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Review Clinical investigations in primary care. 2009
de Souza LC, Sarazin M, Goetz C, Dubois B. · Research and Resource Memory Centre, INSERM UMR S-610, Université Pierre et Marie Curie-Paris 06, Pitié-Salpêtrière Hospital, Paris, France. · Front Neurol Neurosci. · Pubmed #19182457 No free full text.
Abstract: Alzheimer's disease (AD) is a progressive neurodegenerative disorder that represents the most common form of dementia. The most prominent feature of AD is the decline in cognitive function, with an early impairment of episodic memory. The memory deficit of an AD patient is characterized by the amnestic syndrome of the medial temporal type. As the disease progresses, the condition often manifests in language disorders, visuospatial deficits and executive dysfunctions. Patients often have neuropsychiatric disturbances, as apathy and psychotic symptoms. Loss of autonomy follows cognitive impairment. The clinical diagnosis of AD is based on a complete medical examination with a neuropsychological evaluation. The FCSRT (free and cued selective reminding test) is recommended for the identification of the amnestic syndrome of the medial temporal type, which is defined by: (1) a very poor free recall and (2) a decreased total recall due to an insufficient effect of cueing. The neuropsychological tests should also assess other cognitive functions that may be perturbed in AD, such as executive functions, praxis, visuospatial capacities and language. Neuroimaging and biological exams (genetics, biomarkers) are of great utility in the evaluation. Other medical, neurological, or psychiatric disorders which could account for the impairment in memory and related symptoms must be always investigated.
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Article fMRI activation changes during successful episodic memory encoding and recognition in amnestic mild cognitive impairment relative to cognitively healthy older adults. 2008
Trivedi MA, Murphy CM, Goetz C, Shah RC, Gabrieli JD, Whitfield-Gabrieli S, Turner DA, Stebbins GT. · Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. · Dement Geriatr Cogn Disord. · Pubmed #18663302 No free full text.
Abstract: BACKGROUND/AIMS: Previous functional MRI studies in individuals with amnestic mild cognitive impairment (AMCI), a putative, prodromal form of Alzheimer's disease, reveal substantial regional changes in brain activation during episodic memory function. METHODS: Functional MRI was applied to examine changes in brain activation during different stages of episodic memory function using a subsequent memory task in individuals with AMCI relative to older normal controls. RESULTS: We found that the AMCI group displayed greater activation in the right hippocampus but less activation in the frontal cortex relative to the older normal control group during intentional encoding of items that were subsequently recognized. We observed nearly the opposite pattern of results for successful recognition. The AMCI group displayed less activation in the medial temporal cortex but greater activation in the frontal cortex. In addition, the AMCI group showed reduced activation in the medial temporal and frontal cortices during incidental encoding of novel information during recognition. CONCLUSION: The results of the present study suggest that brain activation differences in individuals with AMCI are modulated by the stage of episodic memory examined (i.e. intentional vs. incidental encoding vs. recognition). These observations may help to clarify some of the conflicting findings regarding brain activation changes in AMCI.
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