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Observational Study
. 2022 Jul 19;14(1):96.
doi: 10.1186/s13195-022-01037-0.

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

Frederic Blanc  1   2 , Vincent Bouteloup  3   4 , Claire Paquet  5 , Marie Chupin  6 , Florence Pasquier  7 , Audrey Gabelle  8 , Mathieu Ceccaldi  9 , Paulo Loureiro de Sousa  10 , Pierre Krolak-Salmon  11 , Renaud David  12 , Clara Fischer  6 , Jean-François Dartigues  3   13 , David Wallon  14 , Olivier Moreaud  15 , Mathilde Sauvée  15 , Catherine Belin  16 , Sandrine Harston  17 , Anne Botzung  18 , Timothée Albasser  18 , Catherine Demuynck  18 , Izzie Namer  10 , Marie-Odile Habert  6 , Stéphane Kremer  10 , Olivier Bousiges  18 , Marc Verny  19   20 , Candice Muller  18 , Nathalie Philippi  18   10 , Geneviève Chene  3   4 , Benjamin Cretin  18   10 , Jean-François Mangin  6   21 , Carole Dufouil  3   4
Affiliations
Observational Study

Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

Frederic Blanc et al. Alzheimers Res Ther. .

Abstract

Background: Isolated subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) are the prodromal phases of dementia with Lewy bodies (DLB). MEMENTO is a nationwide study of patients with SCI and MCI with clinic, neuropsychology, biology, and brain imaging data. We aimed to compare SCI and MCI patients with symptoms of prodromal DLB to others in this study at baseline.

Methods: Participants of the French MEMENTO cohort study were recruited for either SCI or MCI. Among them, 892 were included in the Lewy sub-study, designed to search specifically for symptoms of DLB. Probable prodromal DLB diagnosis (pro-DLB group) was done using a two-criteria cutoff score among the four core clinical features of DLB. This Pro-DLB group was compared to two other groups at baseline: one without any core symptoms (NS group) and the one with one core symptom (1S group). A comprehensive cognitive battery, questionnaires on behavior, neurovegetative and neurosensory symptoms, brain 3D volumetric MRI, CSF, FDG PET, and amyloid PET were done.

Results: The pro-DLB group comprised 148 patients (16.6%). This group showed more multidomain (59.8%) MCI with slower processing speed and a higher proportion of patients with depression, anxiety, apathy, constipation, rhinorrhea, sicca syndrome, and photophobia, compared to the NS group. The pro-DLB group had isolated lower P-Tau in the CSF (not significant after adjustments for confounders) and on brain MRI widening of sulci including fronto-insular, occipital, and olfactory sulci (FDR corrected), when compared to the NS group. Evolution to dementia was not different between the three groups over a median follow-up of 2.6 years.

Conclusions: Patients with symptoms of prodromal DLB are cognitively slower, with more behavioral disorders, autonomic symptoms, and photophobia. The occipital, fronto-insular, and olfactory bulb involvement on brain MRI was consistent with symptoms and known neuropathology. The next step will be to study the clinical, biological, and imaging evolution of these patients.

Trial registration: Clinicaltrials.gov , NCT01926249.

Keywords: Dementia with Lewy bodies; Lewy body disease; Mild cognitive impairment; Mild neurocognitive impairment; Prodromal; Subjective cognitive impairment.

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Conflict of interest statement

F.B. was the national coordinator for France for the Eisai Delphia (E2027) and Axovant Headway-DLB therapeutic trials; he is currently the national coordinator for France of the Roche Graduate therapeutic trial; he had received honoraria from Roche, Eisai, and Biogen for oral presentations. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CSF, FDG PET, and amyloid PET analysis of the three groups: pro-DLB group (2 or more core symptoms of DLB), one symptom group (one core symptom), and no symptom group (no core symptom). For descriptive purposes, amyloid PET SUVRs were standardized for each radioligand
Fig. 2
Fig. 2
Results of the CSF and amyloid PET biomarkers for prodromal dementia with Lewy bodies group (pro-DLB), group with only one core symptom (1S), and group without any core DLB symptoms (NS)
Fig. 3
Fig. 3
Enlargement of brain sulci in patients with one (1S group) or two (pro-DLB) core symptoms of prodromal dementia with Lewy bodies
See this image and copyright information in PMC

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