Sintomas neuropsiquiátricos e domínios cognitivos específicos no comprometimento cognitivo leve

Barnes, Lucas Luchesi; Mella, Lucas Francisco Botequio; Lopes, Francisca Daniele Ferreira; Santos Junior, Amilton dos; Dalgalarrondo, Paulo

doi:10.1590/1980-5764-DN-2024-0187

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Original Article • Dement. neuropsychol. 18 • 2024 • https://doi.org/10.1590/1980-5764-DN-2024-0187 linkcopiar

Sintomas neuropsiquiátricos e domínios cognitivos específicos no comprometimento cognitivo leve

Autoria SCIMAGO INSTITUTIONS RANKINGS

Sintomas neuropsiquiátricos (SNP) como depressão, ansiedade e apatia estão presentes no comprometimento cognitivo leve (CCL) e são fatores de risco para o declínio cognitivo. No entanto, a relação entre SNP e domínios cognitivos específicos é menos clara.

Objetivo: Este estudo teve como objetivo avaliar se há correlação entre SNP e domínios cognitivos específicos.

Métodos: Estudo transversal que incluiu 174 participantes com CCL, com idade igual ou superior a 55 anos. Foram avaliadas diferenças quanto ao perfil sociodemográfico, neuroimagem e testes neuropsicológicos entre participantes com CCL com e sem SNP.

Resultados: Os participantes com SNP apresentaram menor escolaridade e pior desempenho em testes de atenção e funções executivas. Sintomas psicóticos foram correlacionados com déficits nas funções visuoespaciais; irritabilidade e agitação com desatenção e déficit de controle inibitório; e depressão com desatenção.

Conclusão: Foram encontradas correlações entre alguns SNP com domínios cognitivos específicos, especialmente sintomas psicóticos, mas também agitação, irritabilidade, apatia e depressão.

Palavras-chave:
Disfunção Cognitiva; Manifestações Neurocomportamentais; Testes Neuropsicológicos

	Neuropsychiatric symptoms		Test value	p-value
	Absent	Present	Test value	p-value
Age (mean, SD)	62.3 (7.5)	63.2 (5.8)	4371.5*	0.067
Education (years, SD)	11.8 (4.2)	10.3 (4.4)	2917.5*	0.010
Female (%)	65 (80.2)	74 (79.6)	0.012 (1)†	0.912
Tobacco use (%)	12 (14.8)	24 (25.8)	3,188 (1)†	0.074
Hypertension (%)	42 (51.9)	49 (52.7)	0.12 (1)†	0.912
DM (%)	30 (37)	32 (34.4)	0.13 (1)†	0.718
Dyslipidemia (%)	34 (42)	43 (46.2)	0.319 (1)†	0.572
Fazekas (mean, SD)	1,0 (0.6)	1,0 (0.7)	2862*	0.853
MTA (mean, SD)	0,3 (0.5)	0,4 (0.6)	2559*	0.171
MMSE (mean, SD)	26.8 (2.2)	26.9 (2.0)	3783.5*	0.932
MoCA (mean, SD)	23.0 (3.5)	22,4. (4.1)	3539*	0.491

DOMAIN	n (%)	Mean (SD)
Delusion	2 (2)	0.3 (0.2)
Hallucinations	3 (3)	0.05 (0.3)
Agitation	9 (10)	0.21 (0.7)
Aggressiveness	0	0
Depression/Dysphoria	62 (67)	4.0 (4.3)
Anxiety	38 (41)	3.1 (4.6)
Euphoria/Elation	0	0
Apathy/Indifference	24 (26)	2.8 (5.3)
Disinhibition	0	0
Irritability/Lability	28 (30)	1.9 (3.6)
Aberrant Motor Disorder	0	0
Sleep Disorders	54 (59)	1.8 (2.2)
Appetite and Eating Disorders	8 (9)	0.2 (0.6)
Aberrant Vocalizations	0	0
NPI-C total	93	14.2 (10.7)

	Neuropsychiatric symptoms		Mann-Whitney U Test	p-value
	Absent	Present	Mann-Whitney U Test	p-value
RAVLT- LOT	15.6 (6.5)	15.5 (7.1)	3,628	0.676
RAVLT- Delayed Recall	8.7 (3.1)	8.0 (3.0)	3,506.5	0.431
RAVLT- Recognition	9.9 (5.2)	10.1 (4.1)	3,788.5	0.947
Forward Digit Span	4.6 (1.0)	4.4 (0.8)	3,321.5	0.195
Reverse Digit Span	3.7 (1.0)	3.4 (1.1)	3,234	0.124
Stroop Color Test Congruent (time)	43.0 (11.0)	45.9 (11.4)	4,350.5	0.055
Stroop Color Test Congruent (errors)	0.1 (0.4)	0.04 (0.2)	3,679.5	0.806
Stroop Color Test Incongruent (time)	113.0 (45.8)	141.3 (56.5)	4,576	0.002
Stroop Color Test Incongruent (errors)	2.3 (3.2)	2.8 (4.1)	3,869.5	0.361
ROCF – Copy	26.6 (9.5)	25.2 (8.7)	3,180.5	0.077
ROCF - Memory	9.0 (5.5)	9.7 (6.1)	3,598	0.892
Semantic Verbal Fluency	15.0 (3.7)	14.2 (4.2)	3,277	0.138
Phonemic Verbal Fluency	30.1 (10.8)	27.4 (9.2)	3,302.5	0.161
Luria's Figures	13.1 (1.6)	12.8 (1.9)	3,429	0.300
TMT A	74.2 (31.0)	89 (45)	4,532	0.014
TMT B	144.2 (74.5)	210 (167.5)	3,913	0.012
TNB	54 (5.3)	53 (5.7)	3,383.5	0.247

