Abstract Details

Title Confrontation Naming Deficit in Lewy Body Dementia Patients with Alzheimer’s Disease Co-Pathology

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P16 - Poster Session 16 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-002

Objective

To test the association of confrontation naming performance in LBD patients with AD CSF biomarkers.

Background

Lewy Body Dementias (LBD) are characterized by alpha-synuclein pathology but ~50% have sufficient Alzheimer’s disease (AD) co-pathology at autopsy for a second neuropathological diagnosis. These patients have worse overall prognosis, but little is known regarding the specific influence on cognition. LBD cognitive impairment is heterogeneous with core features of executive and visuospatial dysfunction; however, language difficulty is not uncommon and previous work suggests confrontation naming impairment may be associated with AD tau co-pathology.

Design/Methods

We selected LBD patients (n=86) (PDD=36, DLB=50) with available CSF and neuropsychological data. AD CSF biomarkers were measured using the Luminex platform. We used an autopsy-validated cutpoint (Total-tau:Abeta42 ratio>0.3) to categorize patients as LBD with AD co-pathology (LBD+AD=33) and those without (LBD-AD=53). We used ANCOVA to test between-group comparisons on confrontation naming (30-item Boston Naming Test=BNT) and core features of executive (Letter Fluency=LF) and visuospatial (modified 6-item Judgment of Line Orientation=JOLO) functioning while adjusting for sex, disease duration, global cognition (MMSE) and clinical phenotype. Pearson correlation related testing to CSF analytes.

Results

LBD+AD (mean=20.59, SD=6.31, n=22) performed worse on BNT than LBD-AD (mean=26.12, SD=3.85, n=32) (F=20.846, p<0.0001; clinical phenotype and demographic covariates were not associated with BNT, p>0.1). In contrast, both groups were similarly impaired on LF (LBD+AD mean=7.58, SD=6.31, n=19; LBD-AD mean=9.45, SD=5.19, n=31) (F=1.174, p>0.1) and JOLO (LBD+AD mean=3.07, SD=2.22, n=15; LBD-AD mean=4.08, SD=1.98, n=25) (F=2.414, p>0.1). We also found a moderate correlation between lower BNT score and increased CSF total-tau (r=-0.52, p<0.0001) and phosphorylated-tau (r=-0.45, p<0.001) but not ABeta42 (r=0.21, p=0.12).

Conclusions

These findings suggest that AD tau co-pathology has a specific influence on phenotypic expression of LBD in the language domain. BNT may be a useful clinical test to screen for likely mixed pathology, which has important prognostic implications.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Katya Rascovsky (University of Pennsylvania Perelman School of Medicine)	No disclosure on file
Naomi Nevler, MD (Hospital of the University of Pennsylvania)	No disclosure on file
Thomas F. Tropea, DO (University of Pennsylvania)	Dr. Tropea has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bial. The institution of Dr. Tropea has received research support from NINDS. The institution of Dr. Tropea has received research support from Parkinson Foundation. The institution of Dr. Tropea has received research support from Michael J Fox Foundation.
Alice Chen-Plotkin, MD	Dr. Chen-Plotkin has received intellectual property interests from a discovery or technology relating to health care.
Andrew D. Siderowf, MD	Dr. Siderowf has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer-Ingelheim. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for askbio. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for capsida. Dr. Siderowf has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Parkinson Study Group. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theravance. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prilenia. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wave. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurogastrix. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prevail. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alerity. Dr. Siderowf has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Clintrex. Dr. Siderowf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Inhibikase. Dr. Siderowf has a non-compensated relationship as a Scientific Advisory Board with NeuroPacs that is relevant to AAN interests or activities.
Daniel Weintraub	Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Clintrex. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scion. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Modality.ai. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CuraSen. Daniel Weintraub has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Takeda. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Daniel Weintraub has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Daniel Weintraub has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorder Society. The institution of Daniel Weintraub has received research support from NIH. The institution of Daniel Weintraub has received research support from Fox Foundation. The institution of Daniel Weintraub has received research support from IPMDS. Daniel Weintraub has received intellectual property interests from a discovery or technology relating to health care.
Leslie M. Shaw, PhD (Perelman School of Med, U of PA)	Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Shaw has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Shaw has received research support from NIA. The institution of Dr. Shaw has received research support from MJ Fox foundation for Parkinsons Research.
John Q. Trojanowski, MD, PhD (University of PA School of Med)	Dr. Trojanowski has nothing to disclose.
Murray Grossman, MD, FAAN (University of Pennsylvania)	Dr. Grossman has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Grossman has received research support from NIH.
David Irwin, MD (University of Pennsylvania)	The institution of Dr. Irwin has received research support from NIH. The institution of Dr. Irwin has received research support from Prevail. The institution of Dr. Irwin has received research support from Passage Bio. The institution of Dr. Irwin has received research support from Alector. The institution of Dr. Irwin has received research support from Transposon. The institution of Dr. Irwin has received research support from Denali. The institution of Dr. Irwin has received research support from Cervo Med.

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