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Prevalence of Primitive Reflexes and Parkinsonian Signs in Dementia

Published online by Cambridge University Press:  02 December 2014

K. A. Links ,
D. Merims ,
M. A. Binns ,
M. Freedman  and
T. W. Chow
K. A. Links
Affiliation:
Baycrest Rotman Research Institute
D. Merims
Affiliation:
Baycrest Rotman Research Institute
M. A. Binns
Affiliation:
Dalla Lana School of Public Health, University Health Network-Mt. Sinai Hospital Baycrest Rotman Research Institute
M. Freedman
Affiliation:
Department of Medicine, Division of Neurology, University Health Network-Mt. Sinai Hospital Division of Neurology, University of Toronto Baycrest Division of Neurology, Toronto, Ontario, Canada
T. W. Chow*
Affiliation:
Department of Medicine, Division of Neurology, University Health Network-Mt. Sinai Hospital Department of Psychiatry, Division of Geriatric Psychiatry, University Health Network-Mt. Sinai Hospital Baycrest Rotman Research Institute Baycrest Division of Neurology, Toronto, Ontario, Canada
*
Baycrest, Rotman Research Institute, 3560 Bathurst Street, 8th Floor Brain Health Complex, Toronto, Ontario, M6A 2E1,Canada.
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Abstract

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Objective:

Primitive reflexes and parkinsonian signs are used by clinicians to differentiate among dementias. We reviewed our clinical sample to determine whether primitive reflexes were more prevalent in frontally-based dementias and whether parkinsonian signs were more common in dementia with Lewy bodies (DLB) than in other types of dementia.

Design:

We retrospectively reviewed charts from 204 patients with dementia who presented for consultation at Baycrest's Ross Memory Clinic between April, 2003, to December, 2007.

Results:

A greater proportion of subjects with DLB and dementia of the Alzheimer type with cardiovascular disease had primitive reflexes than subjects with frontotemporal dementia (FTD). Primitive reflexes were not positively predictive of FTD or vascular dementia (VaD). Dementia with Lewy bodies subjects were more likely to have parkinsonian signs than the other dementias, and bradykinesia and rigidity were positively predictive of FTD. The palmomental reflex was the most common primitive reflex in the sample, and cogwheeling was the most common parkinsonian sign. There was no significant difference between early- and late-stage groups in presence of primitive reflexes or parkinsonian signs.

Conclusions:

Primitive reflexes appear not to be clinically discriminative of frontally-based dementias such as FTD and VaD.

Résumé:

RÉSUMÉ:Objectif:

Les réflexes primitifs et les signes parkinsoniens sont utilisés par les cliniciens pour faire la distinction entre les démences. Nous avons révisé nos observations cliniques pour déterminer si la prévalence des réflexes primitifs était plus élevée dans les démences frontales et si les signes parkinsoniens étaient plus fréquents dans la démence à corps de Lewy (DCL) par rapport aux patients atteints de d’autres types de démence.

Plan de l’étude:

Nous avons révisé rétrospectivement les dossiers de 204 patients atteints de démence qui ont consulté au Baycrest Hospital Ross Memory Clinic entre avril 2003 et décembre 2007.

Résultats:

Une proportion plus élevée de sujets atteints de DCL et de démence de type Alzheimer accompagnée de maladie cardiovasculaire avaient des réflexes primitifs que les patients atteints de démence frontotemporale (DFT). Les réflexes primitifs n’étaient pas des facteurs de prédiction positifs de la DFT ou de la démence vasculaire (DVA). Les sujets atteints de DCL étaient plus susceptibles d’avoir des signes parkinsoniens que les patients atteints d’autres démences et la bradycinésie et la rigidité étaient des facteurs de prédiction positifs de la DFT. Le réflexe palmo-mentonnier était le réflexe primitif le plus frequent et la roue dentée était le signe parkinsonien le plus fréquent. Il n’y avait pas de différence significative entre les groupes en phase précoce et en phase tardive de la maladie quant à la présence des réflexes primitifs ou des signes parkinsoniens.

Conclusions:

Au point de vue clinique, les réflexes primitifs ne semblent pas ètre discriminants dans les démences frontales telles la DFT et la DVA.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 5 , September 2010 , pp. 601 - 607
Copyright
Copyright © The Canadian Journal of Neurological 2010

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