Aberrant Motor Behavior Research Articles

Neuropsychiatric symptoms and severity of dementia.

Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their familiesOBJECTIVETo evaluate the prevalence of NPS as a specific stage of dementia status.METHODSA cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software.RESULTSThe 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006).CONCLUSIONAlzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

Amelioration of Behavioral Abnormalities in BH4-deficient Mice by Dietary Supplementation of Tyrosine

This study reports an amelioration of abnormal motor behaviors in tetrahydrobiopterin (BH4)-deficient Spr −/− mice by the dietary supplementation of tyrosine. Since BH4 is an essential cofactor for the conversion of phenylalanine into tyrosine as well as the synthesis of dopamine neurotransmitter within the central nervous system, the levels of tyrosine and dopamine were severely reduced in brains of BH4-deficient Spr −/− mice. We found that Spr −/− mice display variable ‘open-field’ behaviors, impaired motor functions on the ‘rotating rod’, and dystonic ‘hind-limb clasping’. In this study, we report that these aberrant motor deficits displayed by Spr −/− mice were ameliorated by the therapeutic tyrosine diet for 10 days. This study also suggests that dopamine deficiency in brains of Spr −/− mice may not be the biological feature of aberrant motor behaviors associated with BH4 deficiency. Brain levels of dopamine (DA) and its metabolites in Spr −/− mice were not substantially increased by the dietary tyrosine therapy. However, we found that mTORC1 activity severely suppressed in brains of Spr −/− mice fed a normal diet was restored 10 days after feeding the mice the tyrosine diet. The present study proposes that brain mTORC1 signaling pathway is one of the potential targets in understanding abnormal motor behaviors associated with BH4-deficiency.

Impact of behavioral subsyndromes on cognitive decline in Alzheimer’s disease: data from the ICTUS study

Behavioral and psychological symptoms of dementia (BPSD) represent common manifestations among patients affected by Alzheimer's disease (AD). Some reports have recently classified BPSD into specific clusters/subsyndromes exploring the internal structure of the Neuropsychiatric Inventory (NPI). We evaluated whether specific behavioral subsyndromes are associated with worsening cognitive function. Mild to moderate AD patients were recruited from the cohort of the Impact of Cholinergic Treatment USe (ICTUS) study. Neuropsychiatric symptoms were classified in three subsyndromes, identified at baseline, grouping different combinations of NPI items: (1) "psychotic" ("delusions" and/or "hallucinations"); (2) "affective" ("agitation" and/or "depression" and/or "anxiety" and/or "irritability"); and (3) "behavioral" ("euphoria" and/or "apathy" and/or "disinhibition" and/or "aberrant motor behavior"). Mixed model analyses were performed to measure six-monthly changes in the ADAS-Cog score over a follow-up of 2 years, according to these subsyndromes. All analyses were stratified according to AD severity as defined by the Clinical Dementia Rating (CDR). A total of 1,375 AD subjects were recruited. No NPI cluster was found to significantly (p < 0.05) affect the rate of cognitive decline across the 3 CDR classes. Our results suggest that the cognitive course of AD is not substantially influenced by the presence of specific neuropsychiatric phenotypes. Further studies are needed to extend the present findings and identify possible biological and clinical bases for behavioral subsyndromes.

Sleep Disturbances in Alzheimer’s Disease Are Associated With Neuropsychiatric Symptoms and Antidementia Treatment

Sleep disturbances (SDs) in Alzheimer's disease (AD) may significantly affect the behavioral, functional, and cognitive capacities of patients to the point of becoming a major determinant of caregiver burden. We conducted a cross-sectional study in 125 patients with probable AD to assess the association of SDs with neuropsychiatric symptoms, cognitive and functional status of patients, and severity and duration of dementia and to ascertain the role of antidementia drugs in the treatment of SD. SDs were assessed using the questionnaire on sleep disorders in the Neuropsychiatric Inventory. The prevalence of SDs in this sample was 36%. SDs in patients with AD are significantly associated with depression (Wald's test, 3.983; p < 0.05), disinhibition (Wald's test, 5.522; p < 0.05), and aberrant motor behavior (Wald's test, 7.430; p < 0.01). The patients treated with memantine presented lower mean SDs scores (t = 2.76; p < 0.001). These results highlight the need for a standardized and validated approach to the assessment of SDs in AD.

