Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with "de novo" Parkinson's disease

Marta Picascia, Nicolò G Pozzi, Massimiliano Todisco, Brigida Minafra, Elena Sinforiani, Roberta Zangaglia, Roberto Ceravolo, Claudio Pacchetti

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in initial phase. We addressed whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD.

METHODS: We retrospectively evaluated the neuropsychological tests of iNPH 40 subjects with early symptoms resembling parkinsonism with 47 "de novo" PD patients (dnPD). Only neuropsychological tests performed within one year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD were also compared with a sample of 70 normal controls (NC).

RESULTS: We showed a clear difference in the cognitive profile of iNPH, dnPD patients and NC. The 65% of the iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only the 25.5% of the dnPD patients presented an executive dysfunction. 35% iNPH and 74.5% PD patients, respectively, performed within the normal range (p<0.05).

CONCLUSION: Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalEuropean Journal of Neurology
DOIs
Publication statusE-pub ahead of print - Aug 9 2018

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Normal Pressure Hydrocephalus
Parkinsonian Disorders
Parkinson Disease
Neuropsychological Tests
Differential Diagnosis
Aptitude
Cognition
Reference Values

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title = "Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with {"}de novo{"} Parkinson's disease",
abstract = "OBJECTIVE: The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in initial phase. We addressed whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD.METHODS: We retrospectively evaluated the neuropsychological tests of iNPH 40 subjects with early symptoms resembling parkinsonism with 47 {"}de novo{"} PD patients (dnPD). Only neuropsychological tests performed within one year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD were also compared with a sample of 70 normal controls (NC).RESULTS: We showed a clear difference in the cognitive profile of iNPH, dnPD patients and NC. The 65{\%} of the iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only the 25.5{\%} of the dnPD patients presented an executive dysfunction. 35{\%} iNPH and 74.5{\%} PD patients, respectively, performed within the normal range (p<0.05).CONCLUSION: Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism. This article is protected by copyright. All rights reserved.",
author = "Marta Picascia and Pozzi, {Nicol{\`o} G} and Massimiliano Todisco and Brigida Minafra and Elena Sinforiani and Roberta Zangaglia and Roberto Ceravolo and Claudio Pacchetti",
note = "This article is protected by copyright. All rights reserved.",
year = "2018",
month = "8",
day = "9",
doi = "10.1111/ene.13766",
language = "English",
journal = "European Journal of Neurology",
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T1 - Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with "de novo" Parkinson's disease

AU - Picascia, Marta

AU - Pozzi, Nicolò G

AU - Todisco, Massimiliano

AU - Minafra, Brigida

AU - Sinforiani, Elena

AU - Zangaglia, Roberta

AU - Ceravolo, Roberto

AU - Pacchetti, Claudio

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/8/9

Y1 - 2018/8/9

N2 - OBJECTIVE: The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in initial phase. We addressed whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD.METHODS: We retrospectively evaluated the neuropsychological tests of iNPH 40 subjects with early symptoms resembling parkinsonism with 47 "de novo" PD patients (dnPD). Only neuropsychological tests performed within one year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD were also compared with a sample of 70 normal controls (NC).RESULTS: We showed a clear difference in the cognitive profile of iNPH, dnPD patients and NC. The 65% of the iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only the 25.5% of the dnPD patients presented an executive dysfunction. 35% iNPH and 74.5% PD patients, respectively, performed within the normal range (p<0.05).CONCLUSION: Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: The clinical differentiation between parkinsonism in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) remains challenging in initial phase. We addressed whether an early cognitive profiling might support the differential diagnosis of early iNPH and PD.METHODS: We retrospectively evaluated the neuropsychological tests of iNPH 40 subjects with early symptoms resembling parkinsonism with 47 "de novo" PD patients (dnPD). Only neuropsychological tests performed within one year from the first motor symptom were included. The cognitive spectrum of iNPH and dnPD were also compared with a sample of 70 normal controls (NC).RESULTS: We showed a clear difference in the cognitive profile of iNPH, dnPD patients and NC. The 65% of the iNPH subjects showed a diffuse cognitive impairment, including memory, visuospatial abilities, fronto-executive functioning and attention, whereas only the 25.5% of the dnPD patients presented an executive dysfunction. 35% iNPH and 74.5% PD patients, respectively, performed within the normal range (p<0.05).CONCLUSION: Subjects with iNPH showed an early and diffuse alteration of cognition with respect to dnPD patients. Performing a prompt and accurate neuropsychological evaluation might support the differential diagnosis of these two conditions of parkinsonism. This article is protected by copyright. All rights reserved.

U2 - 10.1111/ene.13766

DO - 10.1111/ene.13766

M3 - Article

C2 - 30091839

JO - European Journal of Neurology

JF - European Journal of Neurology

SN - 1351-5101

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