	1	2	3	4	5	6	7	8	9	10
1. Age
2. Education	-0.349 *
3. Delusions	0.015	-0.069
4. Hallucinations	-0,060	-0.090	0.817 *
5. Agitation	-0.021	-0.141	-0.049	-0.060
6. Depression/Dysphoria	-0.136	0.068	0.147	0.050	-0.182
7. Anxiety	-0.186	0.044	0.034	-0.021	0.365 *	-0.011
8. Apathy/Indifference	-0.040	-0.029	0.235 †	0.158	-0.082	0.367 *	-0.089
9. Irritability/Lability	0.113	-0.118	-0.096	0.004	0.269 *	-0.105	0.297 *	-0.135
10. Sleep disorders	-0.046	0.012	-0.016	0.019	-0.051	0.119	0.033	0.133	0.045
11. Appetite and eating disorders	-0.143	0.046	-0.046	-0.57	-0.101	0.215 †	0.104	0.284 *	0.008	0.146

	MMSE	MoCA	RAVLT-LOT	RAVLT- Delayed Recall	RAVLT-Recognition	Forward Digit Span	Reverse Digit Span	TMT A	TMT B	Stroop Color Test Congruent (time)	Stroop Color Test Congruent (errors)	Stroop Color Test Incongruent (time)	Stroop Color Test Incongruent (errors)	ROCF - Copy	ROCF - Memory	Luria's Figures	Semantic Verbal Fluency	Phonemic Verbal Fluency	BNT
NPI-C total	-0.017	-0.106	0.072	-0.034	0.142	-0.112	-0.039	-0.018	-0.069	-0.066	-0.066	0.029	0.029	-0.046	-0.131	0.117	0.135	0.012	-0.052
Delusions	-0.202	-0.136	0.063	-0.215	-0.225 *	0.025	-0.377 †	-0.017	-0.105	-0.067	-0.017	0.062	0.081	-0.196	-0.089	-0.268 *	-0.099	0.021	-0.345 †
Hallucinations	-0.201	-0.152	0.143	-0.158	-0.209	-0.010	-0.386 †	-0. 019	-0.131	0.005	-0.038	0.010	0.048	-0.232 *	-0.076	-0.263 *	-0.125	0.068	-0.282 *
Agitation	-0.039	-0.073	-0.031	-0.031	-0.119	0.143	-0.069	-0.011	-0.074	-0.025	0.285 †	-0.043	-0.015	-0.069	0.043	0.115	0.034	-0.020	0.026
Depression	-0,151	-0,104	0,153	-0,002	0,043	-0,162	-0,029	0,093	0,043	0,065	-0,133	0,283 †	0,034	-0,025	-0,110	0,066	0,093	-0,001	-0,112
Anxiety	0.004	0.021	0.075	0.064	0.083	0.066	0.186	-0.026	0.007	-0.081	0.135	-0.101	0.060	0.027	0.811	-0.073	0.861	0.073	-0.006
Apathy	-0.010	-0.117	-0.139	0.141	0.019	-0.031	-0.133	-0.090	-0.118	0.038	-0.108	0.019	-0.127	-0.001	-0.096	0.135	0.145	0.003	-0.057
Irritability	0.059	-0.078	-0.043	0.009	0.142	-0.263 *	-0.092	0.048	-0.011	-0.129	-0.065	-0.100	0.210	-0.059	-0.039	0.103	0.009	-0.066	0.079
Sleep disorders	0.150	0.122	0.091	-0.031	0.173	0.054	0.075	-0.002	0.012	0.013	-0.027	-0.026	-0.051	-0.017	-0.198	0.088	-0.093	-0.028	0.057
Appetite disorders	0.081	-0.072	0.049	-0.059	0.188	0.114	0.047	-0.211	-0.119	-0.110	-0.57	-0.040	-0.130	-0.059	-0.090	0.013	-0.068	0.069	-0.048

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[TFN1] Abbreviations: SD, standard deviation; DM, diabetes mellitus; MTA, medial temporal lobe atrophy; MMSE, Mini-Mental State Examination; MoCA, Montreal Cognitive Assessment.

[TFN2] Notes:

[TFN3] ^*
Mann-Whitney U Test;

[TFN4] ^†
Pearson's Chi-squared test (degree of freedom).

[TFN4a] Bold indicates p-values<0.05.