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Mild Cognitive Impairment Subtypes in a Cohort of Elderly Essential Tremor Cases

Published online by Cambridge University Press:  03 April 2017

Kathleen Collins ,
Brittany Rohl ,
Sarah Morgan ,
Edward D. Huey ,
Elan D. Louis  and
Stephanie Cosentino
Kathleen Collins
Affiliation:
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut
Brittany Rohl
Affiliation:
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut
Sarah Morgan
Affiliation:
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut
Edward D. Huey
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
Elan D. Louis
Affiliation:
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut
Stephanie Cosentino*
Affiliation:
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
*
Correspondence and reprint requests to: Stephanie Cosentino, 630 W. 168th Street, New York, NY, 10032. E-mail: sc2460@cumc.columbia.edu
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Abstract

Objectives

Individuals with essential tremor (ET) exhibit a range of cognitive deficits generally conceptualized as “dysexecutive” or “fronto-subcortical,” and thought to reflect disrupted cortico-cerebellar networks. In light of emerging evidence that ET increases risk for Alzheimer’s disease (AD), it is critical to more closely examine the nature of specific cognitive deficits in ET, with particular attention to amnestic deficits that may signal early AD.

Methods

We performed a cross-sectional analysis of baseline data from 128 ET cases (age 80.4±9.5 years) enrolled in a longitudinal, clinical-pathological study. Cases underwent a comprehensive battery of motor-free neuropsychological tests and a functional assessment to inform clinical diagnoses of normal cognition (ET-NC), mild cognitive impairment (MCI) (ET-MCI), or dementia (ET-D). ET-MCI was subdivided into subtypes including: amnestic single-domain (a-MCI), amnestic multi-domain (a-MCI+), non-amnestic single-domain (na-MCI), or non-amnestic multi-domain (na-MCI+).

Results

Ninety-one (71.1%) cases were ET-NC, 24 (18.8%) were ET-MCI, and 13 (10.2%) were ET-D. Within MCI, the a-MCI+ subtype was the most common (13/24; 54.2%) followed by a-MCI (4/24; 16.7%), na-MCI+ (4/24; 16.7%), and na-MCI (3/24; 12.5%). Cases with amnestic MCI demonstrated lower recognition memory Z-scores (−2.4±1.7) than non-amnestic groups (−0.9±1.2) (p=.042).

Conclusions

Amnestic MCI, defined by impaired memory recall but associated with lower memory storage scores, was the most frequent MCI subtype in our study. Such impairment has not been explicitly discussed in the context of ET and may be an early hallmark of AD. Results have implications for the prognosis of specific cognitive deficits in ET. (JINS, 2017, 23, 390–399)

Keywords

Movement disordersCognitionDementiaMemoryExecutive functionLongitudinal

Information

Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 23 , Issue 5 , May 2017 , pp. 390 - 399
Copyright
Copyright © The International Neuropsychological Society 2017 

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