Neuropsychological and neuroanatomical underpinnings of the face pareidolia errors on the noise pareidolia test in patients with mild cognitive impairment and dementia due to Lewy bodies.

OBJECTIVE: Prior research on the Noise Pareidolia Test (NPT) has demonstrated its clinical utility in detecting patients with mild cognitive impairment and dementia due to Lewy Body Disease (LBD). However, few studies to date have investigated the neuropsychological factors underlying pareidolia errors on the NPT across the clinical spectrum of LBD. Furthermore, to our knowledge, no research has examined the relationship between cortical thickness using MRI data and NPT subscores. As such, this study sought to explore the neuropsychological and neuroanatomical factors influencing performance on the NPT utilizing the National Alzheimer's Coordinating Center Lewy Body Dementia Module. METHODS: Our sample included participants with normal cognition (NC; n = 56), LBD with mild cognitive impairment (LBD-MCI; n = 97), and LBD with dementia (LBD-Dementia; n = 94). Archival data from NACC were retrospectively analyzed for group differences in neuropsychological test scores and cognitive and psychiatric predictors of NPT scores. Clinicoradiological correlates between NPT subscores and a small subsample of the above LBD participants were also examined. RESULTS: Analyses revealed significant differences in NPT scores among groups. Regression analysis demonstrated that dementia severity, attention, and visuospatial processing contributed approximately 24% of NPT performance in LBD groups. Clinicoradiological analysis suggests a potential contribution of the right fusiform gyrus, but not the inferior occipital gyrus, to NPT pareidolia error scores. CONCLUSIONS: Our findings highlight the interplay of attention and visuoperceptual functions in complex pareidolia in LBD. Further investigation is needed to refine the utility of NPT scores in clinical settings, including identifying patients at risk for visual illusions and hallucinations.

The Behavioral Dyscontrol Scale in the differential diagnosis of behavioral variant of frontotemporal dementia and Alzheimer disease.

OBJECTIVE: The Behavioral Dyscontrol Scale (BDS) is a brief measure of frontal systems that is adopted from Luria's syndrome analysis approach. The aim of this study was to evaluate the diagnostic utility of the BDS as an objective measure of self-regulation in behavioral variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). METHODS: Two patient groups matched in education and dementia severity (n = 21 bvFTD and 21 AD) recruited from a memory clinic and a matched normal control (NC) group (n = 21) were administered a battery of neuropsychological tests including the BDS. RESULTS: ROC analyses revealed that performance on the BDS discriminated between the bvFTD group and the AD and NC groups, as well as between AD and NC groups. Hierarchical multiple linear regression analysis showed that the majority of the variance in BDS performance was explained by executive tests. CONCLUSIONS: the BDS has good psychometric prosperities; is easy to administer and score; is well tolerated by geriatric patients; and is useful diagnostically for discriminating bvFTD from AD, yielding good to excellent sensitivity and specificity values.