A Comparison Between Early Presentation of Dementia with Lewy Bodies, Alzheimer's Disease, and Parkinson's Disease: Evidence from Routine Primary Care and UK Biobank Data.

OBJECTIVE: The purpose of this study was to simultaneously contrast prediagnostic clinical characteristics of individuals with a final diagnosis of dementia with Lewy Bodies (DLB), Parkinson's disease (PD), and Alzheimer's disease (AD) compared with controls without neurodegenerative disorders. METHODS: Using the longitudinal THIN database in the United Kingdom, we tested the association of each neurodegenerative disorder with a selected list of symptoms and broad families of treatments, and compared the associations between disorders to detect disease-specific effects. We replicated the main findings in the UK Biobank. RESULTS: We used data of 28,222 patients with PD, 20,214 with AD, 4,682 with DLB, and 20,214 healthy controls. All neurodegenerative disorders were significantly associated with the presence of multiple clinical characteristics before their diagnosis, including sleep disorders, falls, psychiatric symptoms, and autonomic dysfunctions. When comparing patients with DLB with patients with PD and patients with AD patients, falls, psychiatric symptoms, and autonomic dysfunction were all more strongly associated with DLB in the 5 years preceding the first neurodegenerative diagnosis. The use of statins was lower in patients who developed PD and higher in patients who developed DLB compared to patients with AD. In patients with PD, the use of statins was associated with the development of dementia in the 5 years following PD diagnosis. INTERPRETATION: Prediagnostic presentations of falls, psychiatric symptoms, and autonomic dysfunctions were more strongly associated with DLB than PD and AD. This study also suggests that although several associations with medications are similar in neurodegenerative disorders, statin usage is negatively associated with PD but positively with DLB and AD as well as development of dementia in PD. ANN NEUROL 2023;94:259-270.

Effect of Stimulus Size in a Visual ERP-Based BCI under RSVP.

Rapid serial visual presentation (RSVP) is currently one of the most suitable paradigms for use with a visual brain-computer interface based on event-related potentials (ERP-BCI) by patients with a lack of ocular motility. However, gaze-independent paradigms have not been studied as closely as gaze-dependent ones, and variables such as the sizes of the stimuli presented have not yet been explored under RSVP. Hence, the aim of the present work is to assess whether stimulus size has an impact on ERP-BCI performance under the RSVP paradigm. Twelve participants tested the ERP-BCI under RSVP using three different stimulus sizes: small (0.1 × 0.1 cm), medium (1.9 × 1.8 cm), and large (20.05 × 19.9 cm) at 60 cm. The results showed significant differences in accuracy between the conditions; the larger the stimulus, the better the accuracy obtained. It was also shown that these differences were not due to incorrect perception of the stimuli since there was no effect from the size in a perceptual discrimination task. The present work therefore shows that stimulus size has an impact on the performance of an ERP-BCI under RSVP. This finding should be considered by future ERP-BCI proposals aimed at users who need gaze-independent systems.