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Introduction: With the advent of anti-ß-amyloid therapies, clinical distinction between Aß + and Aß- in cognitive impairment is becoming increasingly important for stratifying referral and better utilization of biomarker assays. Methods: Cognitive profile, rate of decline, neuropsychiatric inventory questionnaire (NPI-Q), and imaging characteristics were collected from 52 subjects with possible/probable AD. Results: Participants with Aß+ status had lower baseline MMSE scores (24.50 vs. 26.85, p = 0.009) and higher total NPI-Q scores (2.73 vs. 1.18, p < 0.001). NPI-Q score was found to be the only independent predictor for ß-amyloid positivity (p = 0.008). A simple scoring system, namely Clinical ß-Amyloid Positivity Prediction Score (CAPS), was developed by using the following parameters: NPI-Q, rapidity of cognitive decline, and white matter microangiopathy. Data from 48 participants were included in the analysis of accuracy of CAPS. CAP Score of 3 or 4 successfully classified Aß+ individuals in 86.7% cases. Discussion: Clinical ß-Amyloid Positivity Prediction Score is a simple clinical tool for use in primary care and memory clinic settings to predict ß-amyloid positivity in individuals with clinical Alzheimer Syndrome can potentially facilitate referral for Anti Aß therapies. [ABSTRACT FROM AUTHOR]

Byline: Shambaditya. Das, Arpan. Dutta, Peyalee. Sarkar, Souvik. Dubey, Durjoy. Lahiri, Alak. Pandit, Goutam. Gangopadhyay, Biman. Ray Sir, Bilateral facial nerve palsy (FNP) is an uncommon entity (incidence of 1 [...]

Byline: Souvik. Dubey, Durjoy. Lahiri, Biman. Ray The constellation of cerebral calcification, white matter disease, and cyst in brain parenchyma is known as Labrune syndrome, after the name of the [...]

Bilingualism may affect the profile of cognitive disturbances associated with stroke. Its impact on aphasia severity, however, is in need of substantiation. To determine the relationship between bilingualism and vascular aphasia severity. This is an observational cross-sectional study conducted on people with post-stroke aphasia. Our sample included 155 monolingual and 53 bilingual vascular aphasia patients. They were selected in a neurological hospital in Kolkata (West Bengal, India). The Bengali version of Western Aphasia Battery (BWAB) was used in this study. Aphasia severity was compared between monolingual and bilingual participants. The overall difference in the mean aphasia quotient (AQ) between bilingual and monolingual participants was statistically significant (p = 0.009). It was also found that in bilingual participants, aphasia was less severe in certain subgroups, namely: higher lesion volume, male gender, and sub-cortical stroke, while in none of the subgroups a monolingual advantage was documented. Current results suggest that bilingualism represents a protective factor in vascular aphasia; this effect is observed particularly in some aphasia subgroups. [ABSTRACT FROM AUTHOR]

Dementia of vascular origin is a distinct variety with a heterogeneous neuropsychological profile. Very few studies have compared the behavioral dysfunction in the large vessel and small vessel vascular dementia (VaD) and studied the association between executive dysfunction and behavioral dysfunction documented in these patients, between the white matter load in small vessel disease (SVD) and the behavioral dysfunction. 76 patients having a modified Hachinski Ischemic Scale score of ≥ 4 were recruited and categorized into a small vessel and large vessel VaD. The Neuropsychiatric Inventory (NPI) score ≥ 4 per domain for defining clinically relevant symptoms and the Clinical Dementia Rating Scale (CDR) for evaluating the severity of dementia were used. Behavioral and Psychological Symptoms of Dementia (BPSD) were present in 66.67% of patients with SVD and 53.57% of those having large vessel disease. Apathy, euphoria, and disinhibition were more common in SVD, while appetite alterations were more common in large vessel disease. Behavioral dysfunction was also associated with executive dysfunction in both the VaD subtypes and with white matter loads in SVD. We conclude that different VaD subtypes have different behavioral profiles. This might help in understanding the underlying pathophysiology, diagnosis and thus better management of this disorder. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the rate of occurrence of neuropsychiatric symptoms (NPS) and their relationship with age, sex and cognitive performance in subjects with Alzheimer's disease and related dementias (Alzheimer's disease and related dementias [ADRD]). Methods: This is a retrospective matched case‐control study. Data from memory clinic patients included demographic information presence of NPS, and cognitive testing of Orientation, Immediate and Delayed Memory, Visuospatial Function, Working Memory, Attention, Executive Control and Language. Participants were Individuals with subjective cognitive impairment (n = 352), mild cognitive impairment (MCI) (n = 369), vascular MCI (n = 80), Alzheimer's disease (n = 147), vascular dementia (n = 41), mixed dementia (n = 33), and healthy controls (n = 305). Logistic regression was used to investigate the relationship between the presence of NPS, age and sex. A generalised additive model was used to investigate the relationship between presence of NPS, age and cognitive impairment. Analysis of variance was used to investigate differences in cognition between younger and older groups with and without NPS. Results: We found an increased likelihood of occurrence of NPS in younger individuals and females across cohorts. Anxiety, depression, agitation, and apathy were associated with higher overall rate of NPS. We also found that individuals under 65 years of age with NPS had worse cognitive scores than their counterpart without NPS. Conclusion: The younger group with ADRD and NPS had lower cognitive scores, probably reflecting more aggressive neurodegenerative disease. Further work will be needed to elicit the degree to which imaging or mechanistic abnormalities distinguish this group. Key points: Younger individuals with Alzheimer's disease and related dementias (ADRD) were more likely to present with neuropsychiatric symptoms (NPS) than older individuals.Younger individuals with ADRD and NPS showed lower cognitive scores than individuals in the same age group without NPS, which was not observed in the older group. [ABSTRACT FROM AUTHOR]

Byline: Apoorva. Pauranik, Nipun. Pauranik, Pinki. Singh, Durjoy. Lahiri, Gopee. Krishnan Background: Aphasia is one of those clinical conditions, where the role of affiliated professionals, mainly speech language pathologists (SLPs) [...]

Byline: Durjoy. Lahiri, Alfredo. Ardila, Souvik. Dubey, Biman. Ray Introduction: Contemporary neuro-imaging techniques have significantly advanced our understanding of the brain organization of language and the involvement of subcortical areas [...]

Background: Weston Hurst syndrome (WHS), also known as acute hemorrhagic leukoencephalitis (AHLE), has not been previously associated with mixed connective tissue disease (MCTD), a rare rheumatologic disorder. Case presentation: We report a case of a 35‐year‐old female who presented with deep coma with features of previously undiagnosed MCTD and responded favorably to intravenous immunoglobulin (IVIG) therapy. On detailed historical enquiry, clinical examination, and investigation, AHLE was diagnosed. Furthermore, our patient showed significant improvement with IVIG administration, even though initial steroid therapy was unsuccessful. Conclusion: AHLE, an associated novel neurological manifestation of MCTD, can be responsive to IVIG, which makes this case reportable from the diagnostic as well as the therapeutic point of view. [ABSTRACT FROM AUTHOR]

Background: Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome. Methods: We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models. Results: We included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67–82]), than encephalopathy (54% [42–65]). Intensive care use was high (38% [35–41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27–32]. The hazard of death was comparatively lower for patients in the WHO European region. Interpretation: Neurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission. [ABSTRACT FROM AUTHOR]