Journal of the neurological sciences
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Prospective memory (ProM) involves remembering to perform actions after a delay, such as buying groceries on the way home from work. Retrospective memory (RetM) involves remembering events from the past. It is known that the memory impairment in Alzheimer's disease (AD) generalizes across (a) these two types of memory, and (b) encoding, storage, and retrieval within RetM. ⋯ From a population-based study, 21 persons with VaD, 79 with AD, and 352 controls were included. Both dementia groups were impaired on all ProM and RetM variables, but did not differ from one another on any measure. The results are discussed relative to a network view of episodic memory, in which alterations at different sites may result in similar functional impairments.
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Acetazolamide vasoreactive test measures the increment of cerebral blood flow caused by compensatory vasodilatation ability of cerebral vessels which can be detected by transcranial Doppler ultrasound (TCD). This study aimed to compare the vascular reactivity in patients with vascular dementia (VaD) and Alzheimer's disease (AD). ⋯ Acetazolamide vasoreactive test using TCD may be the additional criterion to differentiate VaD from AD. Further study with more number of subjects for the study or higher dose of acetazolamide may be needed to reveal the significant difference of vasoreactive response between VaD and AD patients.
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The organ most frequently affected in mitochondrial disorders, particularly respiratory chain diseases (RCDs), in addition to the skeletal muscle, is the central nervous system (CNS). CNS manifestations of RCDs comprise stroke-like episodes, epilepsy, migraine, ataxia, spasticity, movement disorders, psychiatric disorders, cognitive decline, or even dementia (mitochondrial dementia). So far mitochondrial dementia has been reported in MELAS, MERRF, LHON, CPEO, KSS, MNGIE, NARP, Leigh syndrome, and Alpers-Huttenlocher disease. ⋯ Therapy of mitochondrial dementia relies on symptomatic measures. Only single patients profit from cholinesterase inhibitors or memantine, antioxidants, vitamins, coenzyme-Q, or other substitutes. Overall, mitochondrial dementia is an important differential of dementias and should be considered in patients with multi-system disease.
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Non-linguistic cognitive impairments may limit rehabilitation efficacy in patients with aphasia. The aim of this study was to determine whether post-stroke aphasia was associated with impairments of visuo-spatial working memory and abstract thinking and whether these deficits adversely affected language recovery. ⋯ Even though the patients' non-linguistic cognitive abilities were impaired in general, the patients were heterogeneous with regard to their deficits. Linguistic and non-linguistic deficits appeared to be distinct, although they could be concurrent. Visuo-spatial working memory was associated with the degree of improvement in two functions crucial to language communication: naming and comprehension. No relationship was found between language therapy outcome and abstract thinking ability.
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Randomized Controlled Trial
Gray matter atrophy and disability progression in patients with early relapsing-remitting multiple sclerosis: a 5-year longitudinal study.
We assessed the relationship between gray matter (GM) and white matter (WM) atrophy and clinical status in early relapsing-remitting multiple sclerosis (MS) patients over 5 years. A group of 181 patients who participated in the ASA (Avonex-Steroid-Azathioprine) study and had complete clinical and MRI assessments over 2 and 5 years was investigated. One hundred seventy (170) patients completed the 12-month follow-up, 147 the 24-month, 98 the 36-month, 65 the 48-month and 47 the 60-month. ⋯ Decline in PBVC and GMV were predictive markers of disability deterioration. Correlation of T2-LV with clinical status was weaker and decreased over time. Higher number of relapses was associated with faster decline in whole brain volume.