Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study

Abstract Aim Neurological soft signs (NSSs) encompass subtle neurological abnormalities, often indicative of impaired motor and sensory integration, observed in various neuropsychiatric conditions. NSSs have been recently investigated as potential diagnostic markers in neurodegenerative dementias. W...

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Main Authors: Federico Emanuele Pozzi, Anna Falco, Gaia Gotti, Giuseppe Fiamingo, Giulia Remoli, Ildebrando Appollonio, Carlo Ferrarese, Lucio Tremolizzo
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:PCN Reports
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Online Access:https://doi.org/10.1002/pcn5.70143
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author Federico Emanuele Pozzi
Anna Falco
Gaia Gotti
Giuseppe Fiamingo
Giulia Remoli
Ildebrando Appollonio
Carlo Ferrarese
Lucio Tremolizzo
author_facet Federico Emanuele Pozzi
Anna Falco
Gaia Gotti
Giuseppe Fiamingo
Giulia Remoli
Ildebrando Appollonio
Carlo Ferrarese
Lucio Tremolizzo
author_sort Federico Emanuele Pozzi
collection DOAJ
description Abstract Aim Neurological soft signs (NSSs) encompass subtle neurological abnormalities, often indicative of impaired motor and sensory integration, observed in various neuropsychiatric conditions. NSSs have been recently investigated as potential diagnostic markers in neurodegenerative dementias. We aimed to confirm an NSS increase in subjects with cognitive decline and evaluate them in the differential diagnosis of neurodegenerative dementias. Methods A sample of 93 subjects with dementia (34 with Alzheimer's disease [AD], 29 with frontotemporal dementia [FTD], 16 with Lewy body disease [LBD], and 14 with corticobasal syndrome [CBS]) and 93 healthy controls (HCs) were assessed using the 16‐item Heidelberg NSS Scale. Results Subjects with neurodegenerative dementias exhibited significantly higher NSS scores than HCs (20.4 ± 7.9 vs. 5.7 ± 4.2, p < 0.01). Notably, those with CBS/LBD showed markedly elevated NSSs compared to those with AD and FTD (26.2 ± 6.7 vs. 18.4 ± 7.1 and 16.6 ± 6.5, respectively, p < 0.01). Diagnosis, Mini‐Mental State Examination (MMSE), Frontal Assessment Battery, and anticholinergic burden were significant predictors of NSS expression in subjects with dementia. In HCs, only age and MMSE were significant predictors. A reduced Neurological Soft Signs (rNSS) Scale, including only five items that can be administered in less than a minute, demonstrated diagnostic performances comparable to the full NSS Scale. Conclusion NSSs are increased across neurodegenerative dementia subtypes, particularly in CBS and LBD. The Heidelberg NSS Scale, as well as its variant rNSS, may serve as quick and informative tools to be added to the visits in memory clinics.
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spelling doaj-art-6f9a712cbc5846cc841a4a79a8db66392025-08-20T03:27:57ZengWileyPCN Reports2769-25582025-06-0142n/an/a10.1002/pcn5.70143Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS studyFederico Emanuele Pozzi0Anna Falco1Gaia Gotti2Giuseppe Fiamingo3Giulia Remoli4Ildebrando Appollonio5Carlo Ferrarese6Lucio Tremolizzo7Neurology Department Fondazione IRCCS San Gerardo dei Tintori Monza ItalySchool of Medicine and Surgery University of Milano‐Bicocca Milan ItalySchool of Medicine and Surgery University of Milano‐Bicocca Milan ItalySchool of Medicine and Surgery University of Milano‐Bicocca Milan ItalyNeurology Department Fondazione IRCCS San Gerardo dei Tintori Monza ItalyNeurology Department Fondazione IRCCS San Gerardo dei Tintori Monza ItalyNeurology Department Fondazione IRCCS San Gerardo dei Tintori Monza ItalyNeurology Department Fondazione IRCCS San Gerardo dei Tintori Monza ItalyAbstract Aim Neurological soft signs (NSSs) encompass subtle neurological abnormalities, often indicative of impaired motor and sensory integration, observed in various neuropsychiatric conditions. NSSs have been recently investigated as potential diagnostic markers in neurodegenerative dementias. We aimed to confirm an NSS increase in subjects with cognitive decline and evaluate them in the differential diagnosis of neurodegenerative dementias. Methods A sample of 93 subjects with dementia (34 with Alzheimer's disease [AD], 29 with frontotemporal dementia [FTD], 16 with Lewy body disease [LBD], and 14 with corticobasal syndrome [CBS]) and 93 healthy controls (HCs) were assessed using the 16‐item Heidelberg NSS Scale. Results Subjects with neurodegenerative dementias exhibited significantly higher NSS scores than HCs (20.4 ± 7.9 vs. 5.7 ± 4.2, p < 0.01). Notably, those with CBS/LBD showed markedly elevated NSSs compared to those with AD and FTD (26.2 ± 6.7 vs. 18.4 ± 7.1 and 16.6 ± 6.5, respectively, p < 0.01). Diagnosis, Mini‐Mental State Examination (MMSE), Frontal Assessment Battery, and anticholinergic burden were significant predictors of NSS expression in subjects with dementia. In HCs, only age and MMSE were significant predictors. A reduced Neurological Soft Signs (rNSS) Scale, including only five items that can be administered in less than a minute, demonstrated diagnostic performances comparable to the full NSS Scale. Conclusion NSSs are increased across neurodegenerative dementia subtypes, particularly in CBS and LBD. The Heidelberg NSS Scale, as well as its variant rNSS, may serve as quick and informative tools to be added to the visits in memory clinics.https://doi.org/10.1002/pcn5.70143Alzheimer' diseaseclinical neurologycognitiondementianeurodegeneration
spellingShingle Federico Emanuele Pozzi
Anna Falco
Gaia Gotti
Giuseppe Fiamingo
Giulia Remoli
Ildebrando Appollonio
Carlo Ferrarese
Lucio Tremolizzo
Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
PCN Reports
Alzheimer' disease
clinical neurology
cognition
dementia
neurodegeneration
title Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
title_full Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
title_fullStr Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
title_full_unstemmed Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
title_short Neurological soft signs in neurodegenerative dementias: Results of the DemeNSS study
title_sort neurological soft signs in neurodegenerative dementias results of the demenss study
topic Alzheimer' disease
clinical neurology
cognition
dementia
neurodegeneration
url https://doi.org/10.1002/pcn5.70143
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