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Aim: The aim was to evaluate the contribution of cerebral perfusion SPECT data and ERPs recording as tools to serve the neuropsychological and clinical diagnosis in Mild Cognitive Impairment (MCI). Methods: Forty-three patients (age 66.4±7.6; 12 men; MMSE 27.1±2.3; education 10.7±4.1) performed a selective neuropsychological battery to assess general cognitive status, short- and long-term verbal memory, general intelligence, constructional praxia and verbal fluency. All patients underwent ERPs recordings (N400 and P300) and 99mTcHMPAO SPECT. Results: Pathological performances were recorded in the following neurological tests: Rey Auditory Verbal Learning Test (45.0%), FAB (42.9%), Verbal Span (39.5%), Prose Recall (37.2%). The P300 and N400 were altered in 39.5% and 85.0% of the patients tested, respectively. Overall, a significantly higher regional hypoperfusion incidence was detected in all patients with a special interest of the limbic lobe bilaterally, the left frontal lobe (BA6,8,9,44) and of the left temporal lobe (BA20,22,38). Conclusion: According to our findings, MCI subjects show a significantly altered ERPs and SPECT pattern: the functional impairment is likely to precede detectable structural changes and cognitive deficit. Thus, the use of ERPs and SPECT might be considered as a valuable tool for clinicians to longitudinally screen and monitor subjects with memory disorders, so an early diagnosis of MCI might be able to predict the conversion from MCI to dementia.

Aim: To evaluate whether the presence of GBA or PARK2 gene mutations are associated to more severe impulse control disorders and related behaviors (ICD-RB) in Parkinson’s disease (PD). Methods: We enrolled a consecutive series of PD patients according with the following criteria: diagnosis of PD according to Gelb’s criteria; early-onset of PD (< 50 years) or positive family history for PD; disease duration of at least 3 years; dopaminergic treatment of at least 300 LED; genetic assessment available for PARK2 and GBA. Each patient was evaluated with a complete neuropsychological assessment, ICD-RB was investigated using QUIP-rating scale (0-112). QUIP scores were expressed as means (±SD) and compared between the three groups by non-parametric analysis. Results: We enrolled a series of 38 patients. 15 patients carried a mutation in the GBA gene, 12 patients carried a mutation in the Parkin gene, 11 patients were not carriers. There was no difference among groups in age at onset, disease duration or LED. Frequency of ICD was significantly higher in the GBA group compared with Parkin and non carriers (pConclusions: We found more severe ICD-RB in PD patients who carry heterozygous GBA gene mutation than in Parkin patients or in non carrier. GBA mutation status may be an independent risk factor for impulse control disorder and related behaviours in patients with PD.

Observational study of demented patients with psychotic disorders and their pharmacological treatment: the Ad Care experience Aim: Alzheimer evaluation units are a focal point for individuals with cognitive impairment, which could be associated with behaviour disorders. More and more frequently, patients with cognitive deficits who have already been treated by specialists with antipsychotic medications are sent to us for a better diagnosis. Methods: In a period of 12 months, we observed 68 patients afferent for the first time to our Unit Alzheimer (UVA) with cognitive and/or behavioural deficits and based on a data registration sheet, drawn up by us, we obtained immediate information on patients who have already been treated with drugs and which drugs were used. Results: the patients’ data obtained with the SRD allowed us to promptly detect that the 5 subjects affected with Front temporal dementia (FTD) and 1 subject affected with Lewy Body disease already took typical and atypical antipsychotics. None of the 29 patients affected with Alzheimer Disease (AD) took acetylcholinesterase inhibitors, only three took antipsychotics and two took benzodiazepines. 4 out of 9 subject affected with vascular dementia (VaD) were treated with antipsychotics; 5 out of 23 subjects affected with Mild Cognitive Impairment (MCI) took benzodiazepines and tow took antipsychotics Conclusion: A study of data collection extended systematically to all patients attending the UVA may be a tool for rapid use that would allow for a correct estimation of clinical treatment, the evaluation of the tolerability and effectiveness and eventual adverse effects by observing the single subjects in the progression of the disease or in the case of MCI, in the eventual evolution of the disease.