Alzheimer Disease: Werheid K

Förstl H, Werheid K, Ulm K, Schönknecht P, Schmidt R, Pantel J, Hörr R, Gutzmann H, Gertz HJ, Frölich L, Bickel H. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München. · Dtsch Med Wochenschr. · Pubmed #19142839 No free full text.

Abstract: Long-term studies will be pivotal in order to examine the efficacy of preventive and early therapeutic interventions during the preclinical phase of dementia. Biomarkers will be of importance due to the large sample sizes and the necessary logistic efforts, high drop-out rates and slow clinical progression. The validity of functional and even structural imaging methods is currently investigated with early and promising results; it is presently unclear whether conventional csf-markers of Alzheimer's disease (beta-amyloid and tau-proteins) are sufficiently sensitive to monitor the effects of early interventions. It also remains doubtful whether modifications of these methods will ever be useful and available for practical purposes.

Werheid K, Clare L. · Department of Psychology, Humboldt-University at Berlin, Berlin, Germany. · Cortex. · Pubmed #17941348 No free full text.

Abstract: Memory for faces and names has increasingly become a focus of cognitive assessment and research in Alzheimer's disease (AD). This paper reviews evidence from cognitive and clinical neuroscience regarding the question of whether AD is associated with a specific deficit in face recognition, face-name association, and retrieval of semantic information and names. Cognitive approaches conceptualizing face recognition and face-name association have revealed that, compared to other types of visual stimuli, faces are "special" because of their complexity and high intraclass similarity, and because their association with proper names is arbitrary and unique. Neuroimaging has revealed that due to this particular status, face perception requires a complex interplay of highly specialized secondary visual areas located in the occipitotemporal cortex with a widely distributed system of cortical areas subserving further task-dependent processing. Our review of clinical research suggests that AD-related deficits in face recognition are primarily due to mnestic rather than perceptual deficits. Memory for previously studied or famous faces is closely related to mediotemporal and temporocortical brain regions subserving episodic and semantic memory in general, suggesting that AD-related impairments in this domain are due to neural degeneration in these areas. Despite limited specificity due to the apparent absence of a "genuine" domain-specific deficit of face memory in AD, testing memory for faces and names is useful in clinical contexts, as it provides highly sensitive indices of episodic and semantic memory performance. Therefore, clinical assessment of face memory can usefully contribute to early detection of memory deficits in prodromal and initial stages of AD, and represents a basis for further attempts at rehabilitation. Further advantages, such as ecological validity, high task comprehensibility and, in the case of novel face learning, independence from premorbid intelligence level, render measures of face recognition valuable for clinical assessment in early AD.

Werheid K, Thöne-Otto AI. · Institut für Psychologie, Humboldt-Universität zu Berlin. · Nervenarzt. · Pubmed #16228161 No free full text.

Abstract: Memory rehabilitation in dementia patients is gaining importance. Among the increasing number of people affected by Alzheimer's dementia (AD), the number detected in early stages of the disease is growing disproportionately quickly. The reasons are obvious: improved clinical assessment in the initial disease stage, increased sensitization of the elderly towards cognitive deficits, and the prescription of drugs retarding cognitive decline. Given the limited success of early training programs in the 1980s, skepticism towards cognitive training in dementia is still common among clinicians. However, recent international studies in the field give reason for cautious optimism. Memory therapy in the early-to-moderate stages of AD can be successful, if it is tailored to patients' individual daily problems and based on their residual cognitive capacities. The present paper gives an overview of recent findings in clinical and cognitive neuroscience which have led to a conceptual change in the memory rehabilitation of patients with dementia. Based on a review of general principles and rehabilitation techniques proven successful in recent research, recommendations are formulated for future studies evaluating cognitive therapy in dementia.