title: Decision-Making Deficits Associated with Amyloidosis in Lewy Body Disorders.
abstract: Background:Lewy body disorders (LBD) are clinical syndromes characterized by pathological inclusions containing α-synuclein. Cognitive deficits are common or diagnostic in LBD, and may be associated with the presence of beta-amyloid (Aβ), which is a hallmark histopathologic abnormality characteristic of Alzheimer's disease (AD) that can also co-occur with LBD.Objective:In the present study we evaluated whether social decision-making difficulties in LBD are associated with Aβ burden.Methods:Decision-making abilities were measured with a simple, untimed, behavioral task previously validated in patients with behavioral variant frontotemporal dementia, and performance was related to gray matter atrophy on MRI. Aβ burden was assessed by examination of cerebrospinal fluid (CSF) level of Aβ1-42and by autopsy confirmation in a subgroup of patients.Results:The results revealed that LBD patients with evidence of Aβ have reduced social decision-making abilities compared to patients with no evidence of Aβ. The imaging analysis related greater decision-making difficulty in Aβ-positive patients in respect to Aβ-negative patients to gray matter atrophy in medial orbitofrontal. This region is a critical node of a decision-making network as well as a region previously associated with comorbid α-synuclein and Aβ in LBD.Conclusions:These preliminary findings suggest that cognitive difficulties in LBD extend to include deficits in social decision-making and that this may be related to the presence of Aβ.
authors.affiliation: Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of MedicinePhiladelphia, PA, USA; Brain Plasticity and Neurodegeneration Group, German Center for Neurodegenerative Diseases (DZNE)Magdeburg, Germany.
authors.forename: Nicola
authors.initials: N
authors.lastname: Spotorno
authors.affiliation: Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: Corey T
authors.initials: CT
authors.lastname: McMillan
authors.affiliation: Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Irwin
authors.affiliation: Department of Linguistics, University of Pennsylvania Philadelphia, PA, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Clark
authors.affiliation: Department of Pathology, Laboratory Medicine and the Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Lee
authors.affiliation: Department of Pathology, Laboratory Medicine and the Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: John Q
authors.initials: JQ
authors.lastname: Trojanowski
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.affiliation: Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA.
authors.forename: Murray
authors.initials: M
authors.lastname: Grossman
keywords: amyloidosis; biomarkers; decision making; lewy bodies; neuroimaging