Pattern and implications of neurological examination findings in autosomal dominant Alzheimer disease.
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Vöglein Jonathan, Franzmeier Nicolai, Morris John C, Dieterich Marianne, McDade Eric, Simons Mikael, Preische Oliver, Hofmann Anna, Hassenstab Jason, Benzinger Tammie L, Fagan Anne, Noble James M, Berman Sarah B, Graff-Radford Neill R, Ghetti Bernardino, Farlow Martin R, Chhatwal Jasmeer P, Salloway Stephen, Xiong Chengjie, Karch Celeste M, Cairns Nigel, Perrin Richard J, Day Gregory, Martins Ralph, Sanchez-Valle Raquel, Mori Hiroshi, Shimada Hiroyuki, Ikeuchi Takeshi, Suzuki Kazushi, Schofield Peter R, Masters Colin L, Goate Alison, Buckles Virginia, Fox Nick C, Chrem Patricio, Allegri Ricardo, Ringman John M, Yakushev Igor, Laske Christoph, Jucker Mathias, Höglinger Günter, Bateman Randall J, Danek Adrian, Levin Johannes, Dominantly Inherited Alzheimer Network
Аннотация
METHODS: Frequencies of neurological examination findings were compared between symptomatic mutation carriers and non mutation carriers from the Dominantly Inherited Alzheimer Network (DIAN) to define AD neurological examination findings. AD neurological examination findings were analyzed regarding frequency, association with and predictive value regarding cognitive decline, and association with brain atrophy in symptomatic mutation carriers.
RESULTS: AD neurological examination findings included abnormal deep tendon reflexes, gait disturbance, pathological cranial nerve examination findings, tremor, abnormal finger to nose and heel to shin testing, and compromised motor strength. The frequency of AD neurological examination findings was 65.1%. Cross-sectionally, mutation carriers with AD neurological examination findings showed a more than two-fold faster cognitive decline and had greater parieto-temporal atrophy, including hippocampal atrophy. Longitudinally, AD neurological examination findings predicted a significantly greater decline over time.
DISCUSSION: ADAD features a distinct pattern of neurological examination findings that is useful to estimate prognosis and may inform clinical care and therapeutic trial designs.