Neuropsychiatric symptoms in Alzheimer's disease are related to functional connectivity alterations in the salience network

Neuropsychiatric syndromes are highly prevalent in Alzheimer's disease (AD), but their neurobiology is not completely understood. New methods in functional magnetic resonance imaging, such as intrinsic functional connectivity or "resting-state" analysis, may help to clarify this issue. Using such approaches, alterations in the default-mode and salience networks (SNs) have been described in Alzheimer's, although their relationship with specific symptoms remains unclear. We therefore carried out resting-state functional connectivity analysis with 20 patients with mild to moderate AD, and correlated their scores on neuropsychiatric inventory syndromes (apathy, hyperactivity, affective syndrome, and psychosis) with maps of connectivity in the default mode network and SN. In addition, we compared network connectivity in these patients with that in 17 healthy elderly control subjects. All analyses were controlled for gray matter density and other potential confounds. Alzheimer's patients showed increased functional connectivity within the SN compared with controls (right anterior cingulate cortex and left medial frontal gyrus), along with reduced functional connectivity in the default-mode network (bilateral precuneus). A correlation between increased connectivity in anterior cingulate cortex and right insula areas of the SN and hyperactivity syndrome (agitation, irritability, aberrant motor behavior, euphoria, and disinhibition) was found. These findings demonstrate an association between specific network changes in AD and particular neuropsychiatric symptom types. This underlines the potential clinical significance of resting state alterations in future diagnosis and therapy.

The effects of small vessel disease and amyloid burden on neuropsychiatric symptoms: a study among patients with subcortical vascular cognitive impairments

Neuropsychiatric symptoms (NPS) affect the quality of life of patients with dementia and increase the burden on caregivers. We aimed to evaluate how small vessel disease (SVD) such as lacunae or white matter hyperintensities (WMH), and amyloid burden affect NPS. We recruited 127 patients with subcortical vascular cognitive impairment who were assessed with brain magnetic resonance imaging, Pittsburgh compound-B (PiB) positron emission tomography and the neuropsychiatric inventory (NPI). To explore the association between lacunae, WMH, or PiB retention ratio and NPS, we performed multivariate regression analysis after controlling for possible confounders. Each additional lacuna, especially in the frontal region, was associated with higher odds of depression, apathy, aberrant motor behavior, nighttime behavior, appetite changes, and higher score of total NPI; larger WMH volume, especially in the frontal region, was associated with higher odds of apathy and higher score of total NPI. Furthermore, for the effects of lacunae or WMH on total NPI score we set Clinical Dementia Rating Sum of Boxes as the mediator. Greater PiB retention ratio was associated with higher odds of delusions and irritability. The SVD and amyloid pathologies did not show interactive effects on NPS. Our findings suggested that SVD and amyloid burden independently affected specific NPS.

Missing Data Analysis in Drug-Naïve Alzheimer's Disease with Behavioral and Psychological Symptoms

PurposeTo clarify the effects of missing values due to behavioral and psychological symptoms in dementia (BPSD) in Alzheimer's disease (AD) patients on the neuropsychological tests, this study describes the pattern of missing values due to BPSD, and its influence on tests.Materials and MethodsDrug-naïve probable AD patients (n=127) with BPSD and without BPSD (n=32) were assessed with Seoul Neuropsychological Screening Battery including measures of memory, intelligence, and executive functioning. Moreover, patients were rated on Korean Neuropsychiatry Inventory (K-NPI).ResultsThe more severe the K-NPI score, the less neuropsychological tests were assessable, leading to many missing values. Patients with BPSD were more severely demented than those without BPSD. K-NPI scores were significantly correlated with the number of missing values. The effect of BPSD was largest for tests measuring frontal functions. The replacement of the missing values due to BPSD by the lowest observed score also showed the largest effect on tests of frontal function.ConclusionThe global cognitive and behavior scales are related with missing values. Among K-NPI sub-domains, delusion, depressing, apathy, and aberrant motor behavior are significantly correlated for missing values. Data imputation of missing values due to BPSD provides a more differentiated picture of cognitive deficits in AD with BPSD.

