Objectives: The prodromal stage of dementia with Lewy bodies (pro-DLB) has recently been defined (McKeith's et al., 2020). However, the neuropsychological profile, in relation to patient’s clinical onset (i.e., mild cognitive impairment [MCI], psychiatric-onset, or delirium-onset), has not yet been investigated. This study aimed to identify the neuropsychological markers of pro-DLB. Methods: We included pro-DLB patients (20 MCI-DLB, 13 Psychiatric-onset) and 18 MCI due to Alzheimer’s disease (AD). All patients underwent an extensive neuropsychological battery and neuropsychiatric questionnaire. Qualitative neuropsychological indices for principal neurocognitive deficit observed in DLB patients were developed to capture subtle differences in pro-DLB. Results: In comparison to MCI-AD, pro-DLB patients showed a better performance in verbal memory tasks. On the contrary, pro-DLB patients had deficit in computerized tests of alertness and working memory, in visuo-perceptive, visuo-spatial and visuo-constructive processing. Using computerized test of alertness, both MCI-LB and psychiatric-onset patients showed worse performance than MCI-AD. Although MCI-LB had a more severe cognitive profile, no relevant difference emerged between MCI-LB and psychiatric group. Qualitative neuropsychological analysis indicated that MCI-LB committed more visuo-spatial errors than MCI-AD but Psychiatric too. Regarding neuropsychiatric symptoms, MCI-LB patients had greater anxiety, more severe and frequent hallucinations and sleep disorders rather than MCI-AD but not compared to Psychiatric. Conclusions: The neuropsychological profile of pro-DLB patients is characterized by deficits in visuo-perceptive, visuo-spatial and visuo-constructive abilities as well as attention. No significative difference emerged between MCI-LB and Psychiatric, suggesting neuropsychiatric similarity as possible confirmation of LB underlying pathology. The use of computerized tasks and qualitative indices could improve the neuropsychological assessment of prodromal DLB. These findings highlight the need to develop neuropsychological evaluations tailored to detect early alterations in in pro-DLB.
Neuropsychological markers of prodromal Lewy body dementia. Preliminary results / Zazzaro, Giulia; Conti, Desirée; Panigutti, Massimiliano; Bechi Gabrielli, Giulia; Serrentino, Marco; Sepe Monti, Micaela; Talarico, Giuseppina; Canevelli, Marco; Bruno, Giuseppe; D’Antonio, Fabrizia. - (2026). (Intervento presentato al convegno Congresso annuale della Società Italiana di Neuropsicologia (SINP) 2025 tenutosi a Copenhagen; Denmark).
Neuropsychological markers of prodromal Lewy body dementia. Preliminary results
Giulia ZazzaroPrimo
;Desirée ContiSecondo
;Massimiliano Panigutti;Giulia Bechi Gabrielli;Marco Serrentino;Micaela Sepe Monti;Giuseppina Talarico;Marco Canevelli;Giuseppe Bruno;Fabrizia D’AntonioUltimo
2026
Abstract
Objectives: The prodromal stage of dementia with Lewy bodies (pro-DLB) has recently been defined (McKeith's et al., 2020). However, the neuropsychological profile, in relation to patient’s clinical onset (i.e., mild cognitive impairment [MCI], psychiatric-onset, or delirium-onset), has not yet been investigated. This study aimed to identify the neuropsychological markers of pro-DLB. Methods: We included pro-DLB patients (20 MCI-DLB, 13 Psychiatric-onset) and 18 MCI due to Alzheimer’s disease (AD). All patients underwent an extensive neuropsychological battery and neuropsychiatric questionnaire. Qualitative neuropsychological indices for principal neurocognitive deficit observed in DLB patients were developed to capture subtle differences in pro-DLB. Results: In comparison to MCI-AD, pro-DLB patients showed a better performance in verbal memory tasks. On the contrary, pro-DLB patients had deficit in computerized tests of alertness and working memory, in visuo-perceptive, visuo-spatial and visuo-constructive processing. Using computerized test of alertness, both MCI-LB and psychiatric-onset patients showed worse performance than MCI-AD. Although MCI-LB had a more severe cognitive profile, no relevant difference emerged between MCI-LB and psychiatric group. Qualitative neuropsychological analysis indicated that MCI-LB committed more visuo-spatial errors than MCI-AD but Psychiatric too. Regarding neuropsychiatric symptoms, MCI-LB patients had greater anxiety, more severe and frequent hallucinations and sleep disorders rather than MCI-AD but not compared to Psychiatric. Conclusions: The neuropsychological profile of pro-DLB patients is characterized by deficits in visuo-perceptive, visuo-spatial and visuo-constructive abilities as well as attention. No significative difference emerged between MCI-LB and Psychiatric, suggesting neuropsychiatric similarity as possible confirmation of LB underlying pathology. The use of computerized tasks and qualitative indices could improve the neuropsychological assessment of prodromal DLB. These findings highlight the need to develop neuropsychological evaluations tailored to detect early alterations in in pro-DLB.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
