Symptomatology and Neuropathology of patients presenting with focal cortical signs.

Here, we describe two patients who presented with focal cortical signs and underwent neuropathological examination. Case 1 was a 73-year-old woman with progressive speech disorder and abnormal behavior. She showed agraphia of the frontal lobe type, featured by the omission of kana letters when writing, other than pyramidal tract signs, pseudobulbar palsy, and frontal lobe dementia.

Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac I-MIBG scintigraphy in memory clinics.

Background: Rapid eye movement sleep behaviour disorder (RBD) is associated with reduced cardiac I-metaiodobenzylguanidine (MIBG) uptake and often precedes the onset of Lewy body (LB) disorders. We investigated the role of cardiac I-MIBG scintigraphy in relation to probable RBD for the clinical diagnosis of prodromal dementia with Lewy bodies (DLB) in memory clinics.

Methods: We reviewed clinical profiles of 60 consecutive patients who underwent cardiac I-MIBG scintigraphy in our memory clinics.

Prevalence and Clinical Implications of the Mirror and TV Signs in Advanced Alzheimer's Disease and Dementia with Lewy Bodies.

Objective: To explore the prevalence and clinical implications of the mirror and TV signs in the moderate to advanced stages of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).

Methods: We retrospectively examined the prevalence of clinical and psychiatric symptoms including the mirror and TV signs in 200 subjects with AD and 200 with DLB and evaluated the relationships among the symptoms.

Results: The mirror sign was found in 3.

Postural Abnormality in Parkinson's Disease: A Large Comparative Study With General Population.

Background: Postural abnormalities in Parkinson's disease (PD) patients and unimpaired elderly are not well differentiated. Factors related to postural abnormality associated with PD are controversial.

Objective: We assessed differences in postural change between PD patients and unimpaired elderly and elucidated factors related to abnormal posture in PD patients.

Dementia with Lewy bodies presenting as frontotemporal dementia phenotype.

We herein report two patients with dementia with Lewy bodies (DLB) presenting characteristic symptoms suggestive of the behavioural variant of frontotemporal dementia (bvFTD). Patient 1 presented behavioural and personality changes from the onset, such as restlessness, compulsive behaviours, and stereotypical speech. A neuroimaging study showed preferential frontal involvement, and this patient fulfilled the diagnostic criteria for bvFTD.

Historical review of academic concepts of dementia in the world and Japan: with a short history of representative diseases.

Expanding our knowledge of the history of dementia may be beneficial for its holistic understanding. This article aims to review the trajectory of the concepts of dementia in the world and Japan. Historical backgrounds of major dementia diseases are also addressed.

Prevalence and clinical implication of microbleeds in dementia with lewy bodies in comparison with microbleeds in Alzheimer's disease.

Background: Cerebral microbleeds (MBs) have been well investigated in Alzheimer's disease (AD), but not very extensively in non-AD dementias or in dementia with Lewy bodies (DLB).

Aims: To elucidate the clinical significance of MBs in DLB.

Methods: We compared the prevalence, locations and risk factors for MBs in 59 DLB and 81 AD patients.

5-fluorouracil-induced leukoencephalopathy with acute stroke-like presentation fulfilling criteria for recombinant tissue plasminogen activator therapy.

A 61-year-old man underwent systemic chemotherapy with intravenous infusion of nedaplatin and 5-fluorouracil. On the day after the final drug administration, he suddenly experienced difficulty in speaking followed by left-sided weakness. His National Institutes of Health Stroke Scale score was 12.

Cerebral microhemorrhage in Marchiafava-Bignami disease detected by susceptibility-weighted imaging.

Marchiafava-Bignami disease (MBD) is a rare alcohol-associated disorder. Clinical features include not only disturbed consciousness, dysarthria, tetraparesis, astasia-abasia, and symptoms of interhemispheric disconnection as initial symptoms but also cognitive deficits as clinical outcomes. The clinical significance of cerebral microhemorrhage (CMH) has been recognized in patients with cognitive deficits; however, the presence of CMH in patients with MBD has not been emphasized.

[Clinical types of FTLD: progressive nonfluent aphasia; comparative discussions on the associated clinical presentations].

