First symptom guides diagnosis and prognosis in neurodegenerative diseases—a retrospective study of autopsy proven cases

Background and purpose Clinical diagnostic criteria for neurodegenerative diseases have been framed based on clinical phenomenology. However, systematic knowledge about the first reported symptoms in is lacking. Therefore, aim was to determine prevalence implications of symptom (FS) as assessed by medical history neuropathologically proven diseases. Methods Neuropathological diagnoses from Neurobiobank Munich, Germany, were matched with records analyses prognostic values FSs. Results In all, 301 patients neuropathological Alzheimer disease (AD), progressive supranuclear palsy (PSP), frontotemporal lobar degeneration (FTLD), Lewy body (LBD) including indistinguishable phenotypes Parkinson dementia bodies, multiple system atrophy (MSA) corticobasal (CBD) studied. Memory disturbance most common FS AD (34%), FTLD (19%) LBD (26%), gait PSP (35%) MSA (27%) aphasia personality changes CBD (20%, respectively). a model adjusting general population, predicted memory 79.0%, 97.2%, 96.0% cognitive 99.0%. Gait tremor 54.6% 97.3%, coordination 59.4% dysarthria 73.0%. Cognitive FSs associated longer survival (12.0 vs. 5.3 years; p < 0.001) (8.2 4.1 = 0.005) motor shorter (7.2 9.7; 0.048). Conclusions Assessing may be beneficial accuracy diagnosis prognosis thereby improve care precision study recruitment.