Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort

Frédéric Blanc (1, 2, 3) , Vincent Bouteloup (4, 5) , Claire Paquet (6) , Marie Chupin (7) , Florence Pasquier (8, 9) , Audrey Gabelle (10, 11, 12) , Mathieu Ceccaldi (13, 14) , Paulo Loureiro de Sousa (2) , Pierre Krolak-Salmon (15) , Renaud David (16, 17, 18) , Clara Fischer (7) , Jean-François Dartigues (19, 5) , David Wallon (20) , Olivier Moreaud (21, 22) , Mathilde Sauvée (21, 22) , Catherine Belin (6) , Sandrine Harston (5) , Anne Botzung (3, 1) , Timothée Albasser (3, 1) , Catherine Demuynck (1, 3) , Izzie-Jacques Namer (2) , Marie-Odile Habert (7) , Stéphane Kremer (2) , Olivier Bousiges (1, 3) , Marc Verny (23, 24) , Candice Muller (1, 3, 2) , Nathalie Philippi (25, 1, 3) , Geneviève Chêne (5, 4) , Benjamin Cretin (2, 1, 3) , Jean-François Mangin (7, 26) , Carole Dufouil (4, 5)

1 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
2 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
3 CMRR Strasbourg - Centre Mémoire Ressources et Recherche [Strasbourg]
4 BPH - Bordeaux population health
5 CHU de Bordeaux - Centre Hospitalier Universitaire de Bordeaux
6 AP-HP - Hopital Saint-Louis [AP-HP]
7 CATI - Centre d'Acquisition et de Traitement des Images [Paris] = CATI Multicenter Neuroimaging Platform
8 LilNCog - Lille Neurosciences & Cognition - U 1172
9 CMRR - Centre Mémoire de Ressources et de Recherche [Lille-Bailleul]
10 INM - Institut des Neurosciences de Montpellier
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 CMRR - Centre Mémoire de Ressources et de Recherches
13 TIMONE - Hôpital de la Timone [CHU - APHM]
14 INS - Institut de Neurosciences des Systèmes
15 HCL - Hospices Civils de Lyon
16 CobTek - Cognition Behaviour Technology
17 CHU Nice - Centre Hospitalier Universitaire de Nice
18 CMRR Nice - Centre Mémoire de Ressources et de Recherche [Nice]
19 UB - Université de Bordeaux
20 Service de neurologie [Rouen]
21 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
22 CMRR - Centre Mémoire de Ressources et de Recherche [Grenoble]
23 CHU Pitié-Salpêtrière [AP-HP]
24 B2A-IBPS - Adaptation Biologique et Vieillissement = Biological Adaptation and Ageing
25 UNISTRA - Université de Strasbourg
26 NEUROSPIN - Service NEUROSPIN

Background Isolated subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) are the prodromal phases of dementia with Lewy bodies (DLB). MEMENTO is a nationwide study of patients with SCI and MCI with clinic, neuropsychology, biology, and brain imaging data. We aimed to compare SCI and MCI patients with symptoms of prodromal DLB to others in this study at baseline. Methods Participants of the French MEMENTO cohort study were recruited for either SCI or MCI. Among them, 892 were included in the Lewy sub-study, designed to search specifically for symptoms of DLB. Probable prodromal DLB diagnosis (pro-DLB group) was done using a two-criteria cutoff score among the four core clinical features of DLB. This Pro-DLB group was compared to two other groups at baseline: one without any core symptoms (NS group) and the one with one core symptom (1S group). A comprehensive cognitive battery, questionnaires on behavior, neurovegetative and neurosensory symptoms, brain 3D volumetric MRI, CSF, FDG PET, and amyloid PET were done. Results The pro-DLB group comprised 148 patients (16.6%). This group showed more multidomain (59.8%) MCI with slower processing speed and a higher proportion of patients with depression, anxiety, apathy, constipation, rhinorrhea, sicca syndrome, and photophobia, compared to the NS group. The pro-DLB group had isolated lower P-Tau in the CSF (not significant after adjustments for confounders) and on brain MRI widening of sulci including fronto-insular, occipital, and olfactory sulci (FDR corrected), when compared to the NS group. Evolution to dementia was not different between the three groups over a median follow-up of 2.6 years. Conclusions Patients with symptoms of prodromal DLB are cognitively slower, with more behavioral disorders, autonomic symptoms, and photophobia. The occipital, fronto-insular, and olfactory bulb involvement on brain MRI was consistent with symptoms and known neuropathology. The next step will be to study the clinical, biological, and imaging evolution of these patients. Trial registration Clinicaltrials.gov , NCT01926249

Mots clés: Dementia with Lewy bodies; Lewy body disease; Mild cognitive impairment; Mild neurocognitive impairment; Prodromal; Subjective cognitive impairment

Domaines: Neurosciences; Médecine humaine et pathologie

Frédéric Blanc, Vincent Bouteloup, Claire Paquet, Marie Chupin, Florence Pasquier, et al.. Prodromal characteristics of dementia with Lewy bodies: baseline results of the MEMENTO memory clinics nationwide cohort. Alzheimer's Research and Therapy, 2022, 14 (1), pp.96. ⟨10.1186/s13195-022-01037-0⟩. ⟨hal-03769651⟩