Objective: We have designed a characteristic 8-item parkinsonism questionnaire for the screening of motor dysfunction due to Lewy body dementia (LBD). We aim to test the effectiveness for the discrimination of motor dysfunction due to Parkinson’s disease dementia (PDD) from vascular dementia (VaD).

Background: Motor dysfunction is the striking feature for both Parkinson’s disease (PD) and cerebral vascular disease (CVD). However, detailed information of motor symptoms for the discrimination of the two diseases is difficult to be acquired.

Method: This study is a retrospective analysis of the project History-based Artificial Intelligent Clinical Dementia Diagnostic System (HAICDDS). A consecutive series of patients with PDD or VaD were analyzed and compared. In their demographical, clinical, neuropsychological, motor, and neuroimaging characteristics.

Results: A total of 743 participants were analyzed, included 218 PDD and 525 VaD. Compared with VaD, PDD showed higher frequency in the first 6 parkinsonism symptoms of the questionnaire (all p < 0.001) and the last symptom (monotonic and hypotonic speech, p = 0.037). However, the 7th symptom (easily falling in the early stage, p = 0.309) was not different between two groups. A cut-off score of 2/3 of total score was suggested for the discrimination of PDD from VaD (sensitivity 0.858; specificity 0.625; AUC 0.809). Whereas, if the 7th and 8th symptoms were replaced with questions regarding the history of cerebrovascular disease (CVD) and the temporal relationship of dementia and CVD, a cut-off score of 2/3 of newer total score was found better for the discrimination of PDD from VaD (sensitivity 0.835; specificity 0.855; AUC 0.923).

Conclusion: This study revealed that a simple characteristic parkinsonism questionnaire was clinically effective for the discrimination PDD from VaD. It deserves attention that a relative high prevalence (37.5%) of LBD like motor dysfunction were found in VaD patients which might rise the possibility of mixed pathologies in these patients.

References: Dahodwala, N., Siderowf, A., Baumgarten, M., Abrams, A., & Karlawish, J. (2012). Screening questionnaires for parkinsonism: a systematic review. Parkinsonism & related disorders, 18(3), 216-224.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/characteristic-parkinsonism-questionnaire-for-the-discrimination-of-parkinsons-disease-dementia-from-vascular-dementia/