Progressive nonfluent aphasia (PNFA) is one of the 3 clinical presentations of frontotemporal lobar degeneration (FTLD), the other 2 being frontotemporal dementia and semantic dementia (SD). PNFA and SD, both representing relentlessly progressive language impairment in the realm of FTLD, may share a large part with primary progressive aphasia (PPA). A salient distinction between PPA and PNFA or SD is that PPA includes another clinical type, namely, logopenic/phonemic aphasia (LPA), which is not represented in FTLD.

Visuospatial function is a significant contributor to functional status in patients with Alzheimer's disease.

Background: Contribution of visuospatial abilities to the functional status in patients with Alzheimer's disease (AD) has been controversial.

Aim: To address whether visuospatial abilities have independent association with functional measures in patients with AD.

Methods: We regressed performances on a global cognitive (the revised Hasegawa Dementia Scale: HDSR), executive/ visuoconstruction (Clock drawing), visuoperception (Clock reading: CRT), simple visuoconstruction (figure copying), and frontal behavioral tasks on measures of basic and instrumental activities of daily living (BADL and IADL) in 57 patients (78.

SPECT-identified neuroanatomical predictor of the cognitive effects of donepezil treatment in patients with Alzheimer's disease.

Background/objective: We attempted to determine whether the pretreatment regional cerebral blood flow (rCBF) might predict cognitive changes in response to donepezil treatment, as assessed in terms of the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), and in relation to the severity of subcortical hyperintensities (SH).

Method: Forty-one patients with Alzheimer's disease (AD) were treated with donepezil at baseline. All the patients underwent a single photon emission computed tomography examination before donepezil therapy.

[Germinoma presenting with personality and socio-behavioral abnormalities may challenge differential diagnoses].

We described the major diagnostic difficulties encountered in the case of a 25-year-old man with the pathological diagnosis of a germinoma. The patient initially developed an eating disorder at the end of 2003 and a character change ensued since the beginning of 2004. On admission in August 2004, his cardinal symptoms and signs included marked apathy, depersonalization, generalized muscle wasting, and decreased tendon reflexes.

Progressive agraphia can be a harbinger of degenerative dementia.

By investigating three patients with progressive agraphia, we explored the possibility that this entity is an early sign of degenerative dementia. Initially, these patients complained primarily of difficulties writing Kanji (Japanese morphograms) while other language and cognitive impairments were relatively milder. Impairments in writing Kana (Japanese syllabograms), verbal language, executive function, visuo- and visuospatial cognition and memory were identified by neuropsychological testing.

Do lesions involving the cortical cholinergic pathways help or hinder efficacy of donepezil in patients with Alzheimer's disease?

Aims: To investigate the influences of vascular lesions detected by MRI, lesions involving the cortical cholinergic pathways and hippocampal thickness on therapeutic responsiveness to donepezil in patients with Alzheimer's disease (AD).

Methods: The study cohort contained 67 patients with probable AD. We used the revised Hasegawa Dementia Rating (HDS-R) and the Clock Drawing Test (CDT) to evaluate drug efficacy for 24 months.

Do vascular lesions and related risk factors influence responsiveness to donepezil chloride in patients with Alzheimer's disease?

The purpose was to identify vascular influences on the responsiveness to donepezil chloride. The study included 50 untreated probable Alzheimer's disease patients with the Modified Hachinski Ischemic Score <4. We assessed baseline cognitive status using the Revised Hasegawa Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) and the clock drawing test (CDT).

[Acute onset of somnolence and amnesia due to cerebral infarction of bilateral thalamus accompanied with tuberculous meningitis: a case report].

A 55-year-old man was admitted to our hospital because of somnolence and aspontaneity. He was hospitalized in the psychopathic ward under the initial diagnosis of depression. Chest X-ray showed infiltration in both upper lobe.

[A case of amyotrophic lateral sclerosis with dementia presenting long clinical course].

We describe a patient with amyotrophic lateral sclerosis with dementia (ALS-D) displaying a long clinical course. A 68-year-old Japanese male with no family history of note was admitted complaining of severe dysarthria and dysphagia. At 63 years old, Pick's disease was diagnosed on the basis of abnormal behavior, such as "Denkfaulheit" and moria, and temporal lobe atrophy observed on magnetic resonance imaging (MRI).