Dementia of the Alzheimer type: effects on the spontaneous EEG described by dipole sources

The present study on brain electrical activity in healthy subjects (n = 35) and patients suffering from dementia of the Alzheimer type (DAT; n = 35) used Fast Fourier Transformation-dipole approximation to quantify differences between the two groups. DAT patients showed a shift of alpha and beta activity toward frontal brain regions. The amount of this shift correlated with the degree of dementia. The relative distribution of magnitude of activity between the frequency bands differed between DAT patients and control subjects. DAT patients had higher magnitudes in the slow frequency range, correlating with the severity of dementia, and lower ones in the alpha and beta range compared with findings in age-matched control subjects.     

Autocrine/paracrine role of adrenomedullin in cultured endothelial and mesangial cells

Neuropsychological profiles were assessed in a large group of nondemented control subjects (n = 261) and individuals with dementia of the Alzheimer type (DAT) (n = 407) by subjecting their psychometric test results to a factor analysis. Nondemented control subjects were functionally homogeneous with only one factor accounting for the results. The results of the factor analysis on the very mild DAT and mild DAT groups, however, yielded a mental control/frontal factor, a memory-verbal/temporal factor, and a visuospatial/parietal factor. Forty-one of the original set of participants came to autopsy an average of 5.1 years after psychometric testing and had neurofibrillary tangles, total senile plaques, and cored senile plaques estimated from frontal, temporal, and parietal regions. The results of correlations indicated that the relative burden of cored senile plaques was systematically related to the three psychometric factors. These results suggest a connection between the specific functions as defined by neuropsychological measures and specific neuropathology occurring in associated areas of cortex.     

Neuropsychologic method in diagnosis of mild dementia in elderly and senile patients

Clinical neuropsychologic investigation was performed in 95 patients of elderly and senile age with mild dementia: 20 individuals with Alzheimer's disease (AD), 25 patients with senile dementia of Alzheimer's type (SDAT), 25 patients with vascular dementia (VD) and 25 patients with combined dementia of vascular and Alzheimer's types (DAT/VD). Clinical diagnosis of mild dementia was performed according to ICD-10. Neuropsychologic study was based on the theory and method of A.R. Luria. Syndrome of disorder of high psychic functions (HPF) in patients with mild SDAT was characterised by pathology of frontal cerebral structures and by significantly less defects of profound cerebral structures. According to the examination results the group of patients with mild AD was divided into 2 subgroups: 1) patients in which syndrome of HPF disorders was determined by pathology of parietal-temporal and profound cerebral structures and 2) patients with dysfunction of profound and frontal cerebral structures. Symptoms associated with profound cerebral structures were the main ones in patients with mild VD. Syndrome of HPF disorder included in mild DAT/VD symptoms connected with subcortical and profound brain structures as well as with frontal structures too. Besides, there were also defects in posterior frontal and parietal structures of the brain.     

EEG power spectra of normal preadolescent twins. Gender differences of quantitative EEG maturation

To determine developmental changes of quantitative EEG maturation, we investigated the electroencephalogram (EEG) power spectra in a sample of 72 pairs of healthy twins (144 subjects, 75 girls and 69 boys) ranging in age from 7-15 years. Main spectral parameters were measured in 16 EEG channels. The statistical significance of differences in the EEG power spectra was compared in relation to age and gender. Gender differences were tested by comparing the EEG parameters of boys and girls in the whole sample and separately in the subgroup of dizygotic twins of the opposite sex (DZO twin pairs). A statistically significant decrease of absolute power occurred with increasing age. A significant redistribution of relative power also appeared in higher age, mainly consisting of a progressive increase of alpha 2 power inversely related to relative alpha 1 and theta power. Polynomial regression models of the relation between alpha 2 and theta relative power with age were best described by a 5-order function. The mean frequency of activity across all spectra also increased with age and was maximal in the eldest subjects (13-15 years), with a significantly higher mean frequency of alpha 2 power in females. Similar age and gender differences were less marked in the subgroup of DZO twin pairs. The topographic distribution of spectral bands in normal subjects suggested an earlier maturation of midparietal or occipital than frontocentral regions, and indicated that the growth spurt does not occur simultaneously over homologous right and left hemisphere regions at the same age.     

