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Measuring the Course of Alzheimer's Disease

A Longitudinal Study of Neuropsychological Function and Changes in P3 Event-Related Potential

Published online by Cambridge University Press:  02 January 2018

David St Clair*
Affiliation:
University of Edinburgh Departmentof Psychiatry
Ivy Blackburn
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital
Douglas Blackwood
Affiliation:
University of Edinburgh Department of Psychiatry
Gillian Tyrer
Affiliation:
Fife Health Board
*
Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF

Abstract

On two occasions one year apart, the cognitive performance of 12 patients with presenile dementia Alzheimer type (ATD) and 14 with alcoholic Korsakoff syndrome (KS) was assessed both psychologically using the Christensen version of Luria's neuropsychological investigation and physiologically by measuring P300 (P3) and other long-latency auditory event-related potentials. All patients with ATD showed evidence of psychological deterioration and most also showed changes in auditory P3, whereas on all measures the KS group remained essentially unchanged. The extent of the changes in the ATD group varied, but in general those patients with most psychological deterioration also displayed the biggest changes in P3 wave form. There were two patterns of decline: a majority followed the traditional progressive course associated with Alzheimer disease; and in a minority, decline was slower. Methods for determining the rate of decline in individual patients with ATD, together with the prognostic implications, are discussed.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Alzheimer, A. (1907) Über eine eigenertige Erkrankung der Hirnrinde. Allgemein Zeitschrift fur Psychiatrie, 64, 146148.Google Scholar
Ball, M. J., Fisman, M., Hachinski, V., Blume, W., Fox, A., Kral, V. A., Kirshen, A. J., Fox, H. & Merskey, H. (1985) A new definition of Alzheimer's disease: a hippocampal dementia. The Lancet, i, 1416.Google Scholar
Berg, L., Hughes, C. P., Coben, L. A. et al (1982). Mild senile dementia of Alzheimer type: research diagnostic criteria, recruitment, and description of a study population. Journal of Neurology, Neurosurgery and Psychiatry, 45, 926968.CrossRefGoogle ScholarPubMed
Blackburn, I. M. & Tyrer, G. T. (1985) The value of Luria's neuropsychological investigation for the assessment of cognitive dysfunction in Alzheimer type dementia. British Journal of Clinical Psychology, 24, 171179.CrossRefGoogle ScholarPubMed
Blackwood, D. H. R., Whalley, L. J., Christie, J. E. etal (1987) Changes in auditory P3 event-related potential in schizophrenia and depression. British Journal of Psychiatry, 150, 154160.Google Scholar
Bondareff, W., (1983) Age with Alzheimer disease. The Lancet, i, 1447.CrossRefGoogle Scholar
Christensen, A. L. (1979) Luria's Neuropsychological Investigation, 2nd edn. Copenhagen: Munksgaard.Google Scholar
Coblentz, J. M., Mattis, S., Zungesser, L. H. et al (1973) Presenile dementia. Archives of Neurology, 29, 299308.Google Scholar
Constantinidis, J., Yanniotis, G. & de Ajuriaguerra, J. (1978) Syndrome démentia sénile avec dilatation de ventricles cérébraux sans autres lésions (a propos de 18 observations anatomo-cliniques). Schweizer Archiv für Neurologie, Neurochirurgie und Psychiatrie, 121, 229248.Google Scholar
Duffy, F. H., Albert, M. S. & McAnulty, G. (1984) Brain electrical activity in patients with presenile and senile dementia of the Alzheimer's type. Annals of Neurology, 16, 439448.Google Scholar
Hagberg, B. O. & Ingvar, D. H. (1976) Cognitive reduction in presenile dementia related to regional abnormalities of the cerebral blood flow. British Journal of Psychiatry, 128, 209222.Google Scholar
Halgren, E., Squires, N. K., Wilson, C. L., Rohrbaugh, J. W., Babb, T. L. & Crandall, P. H. (1980) Endogenous potentials generated in the human hippocampal formation and amygdala by infrequent events. Science, 210, 803805.Google Scholar
Henderson, D. K. & MacLachlan, S. H. (1930) Alzheimer's disease. Journal of Mental Science, 76, 646661.Google Scholar
Hyman, B. T., Vanhoesen, G. W., Damasio, A. R. & Barnes, C. L. (1984) Alzheimer's disease: cell-specific pathology isolates the hippocampal formation. Science, 225, 11681170.Google Scholar
Kasniak, A. W., Fox, J., Crandell, D. L. et al (1978) Predictors of mortality in presenile and senile dementia. Annals of Neurology, 3, 246252.CrossRefGoogle Scholar
Kopelman, M. D. (1985) Multiple memory deficits in Alzheimer's type dementia: implications for pharmacotherapy. Psychological Medicine, 15, 527543.Google Scholar
Luria, A. R. (1966) Hunum Brain and Psychology Processes. New York: Harper and Row.Google Scholar
Neary, D. & Snowden, J. S. (1985) Psychological correlates of presenile dementia. Interdisciplinary Topics in Gerontology, 20, 2434.CrossRefGoogle Scholar
Nie, N. H., Hull, C. H., Jenkins, J. G. & Steinbrenner, K. (1975) Statistical Package for the Social Sciences, 2nd edn. McGraw-Hill.Google Scholar
Office of Population Censuses and Surveys (1985) Birth Statbtics. FMI No. 12. London: HMSO.Google Scholar
Pearson, R. C. A., Esiri, M. M., Hiorns, R. W., Wilcock, G. K. & Powell, T. P. S. (1985) Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease. Proceedings of the National Academy of Science (USA), 82, 45314534.Google Scholar
Polich, J., Ehlers, C., Otis, S. et al (1986) P300 latency reflects the degree of cognitive decline in dementing illness. Electroencephalography and Clinical Neurophysiology, 63, 138144.Google Scholar
Reisberg, B. (1983) Clinical presentation, diagnosis and symptomatology of age associated cognitive decline and Alzheimer's disease. In Alzheimer's Disease: the Standard Reference (ed. B. Reisberg). New York: Free Press.Google Scholar
Rosen, W. G., Mohs, R. C. & Davis, K. L. (1984) A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 11, 13561364.Google Scholar
Sim, M. & Sussman, I. (1962) Alzheimer's disease: its natural history and differential diagnosis. Journal of Nervous and Mental Diseases, 135, 489.Google Scholar
Sjogren, H. (1950) Twenty four cases of Alzheimer's disease. Acta Medica Scandinavica, Sappl. 2A6; 225 233.Google Scholar
Slaets, I. P. I. & Fortoens, C. (1984) On the value of P300 event related potentials in the differential dagnosis of dementia. British Journal of Psychiatry, 145, 652656.Google Scholar
StClair, D. M. & Blackwood, D. H. R. (1985) Premature senility in Down's syndrome. The Lancet, ii, 34.Google Scholar
StClair, D. M., Blackwood, D. H. R. & Christie, J. E. (1985) P3 and other long latency auditory evoked potentials in presenile dementia Alzheimer type and alcoholic Korsakoff syndrome. British Journal of Psychiatry, 147, 702707.CrossRefGoogle Scholar
Sulkava, R. & Amberla, K. (1982) Alzheimer's disease and senile dementia of Alzheimer type: a neuropsychological study. Acta Neurologica Scandinavica, 65, 651660.CrossRefGoogle ScholarPubMed
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