Clinical efficacy and changes in the dosages of concomitantly used psychotropic drugs in memantine therapy in Alzheimer's disease with behavioral and psychological symptoms on dementia.

We investigated the clinical efficacy and changes in the dosages of concomitantly used psychotropic drugs in memantine therapy in Alzheimer's disease (AD) with behavioral and psychological symptoms on dementia (BPSD). The subjects were 38 inpatients who had been diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). The outcome measures assessed were BPSD and cognitive function. BPSD was assessed using the neuropsychiatric inventory (NPI) and cognitive function was assessed using the mini-mental examination (MMSE). The changes in the dosages of concomitant psychotropic drugs were also assessed. SIGNIFICANT DECREASES WERE FOUND IN THE MEMANTINE THERAPY GROUP IN THE FOLLOWING NPI TOTAL SCORE AND FIVE NPI SUBSCALES: delusions, hallucinations, agitation, irritability, and aberrant motor behavior, but no significant differences were seen between the memantine therapy group and the control group. Furthermore, the memantine therapy group allowed the dosage of the psychotropic drugs to be significantly reduced compared with the control group. The results of this study suggest that the administration of memantine to patients with AD with BPSD may afford superior efficacy and may also make it possible to reduce the risperidone equivalent dose, the diazepam equivalent dose and the dosage of the psychotropic drugs.

Weight changes in Alzheimer's disease patients with increased aberrant motor behavior

Weight loss and behavioral disturbances are frequent over the course of Alzheimer's disease (AD) and are risk factors for poor outcome. We investigated the impact of aberrant motor behavior (AMB) on weight changes in older adults with AD. The hypothesis that patients with AMB are more likely to lose weight than patients without AMB was assessed. A prospective study of 686 patients with moderate AD from the REAL.FR cohort was assessed. The AMB at baseline was defined by the item 10 from the Neuropsychiatric Inventory scale (NPI-10). Patients were classified as "no or light AMB" (NPI-10 < 4), and "significant AMB" (NPI-10 ≥ 4). Weight changes were determined over the 4-year follow-up. The mean weight change over the 4 years was +2.2 ± 0.9 kg in patients with "significant AMB," whereas weight remained stable in patients with "no or light AMB" (p = 0.02). Older adults with moderate AD and "significant AMB" do gain weight.

Prevalence of Neuropsychiatric Symptoms in Young-Onset Compared to Late-Onset Alzheimer’s Disease – Part 1: Findings of the Two-Year Longitudinal NeedYD-Study

Background/Aims: Knowledge about neuropsychiatric symptoms in young-onset Alzheimer’s disease (YO-AD) is scarce, but essential to establish a prognosis and plan care for YO-AD patients. The aim of this study is to assess frequency parameters of neuropsychiatric symptoms in YO-AD over 2 years and investigate whether there are differences compared with late-onset Alzheimer’s disease (LO-AD). Methods: 98 YO-AD and 123 LO-AD patients and caregivers from two prospective cohort studies were included and assessed every 6 months for 2 years, using the Neuropsychiatric Inventory to evaluate neuropsychiatric symptoms. Results: Over the course of 2 years, the incidence, prevalence and persistence of neuropsychiatric symptoms were in general lower in YO-AD than in LO-AD, specifically for delusions, agitation, depression, anxiety, apathy, irritability and aberrant motor behavior. Frequency of individual symptoms showed large variability in both groups. Within the group of YO-AD patients, apathy was the most prevalent symptom. Conclusion: Neuropsychiatric symptoms, notably apathy, should be paid appropriate attention to in the diagnosis and treatment of YO-AD patients. Further research is needed to gain insight into the mechanisms underlying the differences in neuropsychiatric symptoms between YO-AD and LO-AD.