The clinical diagnosis and misdiagnosis of senile dementia of Lewy body type (SDLT)

BACKGROUND: Current clinical classifications do not contain specific diagnostic categories for patients with senile dementia of the Lewy body type (SDLT), recently proposed as the second commonest neuropathological cause of dementia in the elderly. This study determines how existing clinical diagnosis systems label SDLT patients and suggests how such patients may be identified. METHOD: A range of clinical diagnostic criteria for dementia were applied to case notes of autopsy-confirmed SDLT (n = 20), dementia of Alzheimer type (DAT; n = 21) and multi-infarct dementia (MID; n = 9) patients who had received psychogeriatric assessment. The predictive validity of each set of clinical criteria was calculated against the external criterion of neuropathological diagnosis. RESULTS: Many SDLT patients erroneously met criteria for MID (35% with Hachinski scores > or = 7) or for DAT (15% by NINCDS 'probable AD', 35% by DSM-III-R DAT and 50% by NINCDS 'possible AD'). Up to 85% of SDLT cases could be correctly identified using recently published specific criteria. CONCLUSIONS: SDLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.     

Semantic, phonological, and hybrid veridical and false memories in healthy older adults and in individuals with dementia of the Alzheimer type.

Five groups of participants [young, healthy old, healthy old-old, very mild dementia of the Alzheimer type (DAT), and mild DAT] studied 12-item lists of words that converged on a critical nonpresented word (cold) semantically (chill, frost, warm, ice), phonologically (code, told, fold, old), or in a hybrid list of both (chill, told, warm, old). The results indicate that (a) veridical recall decreased with age and dementia; (b) recall of the nonpresented items increased with age and remained fairly stable across dementia; and (c) false recall varied by list type, with hybrid lists producing superadditive effects. For hybrid lists, individuals with DAT were 3 times more likely to recall the critical nonpresented word than a studied word. When false memory was considered as a proportion of veridical memory, there was an increase in relative false memory as a function of age and dementia. Results are discussed in terms of age- and dementia-related changes in attention and memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebral mapping in patients with dementia of Alzheimer's type

INTRODUCTION: The electric cerebral activity maps complement the conventional electroencefalography quantifying electric cerebral activity. One of the applications is in Alzheimer's dementia. OBJECT: The object of this study is to analyse the differences in the electric cerebral activity, by means a quantified EEG, in DAT and SDAT when compared with a control group of the same age. MATERIAL AND METHODS: Thirty patients meeting the criteria of probabledementia (NINCDS-ADRDA) in the senile (n = 19) and presenile (n = 11) form were studied. They were compared with a control group of the same age, 20 individuals older than and 17 younger than 65. RESULTS: The patients suffering from senile dementia as well as those suffering from the presenile form showed a significative increase of the delta and theta bands. On the other hand, a significant reduction of the alfa frequency bands and mainly those of beta was observed in the patients with ADT but not in the ADST ones. The significant increase of the slow bands in ADT and ADST and the significant decrease of the fast bands in ADT have been found in wide areas. Topographically the biggest affect has been registered in the frontal regions for the beta bands in ADT. CONCLUSIONS: The differences found in the electrical activity, depending on the age, would support Alzheimer's disease heterogeneity.     

A neuropsychological investigation into frontal lobe involvement in dementia of the Alzheimer type.

Studied frontal lobe involvement in dementia of the Alzheimer type (DAT) using 4 neuropsychological tests (verbal fluency, delayed alternation, subject-ordered pointing, and the Wisconsin Card Sorting Test) in 25 patients suffering from DAT and 12 age-matched normal controls. The first 3 tasks demonstrated that a frontal lobe impairment is present at all stages of the disease and is related to disease severity. Results offer information regarding the frontal component in DAT by providing neuropsychological support for the findings of an anterior pathology as reflected in blood flow and metabolism studies. The need for suitable frontal tasks with minimal memory involvement in the study of dementia is emphasized, and the delayed alternation task is recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are frontal and parietal somatosensory evoked potentials functionally dissociated by changing stimulus rate?

