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 Cognitive and neuropsychiatric profiles - DLB, MSA, PD 
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Joined: Fri Aug 11, 2006 1:46 pm
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Post Cognitive and neuropsychiatric profiles - DLB, MSA, PD
This is a very interesting article out of UCSF comparing the cognitive and neuropsychiatric profiles of those with PD, DLB, and MSA. It's a small study: 12 MSA patients, 14 DLB patients, and 14 PD patients at UCSF were tested. (I don't think any of the diagnoses have been confirmed upon autopsy.)

I've copied the highly-understandable abstract below.
Robin


Here's the abstract:

Alzheimer Disease & Associated Disorders. 2009 Oct-Dec;23(4):365-70.

Cognitive and neuropsychiatric profile of the synucleinopathies: Parkinson disease, dementia with lewy bodies, and multiple system atrophy.

Kao AW, Racine CA, Quitania LC, Kramer JH, Christine CW, Miller BL.
Department of Neurology, University of California San Francisco.

Parkinson disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB) share alpha-synuclein immunoreactivity. These "synucleinopathies" have overlapping signs and symptoms, but less is known about similarities and differences in their cognitive and neuropsychiatric profiles. We compared the cognitive and neuropsychiatric profiles of individuals with PD, MSA, and DLB.

Overall, the DLB group showed the most cognitive impairment, the MSA group demonstrated milder impairment, and the PD group was the least cognitively impaired.

The DLB and MSA groups showed worse executive function and visuospatial skills than PD, whereas DLB showed impaired memory relative to both PD and MSA.

On the neuropsychiatric screening, all groups endorsed depression and anxiety; the DLB group alone endorsed delusions and disinhibition.

Consistent with their greater level of cognitive and neuropsychiatric impairment, the DLB group showed the greatest amount of functional impairment on a measure of instrumental activities of daily living (Functional Activities Questionnaire).

We found that MSA subjects had cognitive difficulties that fell between the mild deficits of the PD group and the more severe deficits of the DLB group.

PD, MSA, and DLB groups have similar neuropsychiatric profiles of increased depression and anxiety. Similar underlying alpha-synuclein pathology may contribute to these shared features.

PubMed ID#: 19935145 (see pubmed.gov for this free abstract)


Tue Dec 01, 2009 2:46 am
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Robin,
This is indeed very interesting but my question to you is, which of these diseases cause the more physical issues, as I read through the many writings here many are saying that one person can walk a mile others can't, so is this more the PDD?? Which of course still falls under LBD, correct?

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Irene Selak


Wed Dec 02, 2009 1:53 pm
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Irene,
There's no criteria for any of these diseases that says "if you can walk X distance, then it is or isn't Y disease." Further, neither MSA nor LBD require parkinsonism as symptoms.
Robin


Wed Dec 02, 2009 2:29 pm
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Thanks Robin,
That's the reason I asked because I have never seen anything with the physical side of the disease leaning towards one disease or another, the way I understand it that each LBD'er is different in the disabilities they have ! With this disease you never stop learning!

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Irene Selak


Wed Dec 02, 2009 4:20 pm
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Post puzzled
So many times when Mr B. saw a doctor, everyone asked about depression. I would think a bit and always answer, "No". They appeared puzzled. I began looking for depression. The last six months he prayed more and more but then he still did not seem depressed. Maybe I just missed it as one very good male nurse pointed out that depression manifests itself in many different ways. But my aim was to see him smile, the kids showed him that they cared and appreciated him, he had his radio, misic, and he loved him visiting entities... he had a full life up until the end. He showed elation when Dr W. came to see him durng his last few hours, telling everyone that Dr W. was his best friend in the whole world. His praying was the only indication that he had a troubled mind but the prayers satisfied him. What did I miss? When we get the report back from Mayo in Jax, perhaps we will know more.

DrP


Wed Dec 02, 2009 5:36 pm
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Dorthea,
Strange you should mention depression, many moons ago when my husband first became ill his orginal DX was depression, I fought it for years knowing he was just a quiet gentle man, I am sure there were many days that he was sad but depressed no! I also found that Jim found comfort in the later months in prayer, I think it just gave him peace.

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Irene Selak


Wed Dec 02, 2009 7:06 pm
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Dorthea and Irene
Dorthea, I don't think you missed anything. I see so much of my husband in how you and Irene describe your husbands. Quite and gentle. My husband has always found comfort in prayer and he loves to go to church. Still does! Maybe there is something in the profile of a LBD person. (As soon as I say that someone else will say their LO is the opposite).
I wondered about depression with my husband but I really don't think so either. He loves his music also. When I see him sitting quite and slipping into Lewy Land, I put on his favorite music.
Mary


Thu Dec 03, 2009 11:16 am
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Mary,
Honestly that's about all we can do for them when they slip into a quiet withdraw, we can't change their future but we sure can make their days they are on this earth as pleasant as we can, to me depression is something people deal with on a daily basis not one day here and there, my husband would get into a funk and then a day or two pull out of it!

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Irene Selak


Thu Dec 03, 2009 11:47 am
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Irene
Oh boy! You hit the nail head on when you called it quiet withdrawl. I can never be sure if I should be trying to get him out of the "funk" or leave him be. I find myself saying the serenity prayer a lot these days. to change the things I can, and accept the things I can't change and the wisdom to know the difference.
The real problem is within myself. He has that quite passive personality and has always been that way. Oh, he had times when he set his foot down and wanted things his way but don't we all. Mostly that quiet, gentle passive personality.
Thanks for responding. Makes me feel someone is listening to me.
Mary


Thu Dec 03, 2009 12:27 pm
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Mary,
I have lived my whole life by the words of the Serenity Prayer, it really fits with LBD, I am long past the caregiver days and about all I can do is listen here and hear the words that are spoken from all of you still on the Lewy Path!

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Irene Selak


Thu Dec 03, 2009 1:23 pm
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