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Tainta M, Iriondo A, Ecay-Torres M, Estanga A, de Arriba M, Barandiaran M, Clerigue M, Garcia-Sebastian M, Villanua J, Izagirre A, Saldias J, Aramburu A, Taboada J, Múgica J, Barandiaran A, Arrospide A, Mar J, Martinez-Lage P. Brief cognitive tests as a decision-making tool in primary care. A population and validation study. Neurologia 2022:S2173-5808(22)00082-7. [PMID: 35963538 DOI: 10.1016/j.nrleng.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program. MATERIAL AND METHODS In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample. RESULTS 260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26. CONCLUSION BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC.
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Affiliation(s)
- M Tainta
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain; Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain.
| | - A Iriondo
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Ecay-Torres
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Estanga
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M de Arriba
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Barandiaran
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain; Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - M Clerigue
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | | | - J Villanua
- Osatek SA, Hospital Donostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Izagirre
- Universidad del País Vasco (UPV-EHU), Facultad de Medicina y Enfermería, Donostia-San Sebastián, Guipúzcoa, Spain
| | - J Saldias
- CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain
| | - A Aramburu
- Osakidetza, Organización Sanitaria Integrada (OSI) Debabarrena, Spain
| | - J Taboada
- Osakidetza, Organización Sanitaria Integrada (OSI) Bilbao Basurto, Spain
| | - J Múgica
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, Spain
| | - A Barandiaran
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, Spain
| | - A Arrospide
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain
| | - J Mar
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain; Instituto de Investigación en Servicios Sanitarios Kronikgune, Barakaldo, Vizcaya, Spain
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Tainta M, Iriondo A, Ecay-Torres M, Estanga A, de Arriba M, Barandiaran M, Clerigue M, Garcia-Sebastian M, Villanua J, Izagirre A, Saldias J, Aramburu A, Taboada J, Múgica J, Barandiaran A, Arrospide A, Mar J, Martinez-Lage P. Test cognitivos breves como herramienta de decisión en Atención Primaria. Estudio poblacional y de validación. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Estanga A, Rodriguez-Oroz MC, Ruiz-Martinez J, Barandiaran M, Gorostidi A, Bergareche A, Mondragon E, Lopez de Munain A, Marti-Masso JF. Cognitive dysfunction in Parkinson's disease related to the R1441G mutation in LRRK2. Parkinsonism Relat Disord 2014; 20:1097-100. [PMID: 25127457 DOI: 10.1016/j.parkreldis.2014.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 06/23/2014] [Accepted: 07/09/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The neuropsychological characteristics of patients with Parkinson's Disease (PD) associated with R1441G mutation in the LRRK2 gene (R1441G-PD) are not well known. The aim of this study was to examine the cognitive status and mood of R1441G-PD patients. METHODS Thirty patients with R1441G-PD were compared with thirty idiopathic PD (i-PD) patients who were matched by age, sex, education, disease onset age and duration, using a comprehensive battery of neuropsychological test, and considering the Movement Disorder Society (MDS) criteria for the diagnosis of Mild Cognitive Impairment (PD-MCI) and dementia (PD-Dementia). RESULTS The mean scores in the depression and anxiety scales were similar in the two groups. Depressive symptoms were detected in 31.8% of R1441G-PD and 25% of i-PD patients and anxiety symptoms were evident in 4.5% and 15%, respectively, but the differences were not significant. The only neuropsychological test on which there was a significantly worse performance in the R1441G-PD group was the Boston naming test but the difference became not significant when Bonferroni's correction was applied. The prevalence of PD-MCI was 30% in both R1441G-PD and i-PD, with no differences in the number and type of domains altered given that executive function, memory and attention were mainly affected. PD-Dementia was diagnosed in 13.3% (n = 4) of R1441G-PD and 26.7% (n = 8) of i-PD patients (difference was not significant). CONCLUSION In conclusion, significant differences were not detected between R1441G-PD and i-PD in cognitive, depression and anxiety scales, or PD-MCI and PD-Dementia prevalence, and the cognitive profile was identical in the two groups.
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Affiliation(s)
- A Estanga
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neuroscience, University of the Basque Country UPV/EHU, Spain.
| | - M C Rodriguez-Oroz
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain; Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - J Ruiz-Martinez
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain
| | - M Barandiaran
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain
| | - A Gorostidi
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain
| | - A Bergareche
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain
| | - E Mondragon
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain
| | - A Lopez de Munain
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain; Department of Neuroscience, University of the Basque Country UPV/EHU, Spain
| | - J F Marti-Masso
- Neuroscience Unit, Biodonostia Research Institute, San Sebastian, Spain; Department of Neurology, University Hospital Donostia, San Sebastian, Spain; Department of Neuroscience, University of the Basque Country UPV/EHU, Spain
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Moreno F, Indakoetxea B, Barandiaran M, Alzualde A, Gabilondo A, Estanga A, Ruiz J, Ruibal M, Bergareche A, Martí-Massó JF, López de Munain A. "Frontotemporoparietal" dementia: clinical phenotype associated with the c.709-1G>A PGRN mutation. Neurology 2009; 73:1367-74. [PMID: 19858458 DOI: 10.1212/wnl.0b013e3181bd82a7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mutations in the progranulin gene (PGRN) are a major cause of frontotemporal lobar degeneration with tau-negative and ubiquitin-positive neuronal inclusions. Most previous studies aimed at characterizing the clinical and neuropsychological phenotype of PGRN mutation carriers included patients with different PGRN mutations, assuming that the common proposed pathogenetic mechanism of haploinsufficiency will lead to a comparable phenotype. METHODS We studied 21 patients with a single pathogenic splicing mutation in the PGRN gene (c.709-1G>A) in the same tertiary referral center using homogenous diagnostic criteria and protocols. All patients were of Basque descent. RESULTS Patients exhibited a variable phenotype both in age at onset and initial symptoms. Behavioral variant frontotemporal dementia (52.4%) and progressive nonfluent aphasia (23.8%) were the most common presenting syndromes. Apathy was the most common behavioral symptom. Patients developed a relatively rapidly progressive dementia with features that led to a secondary diagnosis in 61.9% of cases 2 years after primary diagnosis. Notably, this secondary or tertiary diagnosis was corticobasal syndrome in 47.6% of cases, which confirmed the neuropsychological features of parietal lobe dysfunction seen at the initial assessment in 81.8% of patients. CONCLUSIONS Patients carrying the c.709-1G>A mutation in the PGRN gene showed heterogeneous clinical and neuropsychological features and commonly developed corticobasal syndrome as the disease progressed.
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Affiliation(s)
- F Moreno
- Department of Neurology, Hospital Donostia, Paseo Dr. Begiristain sn, CP 20014, San Sebastian, Gipuzkoa, Spain.
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