The cortical somatosensory evoked potentials are known to be sensitive to relatively small changes in the stimulus repetition rate of the afferent nerve. However, conflicting reports exist as to whether frontally and parietally recorded potentials at a given latency show differential behaviors as a function of stimulus rate. Because such dissociations of frontal and parietal potentials can have significant implications for the SEP generation mechanisms, the present study was undertaken to further describe in detail these effects on frontal, central and parietal waveforms after median nerve stimulation. Increasing stimulus repetition rate from 1 Hz to 5 Hz had the following effects: (i) in 9 of 16 subjects, the frontal P20 diminished while parietal N20 clearly remained unaltered, (ii) the central P22 was reduced in all subjects, (iii) frontal N30 and parietal P27 were attenuated in all subjects, the average magnitude of the reductions being nearly equal for these deflections. The results support the view that changing stimulus rate can functionally dissociate frontal and parietal activity around 20 ms, indicating that several partially independent neural populations can contribute to the frontal P20. The results did not lend support for functional dissociation of frontal N30 from parietal P27.     

High frequency oscillations in early cortical somatosensory evoked potentials

OBJECTIVE: To evaluate the characteristics of high frequency (HF) components of the early cortical somatosensory evoked potentials (SEPs). METHODS: We recorded 8-channel SEPs from the frontal and left centro-parietal scalp after right median nerve stimulation with a wide band-pass (0.5-2000 Hz) and digitized at 40 kHz sampling rate in 12 healthy subjects. HF components were analyzed after digital band-pass filtering (300-1000 Hz). The power spectrum was obtained by a maximum entropy method. RESULTS: HF oscillations (maximum power at 600-800 Hz) consisting of 5 to 8 peaks were discriminated from the preceding P14 far-field in all cases and their phases were reversed between the frontal and contralateral parietal regions. In addition, in subjects with a high amplitude central P22 potential in original wide-band recordings, a single HF oscillation with a maximum at the central region was present. Furthermore, this component showed no phase reversal over the centro-parietal area. CONCLUSION: We therefore conclude that HF oscillations are superimposed not only on the tangential N20-P20 but on the radial P22 potential, and are generated from both tangential (area 3b) and radial (area 1) current sources.     

Quantitative MR volumetry in Alzheimer's disease. Topographic markers and the effects of sex and education

We determined topographic selectivity and diagnostic utility of brain atrophy in probable Alzheimer's disease (AD) and correlations with demographic factors such as age, sex, and education. Computerized imaging analysis techniques were applied to MR images in 32 patients with probable AD and 20 age- and sex-matched normal control subjects using tissue segmentation and three-dimensional surface rendering to obtain individualized lobar volumes, corrected for head size by a residualization technique. Group differences emerged in gray and white matter compartments particularly in parietal and temporal lobes. Logistic regression demonstrated that larger parietal and temporal ventricular CSF compartments and smaller temporal gray matter predicted AD group membership with an area under the receiver operating characteristic curve of 0.92. On multiple regression analysis using age, sex, education, duration, and severity of cognitive decline to predict regional atrophy in the AD subjects, sex consistently entered the model for the frontal, temporal, and parietal ventricular compartments. In the parietal region, for example, sex accounted for 27% of the variance in the parietal CSF compartment and years of education accounted for an additional 15%, with women showing less ventricular enlargement and individuals with more years of education showing more ventricular enlargement in this region. Topographic selectivity of atrophic changes can be detected using quantitative volumetry and can differentiate AD from normal aging. Differential effects of sex and years of education can also be detected by these methods. Quantification of tissue volumes in vulnerable regions offers the potential for monitoring longitudinal change in response to treatment.     

Prospective memory and apolipoprotein e in healthy aging and early stage Alzheimer's disease.

