Browsing by Author "Lira, D"

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Fagofobia Como Síntoma Inicial de Demencia Frontotemporal: Reporte de Caso
(Asociacion Colombiana de Psiquiatria, 2022) Custodio, N; Vences, MA; Baca, F; Montesinos, R; Failoc-Rojas, VE; Cuenca, J; Lira, D
Introduction: Frontotemporal dementia is an important cause of dementia, and its diagnosis is complex due to the multiple neurocognitive manifestations that patients present. Eating disorders associated with this pathology have been reported, but phagophobia is an atypical manifestation. Case report: We present the case of a 74-year-old adult patient with onset of phagophobia associated with a progressive and significant loss of executive functions, compromised spatial orientation, presenting in parallel a marked compromise in instrumental daily activities, psychotic symptoms, apathy, gait disturbance and sleep problems. Conclusions: It is important that adult and older patients with eating disorders, particularly those who also present cognitive, behavioural and social dysfunction are evaluated to rule out the broad spectrum of frontotemporal dementia, since timely diagnosis and treatment can improve quality of life or slow its progression.
The Memory Alteration Test Is Correlated with Clinical, Cerebrospinal Fluid, and Brain Imaging Markers of Alzheimer Disease in Lima, Peru
(S. Karger AG, 2024) Custodio, N; Malaga, M; Montesinos, R; Chambergo-Michilot, D; Baca, F; Carbajal, JC; Huilca, JC; Herrera-Perez, E; Lira, D; Diaz, MM; Lanata, S
Introduction: As disease-modifying therapies become available for Alzheimer’s disease (AD), detection of AD in early stages of illness (mild cognitive impairment [MCI], early dementia) becomes increasingly important. Biomarkers for AD in low- and middle-income countries (LMICs) are costly and not widely available; hence, it is important to identify cognitive tests that correlate well with AD biomarker status. In this study, we evaluated the memory alteration test (M@T) to detect biomarker-proven AD and quantify its correlation with neurodegeneration and cerebrospinal fluid (CSF) AD biomarkers in a cohort of participants from Lima, Peru. Methods: This is a secondary analysis of a cohort of 185 participants: 63 controls, 53 with amnestic MCI (aMCI), and 69 with dementia due to AD. Participants underwent testing with M@T and a gold standard neuropsychological battery. We measured total tau (t-tau), phosphorylated tau (p-tau), and beta-amyloid (β-amyloid) in CSF, and evaluated neurodegeneration via medial temporal atrophy score in MRI. We used receiver-operator curves to determine the discriminative capacity of the total M@T score and its subdomains. We used the Pearson coefficient to correlate M@T score and CSF biomarkers. Results: The M@T had an area under the curve (AUC) of 0.994 to discriminate between controls and cognitively impaired (aMCI or AD) patients, and an AUC of 0.98 to differentiate between aMCI and AD patients. Free-recall and cued recall had the highest AUCs of all subdomains. Total score was strongly correlated with t-tau (−0.77) and p-tau (−0.72), and moderately correlated with β-amyloid (0.66). The AUC for discrimination of neurodegeneration was 0.87. Conclusion: The M@T had excellent discrimination of aMCI and dementia due to AD. It was strongly correlated with CSF biomarkers and had good discrimination of neurodegeneration. In LMICs, the M@T may be a cost-effective screening tool for aMCI and dementia caused by AD.