Genetic association between APOE*4 and neuropsychiatric symptoms in patients with probable Alzheimer's disease is dependent on the psychosis phenotype

BackgroundNeuropsychiatric symptoms such as psychosis are prevalent in patients with probable Alzheimer’s disease (AD) and are associated with increased morbidity and mortality. Because these disabling symptoms are generally not well tolerated by caregivers, patients with these symptoms tend to be institutionalized earlier than patients without them. The identification of protective and risk factors for neuropsychiatric symptoms in AD would facilitate the development of more specific treatments for these symptoms and thereby decrease morbidity and mortality in AD. The E4 allele of the apolipoprotein E (APOE) gene is a well-documented risk factor for the development of AD. However, genetic association studies of the APOE 4 allele and BPS in AD have produced conflicting findings.MethodsThis study investigates the association between APOE and neuropsychiatric symptoms in a large sample of clinically well-characterized subjects with probable AD (n=790) who were systematically evaluated using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Behavioral Rating Scale for Dementia (BRSD).ResultsOur study found that hallucinations were significantly more likely to occur in subjects with no APOΕ4 alleles than in subjects with two Ε4 alleles (15% of subjects and 5% of subjects, respectively; p=.0066), whereas there was no association between the occurrence of delusions, aberrant motor behavior, or agitation and the number of Ε4 alleles. However, 94% of the subjects with hallucinations also had delusions (D+H).ConclusionThese findings suggest that in AD the Ε4 allele is differentially associated with D+H but not delusions alone. This is consistent with the hypothesis that distinct psychotic subphenotypes may be associated with the APOE allele.

The prevalence and the course of neuropsychiatric symptoms in patients with dementia

Dementia is prevalent in Norway and other countries and is hallmarked by a decline in memory and other cognitive abilities. In addition to cognitive decline, the vast majority of patients with dementia experience neuropsychiatric symptoms (NPS) such as depression, agitation, psychosis, apathy, or irritability. In this review, we describe the prevalence and the course of NPS in patients with dementia, referring to results of population-based studies, studies of outpatients, and studies of patients in long-term care. For a better comparison of the included studies and for clarification, we have included studies that have assessed NPS with the Neuropsychiatric Inventory (NPI). Overall, we found a high prevalence rate of NPS. At least one NPS (NPI &gt; 0) was present in 56% to 98% of the patients and 62% to 84% of the patients had at least one clinically significant NPS (NPI &gt; 3). The NPS with the highest prevalence rate were apathy, irritability, agitation, depression and anxiety; while delusion, hallucination, disinhibition, aberrant motor behavior and euphoria were the least frequent NPS.

Patterns of neuropsychiatric sub-syndromes in Brazilian and Norwegian patients with dementia

Neuropsychiatric symptoms (NPS) affect the majority of patients who have dementia. Neuropsychiatric sub-syndromes with symptoms that occur together and have common neurobiological correlates have been identified. There are scarce data regarding the comparison of the pattern of the neuropsychiatric sub-syndromes in distinct ethnical and cultural populations. We aim at comparing the pattern of the NPS, and the factor analysis of the Neuropsychiatric Inventory (NPI-10) in two samples of outpatients with dementia living in Brazil and Norway. This is a cross-sectional study. The sample consists of 168 Brazilian and 155 Norwegian demented patients from psychogeriatric facilities and community-based educational programs. Brazilian patients were diagnosed with Alzheimer's disease (63.7%), vascular dementia (15.5%), or mixed dementia (20.8%), whereas the diagnoses of Norwegian patients were Alzheimer's disease (97.4%) and mixed dementia (2.6%). Principal component analysis with the Varimax rotation was used for factor analysis of the NPI-10. Apathy (80.4 %), agitation/aggression (45.8%), and aberrant motor behavior (45.8%) were the most common symptoms in the Brazilian sample. Apathy (72.3%), dysphoria (61.9%), and anxiety (52.3%) were the most frequent symptoms in the Norwegian sample. Factor analysis of the NPI-10 revealed three syndromes for the Brazilian (Psychosis, Mood, Psychomotor) and Norwegian (Psychosis, Mood, Frontal) groups. The frequency of individual NPS may differ among distinct populations. However, Psychosis and Depression are common sub-syndromes in diverse ethnical and cultural patients with dementia. Our findings support the syndromic approach for the clinical assessment of the patients with dementia.

