Profiling spontaneous speech decline in Alzheimer's disease: a longitudinal study.

Objective: This study aims to document the nature and progression of spontaneous speech impairment suffered by patients with Alzheimer's disease (AD) over a 12-month period, using both cross-sectional and prospective longitudinal design.

Methods: Thirty one mild-moderate AD patients and 30 controls matched for age and socio-cultural background completed a simple and complex oral description task at baseline. The AD patients then underwent follow-up assessments at 6 and 12 months.

Memory difficulties are not always a sign of incipient dementia: a review of the possible causes of loss of memory efficiency.

Introduction Or Background: Memory problems are a very common reason for presenting to primary care. There is a need for better treatments for dementia. Increased government and media interest may result in greater number seeking help for memory problems, which may not reduce the dementia gap but rather increase numbers seen who do not have dementia.

Differentiating normal from pathological brain ageing using standard neuropsychological tests.

To diagnose Alzheimer's disease (AD) early, tests sensitive to neuropathology and insensitive to normal ageing are of greatest benefit. We used several neuropsychological tests to identify those best suited to distinguishing Mild Cognitive Impairment (MCI) and early AD from normal ageing. Impairments in long-term memory were found in older adults and these were even greater in MCI and AD.

Cognitive stimulation: the evidence base for its application in neurodegenerative disease.

Multiple modalities of cognitive stimulation (CS) have been designed and tested in samples of patients with probable Alzheimer's disease (AD). Despite the substantial inter-study variability, an overall positive impact of CS is reported. This impact has been especially observed in general measures of cognition.

Awareness and confabulation.

Objective: A single case study with control and normative data of a 74-year-old retired businessman with amnestic mild cognitive impairment, who had spontaneous confabulations concerning fantastic exploits and magical powers as well as déjà vécu experiences.

Methods And Results: His neuropsychological profile showed episodic memory impairment including deficits of recent episodic autobiographical memories and of recognition, but performance was within normal limits on tests assessing source memory for words, the ability to suppress irrelevant items on a continuous recognition memory task, and the detection of stimulus frequency. There were discrete impairments in an ad hoc test measuring his ability to detect and discriminate the source of a range of material including information derived from personal and public events, invented material, and episodes culled from his personal reading.

Translocation of the embodied self without visuospatial neglect.

This is the case report of RB, a 68-year-old retired woman who, following an extensive right sided ischaemic stroke, showed hemiplegia, anosognosia and allochiria, but no somato-sensory deficits and no visuospatial neglect. A high resolution 3D MRI structural scan of her brain was acquired to define the structural damage in detail. Morphometric analyses of grey and white matter data revealed a large lesion which involved most of her right parietal, temporal, and mesial frontal cortex, with partial sparing of the right dorsolateral prefrontal cortex and part of the posterior corpus callosum.

Influence of APOE status on lexical-semantic skills in mild cognitive impairment.

This study characterized the relationship between apolipoprotein E (APOE) status and residual semantic abilities in amnestic mild cognitive impairment (MCI). APOE status (ε4 carrier/non ε4 carrier) was determined in 30 amnestic MCIs and in 22 healthy matched non ε4 carrier controls. The lexical characteristics (age of acquisition, typicality, familiarity) of words produced in a category fluency task were determined.

The neuroanatomical substrate of lexical-semantic decline in MCI APOE ε4 carriers and noncarriers.

Lexical-semantic competency in mild cognitive impairment (MCI) ε4 carriers was used as an endophenotype, and gray matter volume in MCI ε4 carriers/noncarriers and in noncarrier controls was compared. Residual gray matter volumes were correlated with age of acquisition values for words from a category fluency task, an index of semantic competency. MCI patients had significantly impoverished lexical-semantic output compared with controls, more marked in MCI ε4 carriers.

Anosognosia for memory impairment in Alzheimer's disease.

Unlabelled: Stewart G, McGeown WJ, Shanks MF, Venneri A. Anosognosia for memory impairment in Alzheimer's disease. Objective To investigate whether patients with Alzheimer's disease (AD) were able to alter their awareness of memory deficits after exposure to a memory task.

Patterns of brain activity during a semantic task differentiate normal aging from early Alzheimer's disease.

In a study of the effects of normal and pathological aging on semantic-related brain activity, 29 patients with Alzheimer's disease (AD) and 19 controls subjects (10 young and 9 older controls) performed a version of the Pyramids and Palm Trees Test that had been adapted for use during functional magnetic resonance imaging (fMRI). Young and older controls activated the left inferior and middle frontal gyri, precuneus and superior parietal lobule. Right frontal and left temporal cortices were activated only in the young.

Responders to ChEI treatment of Alzheimer's disease show restitution of normal regional cortical activation.

Clinical trials of cholinesterase inhibitor (ChEI) drugs, although generally reporting only minimal improvements in patients with Alzheimer's disease (AD), indicate that a subgroup of patients may respond substantially to treatment. This study aimed to assess the clinically variable ChEI treatment effects in a group of patients with mild AD using a semantic association and an N-back light working memory activation paradigm. Twenty-six patients with probable mild AD treated with a ChEI for 20 weeks were retrospectively divided into responders and non-responders.

