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<p>The cognitive and neuroimaging evolution over the course of dementia with Lewy bodies (DLB) from prodromal stage — Pro-DLB (subjective (SCI) to mild cognitive impairment (MCI)) — is poorly understood. The aim of this study was to analyze from 5-year longitudinal data the trajectories of Pro-DLB patients. The “Lewy- MEMENTO” prospective clinical cohort recruited 773 patients for either SCI or MCI. The Pro-DLB group was compared to a group with prodromal Alzheimer’s disease (Pro-AD), a group with “prodromal DLB and AD” (Pro-DLB + AD), and a group without prodromal DLB and AD (no symptom [NS]). We modeled the 5-year evolution of cognitive functions and the 2-year evolution of brain MRI volumetry on MRI and brain metabolism (FDG PET). The Pro-AD and Pro-DLB + AD groups had more cognitive and functional decline than the Pro-DLB and NS groups (<i>P</i> &lt; .001). The Pro-DLB group had more cognitive decline than the NS group (<i>P</i> &lt; .004). Incident dementia during the follow-up was higher in the Pro-AD (13.0 per 100 person-years) and Pro-DLB + AD (10.3) groups than in the Pro-DLB (1.02) and NS (0.44) groups (<i>P</i> &lt; .001). The decline in the metabolism of the left orbitofrontal cortex was greater in the Pro-DLB + AD group. The volume decrease of hippocampi, entorhinal cortices, amygdalae, and left insula was higher in the Pro-AD and the pro-DLB + AD groups. Patients in the pro-DLB group had less cognitive, functional, brain volume, and metabolism decrease than patients in the Pro-AD and pro-DLB + AD groups. DLB would therefore be a less degenerative and more dysfunctional disease at the prodromal stage.</p>

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Cognitive and neuroimaging outcome of very prodromal dementia with Lewy bodies

  • 期刊论文

  • 发表日期：

    2025年5月25日

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  • Frédéric Blanc,
  • Vincent Bouteloup,
  • Claire Paquet,
  • Marie Chupin,
  • Florence Pasquier,
  • Audrey Gabelle,
  • Mathieu Ceccaldi,
  • Paulo Loureiro de Sousa,
  • Pierre Krolak-Salmon,
  • Renaud David,
  • Clara Fischer,
  • Jean-François Dartigues,
  • David Wallon,
  • Olivier Moreaud,
  • Mathilde Sauvée,
  • Catherine Belin,
  • Claire Roubaud,
  • Anne Botzung,
  • Alix Ravier,
  • Catherine Demuynck,
  • Izzie Namer,
  • Marie-Odile Habert,
  • Olivier Bousiges,
  • Benoît Schorr,
  • Candice Muller,
  • Nathalie Philippi,
  • Geneviève Chêne,
  • Benjamin Cretin,
  • Jean-François Mangin,
  • Carole Dufouil

摘要

The cognitive and neuroimaging evolution over the course of dementia with Lewy bodies (DLB) from prodromal stage — Pro-DLB (subjective (SCI) to mild cognitive impairment (MCI)) — is poorly understood. The aim of this study was to analyze from 5-year longitudinal data the trajectories of Pro-DLB patients. The “Lewy- MEMENTO” prospective clinical cohort recruited 773 patients for either SCI or MCI. The Pro-DLB group was compared to a group with prodromal Alzheimer’s disease (Pro-AD), a group with “prodromal DLB and AD” (Pro-DLB + AD), and a group without prodromal DLB and AD (no symptom [NS]). We modeled the 5-year evolution of cognitive functions and the 2-year evolution of brain MRI volumetry on MRI and brain metabolism (FDG PET). The Pro-AD and Pro-DLB + AD groups had more cognitive and functional decline than the Pro-DLB and NS groups (P < .001). The Pro-DLB group had more cognitive decline than the NS group (P < .004). Incident dementia during the follow-up was higher in the Pro-AD (13.0 per 100 person-years) and Pro-DLB + AD (10.3) groups than in the Pro-DLB (1.02) and NS (0.44) groups (P < .001). The decline in the metabolism of the left orbitofrontal cortex was greater in the Pro-DLB + AD group. The volume decrease of hippocampi, entorhinal cortices, amygdalae, and left insula was higher in the Pro-AD and the pro-DLB + AD groups. Patients in the pro-DLB group had less cognitive, functional, brain volume, and metabolism decrease than patients in the Pro-AD and pro-DLB + AD groups. DLB would therefore be a less degenerative and more dysfunctional disease at the prodromal stage.