Neuropsychiatric Symptoms and Global Functional Impairment along the Alzheimer’s Continuum

Background/Aims: Neuropsychiatric symptoms in Alzheimer’s disease (AD) are highly prevalent. We sought to determine whether neuropsychiatric symptoms were related to global functional impairment at baseline and over a 3-year period in older normal control (NC), mild cognitive impairment (MCI) and mild AD dementia subjects. Methods: Eight hundred and twelve subjects (229 NC, 395 MCI, 188 AD) from the Alzheimer’s Disease Neuroimaging Initiative study underwent cognitive and behavioral assessments over 3 years. Results: Greater hallucinations, anxiety and apathy were associated with greater global functional impairment at baseline, while the presence of hallucinations and apathy at baseline was associated with greater global functional impairment over time across all subjects. The following neuropsychiatric symptoms were not significantly associated with global functioning: delusions, agitation, depression, euphoria, disinhibition, irritability, aberrant motor behaviors, sleep and appetite. Conclusions: These results suggest that increased baseline hallucinations, apathy and anxiety are associated with current and future disease progression in AD.

The association between cognitive impairment and neuropsychiatric symptoms in patients with Parkinson's disease dementia

Neuropsychiatric symptoms (NPS) are common in patients with dementia associated with Parkinson's disease (PDD). The relationship between cognition and NPS in PDD has not been well studied. Patients diagnosed with PDD were assessed for cognitive function and NPS. The instruments used were the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and semantic verbal fluency according to the recommendation of the Movement Disorder Society Task Force. We evaluated 127 PDD patients (76 males/51 females; mean age 77 ± 6.3 years). Their mean MMSE score was 17 ± 6.5 and the mean NPI score was 19 ± 20.4. The most prevalent NPI items were anxiety (57.5%), sleep problems (53.5%), and apathy (52.0%). Principal component factor analysis revealed that 12 items formed three factors, namely "mood and psychosis" (delusion, hallucination, agitation, depression, anxiety, apathy, and irritability), "vegetative" (sleep and appetite problems), and "frontal" (euphoria, disinhibition, and aberrant motor behavior). Symptoms of hallucination were significantly associated with MMSE score, even after controlling for the confounding variables. NPS are common and diverse among patients with PDD. Three specific subgroups of NPS were identified. Hallucination was significantly correlated with cognitive impairment, and could be a predictor of cognition in PDD patients.

P3‐240: Small‐vessel disease, amyloid burden and neuropsychiatric symptoms

Neuropsychiatric symptoms (NPS) are important as they impact the quality of life of patients with dementia and increase burden to care givers. About 90% of patients with Alzheimer's disease (AD) and about 92% of patients with vascular dementia (VaD) experience NPS. When comparing NPS profiles between patients with AD and patients with VaD, previous studies show several conflicting results. In previous studies, diagnosis were made without pathologic informations thus dementia subtypes probably were not clearly classified. In this study, dementia subtypes were classified according to amyloid burden assessed by Pittsburg compound-B (PiB) PET and severity of white matter hyperintensities (WMH) measured on MRI in addition to clinical diagnosis. We tested whether WMH and amyloid burdens affect behavioral and neuropsychiatric symptoms. We prospectively recruited 70 patients with AD and 70 patients with VaD and underwent MRI, [11 C] PiB-PET scan, Neuropsychiatric Inventory (NPI) and MMSE. Three patients with incomplete data and 7 patients who were diagnosed as AD but had no amyloid deposit by PiB PET were excluded. Patients with AD were divided into two groups according to WMH severity (AD with severe WMH and AD without severe WMH) and logistic analysis was done to see effect of WMH on prevalence of NPS. Patients with VaD were divided into two groups according to PiB-PET result (VaD with amyloid deposit and VaD without amyloid deposit) and logistic analysis was done to see effect of amyloid burden on prevalence of NPS. Logistic regression analysis indicated that most NPS (delusion, hallucination, agitation, depression, anxiety, euphoria, apathy, disinhibition, irritability, aberrant motor behavior and appetite changes) were not affected by WMH severity. However, severe WMH was associated with more sleep disturbances in patients with AD (odds ratio 10.78, p=0.026) after adjusted for age, gender, education level and MMSE. In patients with VaD no NPS was affected by amyloid burden. Our results show that neither WMH nor amyloid burden act as major effect modifier regarding NPS.

Prevalence of Neuropsychiatric Symptoms across the Declining Memory Continuum: An Observational Study in a Memory Clinic Setting

Aims: The study aimed to compare the frequency of neuropsychiatric symptoms (NPS) across the declining memory continuum, from normal aging, subjective cognitive impairment (SCI), and mild cognitive impairment (MCI) to Alzheimer’s disease (AD), and to explore the clinical correlates of NPS. Method: In a memory clinic, 157 subjects (46 mild AD patients, 38 MCI individuals, 24 SCI subjects, and 49 normal controls) completed the neurobehavioral assessments with the Neuropsychiatric Inventory (NPI). The clinical significance of each NPI domain was defined as an item score ≥4. Result: Clinically significant depression was more common in the SCI than in the normal control group (p < 0.05). The frequency of NPS was significantly greater in the mild AD group compared to other groups. Clinically significant apathy and aberrant motor behavior were more common among the AD group than the MCI group (p < 0.05). The MMSE score (OR 4.84, 95% CI 1.92–12.16, p = 0.001) and apathy (OR 12.73, 95% CI 1.48–109.68, p = 0.021) significantly determined the diagnostic status as MCI or mild AD. Conclusion: Across the declining memory continuum, the frequency of NPS was highest among mild AD patients. Depression, apathy, and aberrant motor behavior deserve more attention. Presence of apathy might be an independent determinant for mild AD.

Neuropsychiatric symptom clusters of Alzheimer's disease in Hong Kong Chinese: prevalence and confirmatory factor analysis of the Neuropsychiatric Inventory

The aim of this study was to investigate the clustering of symptoms on the Neuropsychiatric Inventory (NPI) and the relative prevalence of symptom clusters in mild and moderate Alzheimer's disease (AD). Confirmatory factor analysis (CFA) was performed on the polychoric correlation matrix of 12 NPI items (scored yes or no) using the weighted least squares with mean and variance adjustment (WLSMV) estimator in Mplus (N = 224 community-dwelling Chinese persons with mild/moderate AD). Severity of AD was determined by Clinical Dementia Rating scores. The relative model fit of three competing measurement models (also known as factor structures) was tested using a modified χ2 difference test. Prevalence rates across mild and moderate stages were compared using χ2 tests. Furthermore, the measurement model of choice was cross-validated in an independent sample of 181 community-dwelling persons with dementia. CFA supported a four-factor model, namely behavioral problems (agitation/aggressiveness, disinhibition, irritability, and aberrant motor behavior), psychosis (delusions and hallucinations), mood disturbance (depression, anxiety, sleep, appetite, and apathy), and euphoria (a stand-alone item that is equivalent to the factor). The most prevalent symptom clusters were behavioral (72%) and mood (69%) disturbances, followed by psychosis (45%). Euphoria was rare (6%). All syndromes were more prevalent in moderate than in mild stage, except for euphoria. In addition, the four-factor model was replicated in the cross-validation sample. The four syndromes provide a parsimonious conceptualization of neuropsychiatric symptoms corresponding to clinical observations and neurochemical changes of the disease. The independent replication in the second sample supports generalization of the four-factor model in Chinese persons with AD.

