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. 2021 Aug 11:13:709215.
doi: 10.3389/fnagi.2021.709215. eCollection 2021.

Motor Dysfunction Questionnaire and Dopamine Transporter Imaging Composite Scale Improve Differentiating Dementia With Lewy Bodies From Alzheimer's Disease With Motor Dysfunction

Pai-Yi Chiu  1   2 , Cheng-Yu Wei  3 , Guang-Uei Hung  4 , Shey-Lin Wu  5   6
Affiliations

Motor Dysfunction Questionnaire and Dopamine Transporter Imaging Composite Scale Improve Differentiating Dementia With Lewy Bodies From Alzheimer's Disease With Motor Dysfunction

Pai-Yi Chiu et al. Front Aging Neurosci. .

Abstract

Objective: Characteristic parkinsonism is the major comorbidity of dementia with Lewy bodies (DLB). We aimed to differentiate DLB from Alzheimer's disease (AD) with motor dysfunction using a composite scale with a characteristic motor dysfunction questionnaire (MDQ) and dopamine transporter (DAT) imaging. It could help detect DLB easily in healthcare settings without movement disorder specialists. Methods: This is a two-phase study. In the design phase, seven questions were selected and composed of a novel MDQ. In the test phase, all participants with DLB, AD, or non-dementia (ND) control completed dementia and parkinsonism survey, the novel designed questionnaire, DAT imaging, and composite scales of MDQ and DAT. The cutoff scores of the MDQ, semiquantitative analysis of the striatal-background ratio (SBR) and visual rating of DAT, and the composite scale of MDQ and DAT for discriminating DLB from AD or ND were derived and compared. Results: A total of 277 participants were included in this study (126 with DLB, 86 with AD, and 65 with ND). Compared with the AD or ND groups, the DLB group showed a significantly higher frequency in all seven items in the MDQ and a significantly lower SBR. For discrimination of DLB from non-DLB with MDQ, SBR, and composite scale, the cutoff scores of 3/2, 1.37/1.38, and 6/5 were suggested for the diagnosis of DLB with the sensitivities/specificities of 0.91/0.72, 0.91/0.80, and 0.87/0.93, respectively. The composite scale significantly improved the accuracy of discrimination compared with either the MDQ or SBR. Conclusion: This study showed that the novel designed simple questionnaire was a practical screening tool and had similar power to DAT scanning to detect DLB. The questionnaire can be applied in clinical practice and population studies for screening DLB. In addition, the composite scale of MDQ and DAT imaging further improved the diagnostic accuracy, indicating the superiority of the dual-model diagnostic tool.

Keywords: Alzheimer's disease; dementia with Lewy bodies; motor dysfunction; non-dementia; striatal–background ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of each item in MDQ among different diagnostic groups. MDQ, motor dysfunction questionnaire.
Figure 2
Figure 2
Comparison of MDQ, SBR, MDQSBR, and MDQVR among the ND, AD, and DLB groups. MDQ, motor dysfunction questionnaire in the history-based artificial intelligence clinical dementia diagnostic system; SBR, striatal–background ratio of dopamine transporter imaging; MDQSBR, the composite scale of MDQ and SBR; MDQVR, the composite scale of MDQ and DAT VR scale; ND, non-dementia control; AD, Alzheimer's disease; DLB, dementia with Lewy bodies.
Figure 3
Figure 3
Comparison of ROC curves of MDQ, SBR, MDQSBR composite scale, and MDQVR composite scale among ND, AD, and DLB groups. (A) DLB vs. non-DLB (ND+AD). (B) DLB vs. AD. (C) DLB vs. ND. ROC, receiver operating characteristic; MDQ, motor dysfunction questionnaire in the history-based artificial intelligence clinical dementia diagnostic system; SBR, striatal–background ratio of dopamine transporter imaging; MDQSBR, the composite scale of MDQ and SBR; MDQVR, the composite scale of MDQ and DAT VR scale; ND, non-dementia control; AD, Alzheimer's disease dementia; DLB, dementia with Lewy bodies.
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References

    1. Ballard C., McKeith I., Burn D., Harrison R., O'Brien J., Lowery K., et al. . (1997). The UPDRS scale as a means of identifying extrapyramidal signs in patients suffering from dementia with Lewy bodies. Acta Neurol. Scand. 96, 366–371. 10.1111/j.1600-0404.1997.tb00299.x - DOI - PubMed
    1. Chan D. K., Hung W. T., Wong A., Hu E., Beran R. G. (2000). Validating a screening questionnaire for parkinsonism in Australia. J. Neurol. Neurosurg. Psychiatry 69, 117–120. 10.1136/jnnp.69.1.117 - DOI - PMC - PubMed
    1. Chang S. F., Su C. L., Chen Z. Y., Lee C. S., Chen R. C. (1996). Neuroepidemiological survey in Ilan, Taiwan (NESIT)(1): validation of screening instrument in an out-patient department population. Acta Neurol. Taiwan 5, 105–110.
    1. Chen K. L., Xu Y., Chu A. Q., Ding D., Liang X. N., Nasreddine Z. S., et al. . (2016). Validation of the Chinese version of montreal cognitive assessment basic for screening mild cognitive impairment. J. Am. Geriatr. Soc. 64, e285–e290. 10.1111/jgs.14530 - DOI - PubMed
    1. Chiu P. Y., Tang H., Wei C. Y., Zhang C., Hung G. U., Zhou W. (2019a). NMD-12: a new machine-learning derived screening instrument to detect mild cognitive impairment and dementia. PLoS ONE 14:e0213430. 10.1371/journal.pone.0213430 - DOI - PMC - PubMed

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