The present study examined whether prospective memory performance discriminates healthy aging from very mild dementia of the Alzheimer type (DAT) and individuals at risk for DAT because of the presence of the apolipoprotein E (ApoE) ε4 allele. Four groups (young subjects, young-old control subjects, old-old control subjects, and subjects with very mild DAT) engaged in an event-based prospective memory task wherein they responded to a specific word embedded in a general knowledge test. Results indicated that prospective memory performance was clearly impaired in the very mild DAT group relative to the healthy older control groups. Moreover, prospective memory performance appears to capture unique variance in discriminating these 2 groups above and beyond standard retrospective memory tests. However, prospective memory was not affected by ApoE status in the young-old control group and, contrary to predictions, the ε4+ old-old control subjects showed better performance than did the ε4- subjects. In contrast to the healthy individuals, in the very mild DAT group, ε4+ subjects showed deficits in performance relative to the ε4- subjects. Discussion focuses on prospective memory as a cognitive indicator of early stage DAT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Isolation and characterization of polyethylene wear debris associated with osteolysis following total shoulder arthroplasty

OBJECTIVE: As anorectic and bulimic patients present similar clinical and neurobiological symptoms, the purpose of this study was to compare brain glucose metabolism at rest in these patients. METHODS: Positron emission tomography with (18-F)-fluorodeoxyglucose was used to evaluate cerebral glucose metabolism (CMRglu) in 10 normal-weight bulimic women, in 10 underweight anorectic patients, and in 10 age- and sex-matched healthy volunteers. RESULTS: Absolute global cortical glucose activity was significantly lower in anorectic patients compared with bulimic and control subjects. Anorectic patients compared with normal control subjects also showed higher relative CMRglu in the inferior frontal cortex and in the basal ganglia, and putamen and caudate relative hypermetabolism when compared with bulimic patients. Thus, both eating disorder groups differed from control subjects in low relative parietal values of glucose. DISCUSSION: While absolute global metabolism seems to be related to weight loss, we can hypothesize either a common parietal cortex dysfunction in eating disorders or a particular sensitivity of this cortex to consequences of eating disturbances.     

Delusions and dementia: clinical and CT correlates

INTRODUCTION: Delusions occur frequently during the course of Alzheimer's disease (AD) and multi-infarct dementia (MID). Their clinical significance and their relationship with progression of disease and involvement of selected cerebral areas are still unclear. The aim of the study was to determine the clinical and CT correlates of delusions in patients with dementia. MATERIAL AND METHODS: A series of 67 probable AD and 32 MID patients, underwent computed tomographic scans, psychometric tests, neurologic and psychiatric examination, and blood and serum tests. RESULTS: Twenty-four patients were found to have delusions during the clinical evaluation. Delusional patients showed a significantly higher age when compared with non-delusional patients. The results of a multiple logistic regression (with stepwise deletion of the redundant variables) of the CT lesions on the presence of delusions, showed that only the presence of isolated white matter lesions in the frontal lobes were significantly related to the occurrence of delusions (Exp B = 3.42; Beta = 1.2; S.E. = 0.6; Sig T = 0.04). Frontal white matter changes were significantly related to delusions when a multiple regression analysis, entering age and total number of lesions at CT scans, was carried out. CONCLUSIONS: We found that focal lesions in the frontal areas were the only variable that appeared to be significantly and independently associated with delusional disorders.     

Regional cerebral blood flow in pediatric moyamoya disease: age-dependent decline in specific regions

Thirteen pediatric patients (ages 4-13 years) who underwent surgical treatment were examined regarding their rCBF in the preoperative periods. The postoperative rCBF was measured 39 times in these 13 patients. Thirteen healthy normal subjects (ages from 6 to 21 years) were also examined. The rCBF in the operculum and in the frontal, parietal, and occipital lobes was measured with 133Xe inhalation method and single photon emission computed tomography. In the parietal and occipital lobes, the preoperative rCBF had a negative and significant correlation with their ages, but not in the operculum or frontal lobe. However, subsequent to the surgical treatment, the rCBF increased significantly in the patients 5 years old or less, and then post-operative rCBF values had significant negative correlations with age in each region.     

