Employed adjusted logistic regression to analyze associations between NPS subtypes and neuropathologic findings.
Main Results:
- EPA was linked to Lewy body and white matter pathology.
- LPA showed associations with neurofibrillary tangles, neuritic plaques, Lewy bodies, and cerebral amyloid angiopathy.
- Affective symptoms (AS) were associated with white matter disease and neurofibrillary tangles.
- All NPS subtypes correlated with increased total neuropathologic burden.
Conclusions:
- NPS timing and clusters have distinct associations with neuropathologic lesions, influenced by ADNC presence.
- NPS severity increases with the number of neuropathologic changes.
- Reducing overall neuropathologic burden may mitigate NPS and harm in dementia.
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