The Role of Neuropsychiatric Symptoms in Research Diagnostic Criteria for Neurodegenerative Diseases

Abstract

Ǹeuropsychiatric syndromes and symptoms play increasingly important roles in research diagnostic criteria for neurodegenerative disorders. Diagnostic criteria were reviewed including those for dementia, Alzheimer's disease, mild cognitive impairment, mild behavioral impairment, prodromal Alzheimer's disease, dementia with Lewy bodies, prodromal dementia with Lewy bodies, Parkinson's disease, multiple system atrophy, frontotemporal dementia, primary progressive aphasia, progressive supranuclear palsy, corticobasal degeneration, traumatic encephalopathy syndrome, Huntington' disease, amyotrophic lateral sclerorsis. All contemporary research diagnostic criteria for neurodegenerative disorders expect those for Parkinson's disease, primary progressive aphasia, multisystem atrophy and amyotrophic lateral sclerosis include neuropsychiatric phenomena as core diagnostic criteria. There are no disease-specific neuropsychiatric symptoms; apathy and disinhibition are common in tauopathies, and rapid-eye-movement sleep behavioral disorder occurs almost exclusively in synucleinopathies. Neuropsychiatric symptoms and syndromes are increasingly integrated into research diagnostic criteria for neurodegenerative disorders; they require clinician skills for recognition; their biology is better understood as their relationships to cognitive, motor, and autonomic symptoms of neurodegenerative disorders are studied. (Am J Geriatr Psychiatry 2021; 29:375−383)

Apathy and Anxiety in De Novo Parkinson's Disease Predict the Severity of Motor Complications

“…Altogether, the present study provides several unique insights into the value of neuropsychiatric features—particularly anxiety and apathy—as indicators of MCT risk in PD. In addition to suggesting prognostic value for these symptoms that could assist clinicians when discussing treatment trajectories with patients, our findings indicate that anxiety and apathy could be biomarkers for neuropathological changes that underlie these complications 30 . Since anxiety, apathy, and other non‐motor features are common in prodromal PD, they could also become increasingly important prognostic biomarkers for understanding disease trajectory.…”

“…This finding supports the notion that pre‐DRT levels of anxiety and apathy may be useful for assessing individual patient risk for motor fluctuations and dyskinesias, which may be useful from a prognostic standpoint. Additionally, our findings indicate the non‐motor features of early PD may be useful biomarkers of latent neurobiological changes or factors that predispose to MCT 30 …”

Substantively Lowered Levels of Pantothenic Acid (Vitamin B5) in Several Regions of the Human Brain in Parkinson’s Disease Dementia

“…These neurodegenerative diseases share several characteristics. Age is a primary risk factor for the development of symptoms (although HD is always caused by a dominant autosomal mutation in the huntingtin gene; the development of symptomology generally occurs with older age), cerebral protein deposition is present in each condition (α-synuclein in PD, tau and amyloid-β in ADD, and huntingtin in HD), and the clinical presentation can show significant overlap, with increased risk of psychological complaints [ 7 ], issues with sleep [ 8 ], and difficulty walking [ 9 ], as well as the progressive development of cognitive impairment [ 10 , 11 ].…”

Discriminant Subspace Low-Rank Representation Algorithm for Electroencephalography-Based Alzheimer’s Disease Recognition

“…To obtain disease-controlling treatments, it is an urgent need to classify the course of AD for early diagnosis. And especially, the National Institutes of Health revised the clinical diagnostic criteria for AD, characterizing research guidelines for early diagnosis and treatment (Cummings, 2021). The progression of AD is mainly divided into three stages.…”