Neuropsychological and neuroimaging preliminary results supporting prodromal dementia with Lewy bodies criteria

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Udgivet i:Alzheimer's & Dementia vol. 21 (Dec 1, 2025)
Hovedforfatter: Zazzaro, Giulia
Andre forfattere: Conti, Desirée, Panigutti, Massimiliano, Gabrielli, Giulia Bechi, Serrentino, Marco, Sepe‐Monti, Micaela, Talarico, Giuseppina, Canevelli, Marco, Bruno, Giuseppe, D'Antonio, Fabrizia
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John Wiley & Sons, Inc.
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LEADER 00000nab a2200000uu 4500
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022 |a 1552-5260 
022 |a 1552-5279 
024 7 |a 10.1002/alz70857_102865  |2 doi 
035 |a 3286759180 
045 0 |b d20251201 
100 1 |a Zazzaro, Giulia  |u Fondazione Santa Lucia IRCCS, Rome, Italy, 
245 1 |a Neuropsychological and neuroimaging preliminary results supporting prodromal dementia with Lewy bodies criteria 
260 |b John Wiley & Sons, Inc.  |c Dec 1, 2025 
513 |a Journal Article 
520 3 |a Background The prodromal stage of dementia with Lewy bodies (pro‐DLB) has been recently defined [1]; however, the neuropsychological and neuroimaging profile of these patients according to the possible clinical onset (i.e., mild cognitive impairment [MCI], psychiatric‐onset, delirum‐onset) has not been thoroughly investigated yet. In this study, we aimed to clarify the neuropsychological and neuroimaging markers of pro‐DLB. Method We included 26 patients with pro‐DLB (17 MCI‐DLB, 8 psychiatric‐onset, 1 delirium‐onset) and 15 with MCI due to Alzheimer's disease (AD). All patients underwent an extensive neuropsychological battery assessing all cognitive domains and neuropsychiatric symptoms. Qualitative neuropsychological indices were developed to capture subtle differences in pro‐DLB. All 26 pro‐DLB patients, a subgroup of 12 MCI‐AD patients, and 13 healthy controls also underwent a structural MRI acquisition. Voxel‐based Morphometry (VBM) analyses were performed to compare differences in gray matter volume between the groups. Result In comparison to MCI‐AD, pro‐DLB patients showed a worse performance in computerized tests of alertness and working memory, in visuo‐perceptive, visuo‐spatial and visuo‐constructive processing, in abstract reasoning and planning tests. While, the same outcomes were observed when comparing MCI‐DLB with MCI‐AD, psychiatric pro‐DLB patients obtained lower scores than MCI‐AD only on computerized trials of alertness. Regarding neuropsychiatric symptoms, pro‐DLB patients had greater anxiety and more severe and frequent hallucinations. Moreover, pro‐DLB patients showed increased atrophy in occipital areas, mainly in early and ventral visual systems, in the inferior parietal lobule, and in frontal regions (e.g., anterior cingulate and orbitofrontal cortex, especially in psychiatric pro‐DLB). Subcortically, atrophy was found in the nucleus accumbens. Relative preservation of the medial temporal lobe was found in pro‐DLB relative to MCI‐AD. Conclusion In line with the full‐blown disease, the neuropsychological profile of pro‐DLB patients is characterized by deficits in visuo‐perceptive, visuo‐spatial and visuo‐constructive abilities as well as executive functions and attention. Accordingly, the neuropsychological assessment should focus on the evaluation of these cognitive domains employing the most sensitive tests (including computerized ones). Notably, the localization of brain atrophy is coherent not only with neuropsychological deficits and neuropsychiatric symptoms, but also with the different phenotypes of pro‐DLB. 
653 |a Neuroimaging 
653 |a Alzheimer's disease 
653 |a Brain 
653 |a Dementia 
653 |a Localization 
653 |a Politics 
653 |a Magnetic resonance imaging 
653 |a Cognition 
653 |a Neuropsychology 
653 |a Psychiatry 
653 |a Cognitive impairment 
653 |a Hallucinations 
653 |a Anxiety 
653 |a Mental disorders 
653 |a Delirium 
653 |a Phenotypes 
653 |a Patients 
653 |a Medial temporal lobe 
653 |a Preservation 
653 |a Short term memory 
653 |a Brain atrophy 
653 |a Cortex 
653 |a Abstract reasoning 
653 |a Medical imaging 
653 |a Neuropsychological assessment 
653 |a Symptoms 
653 |a Executive function 
653 |a Alertness 
653 |a Disease 
653 |a Atrophy 
653 |a Computerization 
653 |a Neuropsychiatric symptoms 
700 1 |a Conti, Desirée  |u Fondazione Santa Lucia IRCCS, Rome, Italy, 
700 1 |a Panigutti, Massimiliano  |u Fondazione Santa Lucia IRCCS, Rome, Italy, 
700 1 |a Gabrielli, Giulia Bechi  |u Sapienza University of Rome, Rome, Italy, 
700 1 |a Serrentino, Marco  |u Sapienza University of Rome, Rome, Italy, 
700 1 |a Sepe‐Monti, Micaela  |u Sapienza University of Rome, Rome, Italy, 
700 1 |a Talarico, Giuseppina  |u Sapienza University of Rome, Rome, Italy, 
700 1 |a Canevelli, Marco  |u Sapienza University of Rome, Rome, Rome, Italy, 
700 1 |a Bruno, Giuseppe  |u Sapienza University of Rome, Rome, Italy, 
700 1 |a D'Antonio, Fabrizia  |u Fondazione Santa Lucia IRCCS, Rome, Italy, 
773 0 |t Alzheimer's & Dementia  |g vol. 21 (Dec 1, 2025) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3286759180/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3286759180/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch