Vol.:(0123456789) 1 3 Journal of Neural Transmission https://doi.org/10.1007/s00702-019-02129-2 NEUROLOGY AND PRECLINICAL NEUROLOGICAL STUDIES - ORIGINAL ARTICLE Diferences in cognitive profles between Lewy body and Parkinson’s disease dementia Alice Martini 1  · Luca Weis 2  · Roberta Schifano 2  · Francesca Pistonesi 3  · Eleonora Fiorenzato 2  · Angelo Antonini 3  · Roberta Biundo 2 Received: 5 November 2019 / Accepted: 18 December 2019 © Springer-Verlag GmbH Austria, part of Springer Nature 2020 Abstract Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) not only difer for the time of onset of cognitive defcits but also present variability in afected functions which are relevant in understanding underlying pathology. Cogni- tive performance of two global cognitive screening scales, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), as well as of a neuropsychological test battery, was evaluated in 18 DLB and 21 PDD patients. Feasibility for each cognitive test was investigated. Both MMSE and MoCA are feasible assessments in PDD and DLB patients. MoCA was more sensitive in discriminating groups as higher number of DLB patients showed pathological performances on the Digit Span Forward subitem (p = 0.049). The Stroop test in PDD and the Trail Making Tests—A and B, and the Benton’s judgment of line orientation tests in both groups were considered not feasible. Among feasible cogni- tive tests in at least one group, Rey–Osterrieth complex fgure test copy (p = 0.013) and semantic fuency (p = 0.038) are sensitive in discriminating DLB from PDD cognitive profle. Trail Making Tests—A and B, the Benton’s judgment of line orientation and the Stroop tests are not feasible for assessing patients with frank dementia. Longitudinal studies should not include those tasks to reduce the risk of missing data once disease progresses and dementia develops. DLB patients present more severe and widespread cognitive dysfunction than PDD, particularly in attentive, visuospatial, and language domains. Keywords Parkinson’s dementia · Dementia with Lewy bodies · Cognition · Mini-Mental State Examination (MMSE) · Montreal Cognitive Assessment (MoCA) · Feasibility Introduction Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) are synucleinopathies (Spillantini and Goedert 2000) characterized by neuronal loss and inclusions containing alpha-synuclein, and are often reported as part of the same spectrum. Neuropathology and imaging studies have revealed that up to 80% of DLB patients present coexisting extracellular Aβ-amyloid plaques (Mandal et al. 2006). PET studies have indicated the presence of amyloid deposits between 10 and 30% in early stage PD (Fiorenzato et al. 2018) and in PDD (Kalaitzakis et al. 2008). The higher severity and charac- teristics of cognitive decline in DLB vs PDD (Kramberger et al. 2017) may be associated with variability in the load and extent of Aβ and alpha-synuclein deposits (Hepp et al. 2016). Clinical diagnosis of DLB is based on the time interval from motor symptoms to dementia onset (MDI) (McKeith et al. 2017). This distinction, based exclusively on temporal criteria, has limitations, as some autopsy-confrmed DLB patients had not manifested extrapyramidal symptoms, and PD patients may show cognitive defcits early or even before motor onset (Brown and Tanner 2017; Thomas et al. 2017). Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00702-019-02129-2) contains supplementary material, which is available to authorized users. * Roberta Biundo roberta.biundo@yahoo.it 1 School of Psychology, Keele University, Newcastle-under-Lyme, UK 2 San Camillo Hospital IRCCS, Via Alberoni 70, 30126 Venice, Italy 3 Department of Neuroscience (DNS), University of Padua, Padua, Italy