Head Turning Sign for Diagnosis of Dementia and Mild Cognitive Impairment: A Revalidation

Ghadiri–Sani, Mona; Larner, AJ

doi:10.1136/jnnp-2013-306573.83

Cited by 7 publications

(14 citation statements)

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“…In 2012, Larner [4] found a modest sensitivity (63%) and good specificity (95%) for cognitive impairment. In 2013, a revalidation study was performed by Ghadiri-Sani and Larner [6] with similar results. Both studies included individuals with mild cognitive impairment (MCI) and a heterogeneous group with dementia defined according to the DSM-IV-TR [7] comprising Alzheimer's disease (AD), frontotemporal lobar degeneration, dementia with Lewy bodies, vascular dementia, and some undefined diagnosis.…”

Section: Introductionmentioning

confidence: 51%

The Head Turning Sign in Dementia and Mild Cognitive Impairment: Its Relationship to Cognition, Behavior, and Cerebrospinal Fluid Biomarkers

Durães

Tábuas‐Pereira

Araújo

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: The head turning sign (HTS) is frequently noticed in clinical practice, but few studies have investigated its etiological and neuropsychological correlates. Methods: The presence and frequency of the HTS was operationalized and prospectively evaluated in patients with Alzheimer’s disease (AD), amnestic mild cognitive impairment (MCI), and behavioral-variant frontotemporal dementia (bvFTD). Cerebrospinal fluid (CSF) samples for AD biomarkers were collected. Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale (GDS), and insight scale scores were ascertained. Results: A total of 84 patients were included. The HTS was more prevalent in AD than in MCI or bvFTD. It correlated negatively with cognitive measures and depression. It also had a positive correlation with CSF total tau and hyperphosphorylated tau proteins. Total tau protein and GDS score were the only variables independently associated with the HTS. Conclusions: The presence of the HTS in a cognitively impaired individual suggests a diagnosis of AD. A higher HTS frequency correlates with higher CSF total tau levels, a smaller GDS score, and worse cognitive measures. In the MCI subgroup, the HTS may suggest a higher risk of progression.

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Section: Introductionmentioning

confidence: 51%

The Head Turning Sign in Dementia and Mild Cognitive Impairment: Its Relationship to Cognition, Behavior, and Cerebrospinal Fluid Biomarkers

Durães

Tábuas‐Pereira

Araújo

et al. 2018

Dement Geriatr Cogn Disord

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show abstract

“…42 Head turning sign (n = 5). A number of studies 23,24,32,33,40 assessed the head turning sign (HTS) in which patients turn towards their caregivers in the face of difficulties or inability to answer a question during cognitive testing. 37 Fukui and colleagues found the independent contributors to head turning frequency were Alzheimer'srelated diseases (dementia or amnestic MCI), female sex, and increasing dementia severity.…”

Section: Narrative Synthesis: Theme 1 -Clues To Incapacity and Cognitmentioning

confidence: 99%

Identifying patterns of communication in patients attending memory clinics: a systematic review of observations and signs with potential diagnostic utility

Bailey¹,

Poole

Blackburn

2018

Br J Gen Pract

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Whether the patient attends with a companion, how they participate, give autobiographical history, demonstrate working memory, and make qualitative observations during routine cognitive testing are all useful in building a diagnostic picture. Future studies should explore these phenomena in larger populations, over longer periods, include dementia subtypes, and develop robust definitions of functional memory disorders to facilitate comparison.

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“…Two non-overlapping pragmatic diagnostic accuracy studies examined the head-turning sign (table 1, middle column) 11 12. The sign was only modestly sensitive for the diagnosis of cognitive impairment (0.63–0.68) but had excellent specificity (0.94–0.95); in other words, it is reliably absent in those without cognitive impairment.…”

Section: Non-canonical Signsmentioning

confidence: 99%

“…The sign was only modestly sensitive for the diagnosis of cognitive impairment (0.63–0.68) but had excellent specificity (0.94–0.95); in other words, it is reliably absent in those without cognitive impairment. The head-turning sign had correspondingly excellent positive predictive value (0.94–0.96), a measure of the probability of disease in a patient with a positive test 11 12. The sign's exact neuropsychological correlates are not currently defined; it might possibly be a somatic marker of amnesia.…”

Section: Non-canonical Signsmentioning

confidence: 99%

Neurological signs of possible diagnostic value in the cognitive disorders clinic: Table 1

Larner

2014

Pract Neurol

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Head Turning Sign for Diagnosis of Dementia and Mild Cognitive Impairment: A Revalidation

Cited by 7 publications

References 0 publications

The Head Turning Sign in Dementia and Mild Cognitive Impairment: Its Relationship to Cognition, Behavior, and Cerebrospinal Fluid Biomarkers

The Head Turning Sign in Dementia and Mild Cognitive Impairment: Its Relationship to Cognition, Behavior, and Cerebrospinal Fluid Biomarkers

Identifying patterns of communication in patients attending memory clinics: a systematic review of observations and signs with potential diagnostic utility

Neurological signs of possible diagnostic value in the cognitive disorders clinic: Table 1

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