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Neuropsychiatric symptoms and their neural correlates in individuals with mild cognitive impairment

Published online by Cambridge University Press:  30 January 2023

Natascia De Lucia Open the ORCID record for Natascia De Lucia [Opens in a new window] ,
Giovanni Carbone ,
Benedetta Muzii ,
Nicola Ferrara ,
Giuseppe Rengo ,
Nelson Mauro Maldonato ,
Grazia Daniela Femminella Open the ORCID record for Grazia Daniela Femminella [Opens in a new window]  and
Alzheimer’s Disease Neuroimaging Initiative
Natascia De Lucia*
Affiliation:
Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Naples, Italy
Giovanni Carbone
Affiliation:
Department of Translational Medical Sciences, “Federico II” University, Naples, Italy
Benedetta Muzii
Affiliation:
Department of Humanistic Studies, “Federico II” University, Naples, Italy
Nicola Ferrara
Affiliation:
Department of Translational Medical Sciences, “Federico II” University, Naples, Italy
Giuseppe Rengo
Affiliation:
Department of Translational Medical Sciences, “Federico II” University, Naples, Italy Instituti Clinici Scientifici Maugeri IRCCS - Scientific Institute of Telese Terme (BN), Telese BN, Italy
Nelson Mauro Maldonato
Affiliation:
Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Naples, Italy
Grazia Daniela Femminella*
Affiliation:
Department of Translational Medical Sciences, “Federico II” University, Naples, Italy Department of Brain Sciences, Imperial College London, London, UK
*
Correspondence should be addressed to: Natascia De Lucia and Grazia Daniela Femminella, via S. Pansini 5, 80131, Naples, Italy. Phone: +39 0817682480; Fax: +39 0817682480. Email: natascia.delucia@unina.it; graziadaniela.femminella@unina.it.
Correspondence should be addressed to: Natascia De Lucia and Grazia Daniela Femminella, via S. Pansini 5, 80131, Naples, Italy. Phone: +39 0817682480; Fax: +39 0817682480. Email: natascia.delucia@unina.it; graziadaniela.femminella@unina.it.
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Abstract

Objectives:

Neuropsychiatric symptoms are common in subjects with MCI and associated with higher risk of progression to AD. The cognitive and neuroanatomical correlates of neuropsychiatric symptoms in MCI have not been fully elucidated. In this study, we sought to evaluate the association between neuropsychiatric symptoms, cognitive function, regional tau deposition, and brain volumes in MCI subjects.

Methods:

A total of 233 MCI and 305 healthy comparisons were selected from the ADNI-3 cohort. All the subjects underwent a comprehensive neuropsychological assessment, volumetric MR brain scan, and Flortaucipir PET for in vivo assessment of regional tau deposition. Prevalence of neuropsychiatric symptoms was evaluated by means of the NPI questionnaire. Multivariate analyses of variance were used to detect differences in cognitive and imaging markers in MCI subjects with and without neuropsychiatric symptoms.

Results:

61.4% MCI subjects showed at least one neuropsychiatric symptom, with the most prevalent ones being depression (26.1%), irritability (23.6%), and sleep disturbances (23.6%). There was a significant effect of neuropsychiatric symptoms on cognitive tests of frontal and executive functions. MCI subjects with neuropsychiatric symptoms showed reduced brain volumes in the orbitofrontal and posterior cingulate cortices, while no effects were detected on regional tau deposition. Posterior cingulate cortex volume was the only predictor of global neuropsychiatric burden in this MCI population.

Conclusions:

Neuropsychiatric symptoms occur early in the AD trajectory and are mainly related to defects of control executive abilities and to the reduction of gray matter volume in the orbitofrontal and posterior cingulate cortices. A better understanding of the cognitive and neuroanatomical mechanisms of neuropsychiatric symptoms in MCI could help develop more targeted and efficacious treatment alternatives.

Keywords

mild cognitive impairmentneuropsychiatric inventoryfrontal functionsADNI-3
Type
Original Research Article
Information
International Psychogeriatrics , Volume 35 , Special Issue 11: Issue Theme: Neuropsychiatric Symptoms of Mild and Major Neurocognitive Disorders , November 2023 , pp. 623 - 632
Copyright
© International Psychogeriatric Association 2023

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Footnotes

*

An affiliation has been added for Giuseppe Rengo. An addendum detailing this change has also been published (doi: 10.1017/S1041610223000376).

Data used IN preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate IN analysis OR writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wpcontent/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf

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