Prolonged cholinergic enrichment influences regional cortical activation in early Alzheimer's disease.

Neuroimaging studies of cholinesterase inhibitor (ChEI) treatment in Alzheimer's disease (AD) indicate that the short and long term actions of ChEIs are dissimilar. fMRI studies of the ChEI rivastigmine have focused on its short term action. In this exploratory study the effect of prolonged (20 weeks) rivastigmine treatment on regional brain activity was measured with fMRI in patients with mild AD.

Neuroanatomical correlates of neuropsychiatric symptoms in Alzheimer's disease.

Alzheimer's disease research has largely concentrated on the study of cognitive decline, but the associated behavioural and neuropsychiatric symptoms are of equal importance in the clinical profile of the disease. There is emerging evidence that regional differences in brain atrophy may align with variant disease presentations. The objective of this study was to identify the regions of decreased grey matter (GM) volume which were associated with specific neuropsychiatric behaviours in patients with mild Alzheimer's disease.

The anatomical bases of semantic retrieval deficits in early Alzheimer's disease.

Semantic abilities deteriorate early in patients with Alzheimer's disease (AD) and their residual language is characterised by strong lexical effects such as the age of acquisition of words and their typicality. The anatomical bases of this early semantic degradation have not been fully explored. To clarify which neural structures, when atrophic, alter lexical-semantic function in patients with very mild AD, this study correlated the lexical attributes of words produced in a semantic fluency task with grey matter density values from 3D MRI scans of mild AD patients.

Regional brain activity after prolonged cholinergic enhancement in early Alzheimer's disease.

This functional magnetic resonance imaging (fMRI) study examined changes in brain activation after prolonged (20 weeks) and stabilized treatment with the cholinesterase inhibitor galantamine in a small group of patients with very mild Alzheimer's disease (AD). Two cognitive activation paradigms were chosen: one requiring semantic association and the other relying on attention and requiring target detection. A group of age- and education-matched healthy controls was also scanned for comparison.

Provoked confabulations in Alzheimer's disease.

Confabulation in Alzheimer's disease (AD) has been the subject of limited investigation. When studied, the phenomenon has been found to share characteristics with memory distortions produced by neurologically intact individuals. Previous studies that have investigated confabulation in AD have failed to take into account the characteristics of the disease and the presence of confabulations in the retrieval of recent autobiographical memory (ABM).

The emergence of delusional companions in Alzheimer's disease: an unusual misidentification syndrome.

Introduction: Misidentifications in the course of organic diseases, including Alzheimer's disease (AD), have been associated with right sided brain dysfunction. The reasons for this association might be clarified by investigating the contribution of neurobiological, cognitive and emotional factors to distinctive types of misidentification.

Methods: This study reports the cases of three patients with AD presenting a novel misidentification delusion in which objects with intrinsically comforting associations, soft toys, were experienced as sentient and triggered associated behaviours.

Patterns of impairment in autobiographical memory in the degenerative dementias constrain models of memory.

Detailed study of the autobiographical memory (ABM) impairments seen in different forms of degenerative dementia, in particular Alzheimer's disease (AD) and semantic dementia (SD) can inform neuropsychological models of memory. A modified ABM questionnaire which allowed more detailed analysis of episodic and semantic ABM was used to study the pattern of deficits in patients with minimal to mild Alzheimer's disease (AD) and in two patients with mild and moderate semantic dementia (SD). The questionnaire tested both cued and free recall.

The age of acquisition of words produced in a semantic fluency task can reliably differentiate normal from pathological age related cognitive decline.

This study examined differences in the characteristics of words produced by healthy elderly controls and by patients with Alzheimer's disease (AD) in a semantic fluency task (generating words from the categories of animals and fruit). Ninety-six AD patients (MMSE 13-29) and 40 controls matched for age and socio-cultural background completed a semantic fluency task. Length, frequency, typicality and age of acquisition (AoA) values were obtained for each word generated.

Empirical evidence of neuroprotection by dual cholinesterase inhibition in Alzheimer's disease.

Brain grey matter density changes were quantified using voxel based morphometry in 26 patients with minimal to mild Alzheimer's disease (AD) treated with three cholinesterase inhibitors over 20 weeks. Patients whose drug treatment also inhibited butyrylcholinesterase did not show the widespread cortical atrophic changes in parietotemporal regions invariably reported in untreated AD patients, and which were detectable in the subgroups treated with selective acetylcholinesterase inhibition. This finding is the first empirical evidence that dual cholinesterase inhibition may have neuroprotective potential in AD.

The evolution of dysgraphia in Alzheimer's disease.

Evidence from recent studies suggests that writing may be an aspect of cognition capable of identifying impairments specific to patients with Alzheimer's Disease (AD). The precise nature and progression of the writing disorder, however, remains unclear. The current study assessed the central and peripheral aspects of writing among a sample of minimal, mild and moderate AD patients and a group of healthy elderly controls on a narrative description task.