Neuropsychiatric Features of Parkinsonism Dementia Complex and Other Neurodegenerative Diseases on Guam (P05.040)

Objective: To assess the neuropsychiatric features of patients with neurodegenerative diseases on Guam. Background A unique clinical syndrome of amyotrophic lateral sclerosis/parkinsonism dementia complex (ALS/PDC) is seen in Guam but other neurodegenerative diseases are also present. Much of the focus has been on the cognitive aspects of these dementias, while it is now known that neuropsychiatric symptoms feature prominently in neurodegenerative disease. The Neuropsychiatric Inventory (NPI) assesses psychopathology in dementia patients by evaluating 12 neuropsychiatric disturbances commonly encountered in patients with dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. Our aim was to compare the neuropsychiatric symptoms of patients with PDC and those with non-PDC neurodegenerative disease. Design/Methods: We evaluated the neuropsychiatric symptoms of 28 consecutive patients with dementia on Guam using the NPI. We used Chi-square tests to compare NPI symptoms in patients with PDC vs. those with non-PDC neurodegenerative diseases. Results: Amongst the 28 patients with dementia and an NPI, 8 had PDC and 20 had another neurodegenerative disease: AD/vascular (8), AD (7), vascular dementia (1), dementia with Lewy bodies (2), and choreiform disorders (2). Comparing the NPI symptoms in patients with PDC vs. all other neurodegenerative disease combined revealed significant differences in incidence of depression (63% vs. 15%, respectively, p=0.02), appetite/eating abnormalities (62% vs. 15%, respectively, p=0.02), and night-time behavior disturbances (50% vs. 10%, respectively, p=0.04). Conclusions: Many neuropsychiatric symptoms were observed in PDC and in non-PDC neurodegenerative diseases on Guam. Depression, changes in eating habits and night-time behavior disturbances were significantly more common in PDC. These differences likely relate to the underlying anatomical alterations and pathophysiology in PDC. Neuropsychiatric symptoms are present in PDC and are distressful to patients and caregivers, further study is required. Disclosure: Dr. Tartaglia has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Geschwind has received personal compensation for activities with Gerson Lehrman Group, Clinical Advisors, MedaCorp and Esai, Inc. as a consultant and/or speaker. Dr. Perry has nothing to disclose. Dr. Afaisen has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Ketelle has nothing to disclose. Dr. Steele has nothing to disclose. Dr. Miller has received personal compensation for activities with Allon Therapeutics, Inc. and TauRx Therapeutics, Ltd. Dr. Miller has received research support from Novartis.

Neuropsychiatric Inventory Profile in Frontal Dementias (P07.170)

Objective: Our propose is to investigate whether there are certain Neuro-Psychiatric Inventory(NPI) item patterns distinguishing among neurodegenerative diseases with frontal component. Background Different neurologic disorders have characteristic neuropsychiatric manifestations and distinctive Neuropsychiatric Inventory (NPI) profiles. Design/Methods: We studied 311 subjects,from 2 specialized dementia centers. Following the international diagnostic criteria all the subjects (male:146, female:165) were classified in six distinct diagnostic entities: behavioral-variant-FTD(bv-FTD, n=121), semantic-FTD(sem-FTD, n=69), primary progressive aphasia(FTD-PPA, n=31), FTD-MotorNeuronDiseasen=4, excluded from further analysis), progressive supranuclear palsy(PSP, n=43), corticobasal degeneration(CBD, n=43). Multivariate regression models were used to assess associations of total NPI score, as well as the score for each one of the 12 NPI items, with disease type, while adjusting for center, gender, age, education, handedness and disease duration. Results: When using bv-FTD as reference disease, total NPI score was strongly significantly lower in CBD(p=0.001), FTD-PPA(p=0.001), PSP(p=0.002), and sem-FTD(p=0.010). In analysis of individual NPI items, compared to bv-FTD, CBD patients had significantly lower scores at the elements of aggressiveness, apathy, irritability, aberrant motor behavior, appetite disturbance, disinhibition and euphoria (p Conclusions: Among neurodegenerative diseases with frontal component, neuropsychiatric function as assessed by the NPI scale was significantly worse in bv-FTD than in any other disease. Among the other diseases, differences were generally small, except a somewhat better overall function in CBD. Disclosure: Dr. Papatriantafyllou has nothing to disclose. Dr. Ghika has nothing to disclose. Dr. Papageorgiou has nothing to disclose. Dr. Tsinia has nothing to disclose. Dr. Lykou has nothing to disclose. Dr. Chatziantoniou has nothing to disclose. Dr. Agiomyrgiannakis has nothing to disclose. Dr. Kyrozis has nothing to disclose. Dr. Papageorgiou has nothing to disclose.