Human cortico-hippocampal activity related to auditory discrimination revealed by neuromagnetic field

We carried out multi-dipole estimation and pursued spatio-temporal brain activity on a time scale of several milliseconds during an auditory discrimination task using a whole-cortex type SQUID system. Neuronal activities were estimated in the medial (hippocampus, parahippocampal gyrus, etc.) and lateral temporal cortices (superior and middle temporal gyri, etc.), the dorsolateral prefrontal cortex (middle and inferior frontal gyri, etc.) and the parietal cortex (supramarginal gyrus, etc.) in the 280-400 ms latency range. The activity in the posterior hippocampal region was the most prominent and long-lasting in parallel with the activities in the other regions. Therefore, the posterior hippocampal region is a central structure engaged in auditory discrimination. The whole-cortex neuromagnetic measurements provided the possibility of imaging the time-varying activities of the human cortico-hippocampal neural networks.     

The utility of intraindividual variability in selective attention tasks as an early marker for Alzheimer’s disease.

This study explored differences in intraindividual variability in 3 attention tasks across a large sample of healthy older adults and individuals with very mild dementia of the Alzheimer’s type (DAT). Three groups of participants (healthy young adults, healthy older adults, very mild DAT) were administered 3 experimental measures of attentional selection and switching (Stroop, Simon, task switching). The results indicated that a measure of intraindividual variability, coefficient of variation (CoV; SD/M), increased across age and early stage DAT. The CoV in Stroop discriminated the performance of ε4 carriers from noncarriers in healthy older controls and the CoV in task switching was correlated with cerebrospinal fluid (CSF) biomarkers predictive of DAT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aberrant spatiotemporal activation profiles associated with math difficulties in children: A magnetic source imaging study.

The study investigates the relative degree and timing of cortical activation in parietal, temporal, and frontal regions during simple arithmetic tasks in children who experience math difficulties. Real-time brain activity was measured with magnetoencephalography during simple addition and numerosity judgments in students with math difficulties and average or above average reading skills (MD group, N = 14), students with below average scores on both math and basic reading tests (MD/RD group, N = 16) and students with above average scores on standardized math tests (control group, N = 25). Children with MD showed increased degree of neurophysiological activity in inferior and superior parietal regions in the right hemisphere compared to both controls and MD/RD students. Left hemisphere inferior parietal regions did not show the expected task-related changes and showed activity at a significant temporal delay. MD students also showed increased early engagement of prefrontal cortices. Taken together, these findings may indicate increased reliance on a network of right hemisphere parietal (and possibly frontal areas as well) for simple math calculations in students who experience math difficulties but perform within normal range in reading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Midline cerebral morphometry distinguishes frontotemporal dementia and Alzheimer's disease

We investigated and contrasted midline cerebral structures in frontotemporal dementia (FTD) and Alzheimer's disease (AD). FTD and AD may be difficult to distinguish clinically. FTD typically affects frontal and anterior temporal regions, whereas AD tends to involve more posterior temporal and parietal areas. We hypothesized that disease-specific cerebral alterations would be differentially reflected in corresponding regions of the corpus callosum (CC), pericallosal CSF space (PCS), or their ratio (CC:PCS). Regions-of-interest (ROIs) from midsagittal MRIs in 17 AD, 16 FTD, and 12 elderly control (EC) subjects were analyzed. ROIs were divided into four regions using an anatomic landmark-based computer algorithm and were adjusted for head size variation. FTD subjects had a much smaller anterior CC region and significantly larger PCS area, particularly in anterior regions. AD and EC subjects did not differ significantly in any total or regional ROI measure. Total and anterior CC:PCS ratios were markedly lower in FTD patients. Across groups, total CC:PCS correlated significantly with midsagittal cerebral area and was similarly associated with Mini-Mental State Examination score. Anterior CC (AD) and PCS (FTD) regions exhibited disease-specific relationships to these variables. A discriminant model using two ROI variables correctly classified 91% of AD and FTD patients, comparing favorably with blind clinical MRI diagnostic ratings. Midline cerebral structural alterations reflect differential patterns of cerebral degeneration in AD and FTD, yielding morphometric indices that may facilitate the study of brain-behavior relationships and differential diagnosis of dementia.