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P4–130: Apraxia as initial presentation of Alzheimer's disease: A case series
Author(s) -
Christie Corina,
Martinez Daniel,
Roca Maria,
O'Neill Santiago,
Bustin Julian,
Richly Pablo,
Manes Facundo
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.05.1520
Subject(s) - posterior cortical atrophy , apraxia , psychology , entorhinal cortex , atrophy , dementia , agnosia , anosognosia , audiology , neuropsychology , episodic memory , neuroscience , medicine , disease , hippocampus , cognition , pathology , aphasia
a multicenter approach.Methods:A total of 17 hospitals participated in this nation wide study (VADAPET). Thirty-seven patients with SVD were recruited according to DSM-IV criteria, probable and possible NINDSAIREN Criteria, and Erkinjuntti’s Clinical Criteria for SVD. Each patient and the caregivers underwent semi-structured interview, Neurologic examination and an extensive neuropsychological evaluation encompassing memory, visuospatial, and frontal executive functions were also undertaken. Laboratory tests, brain MRI and MRA, as well as FDG-PET for SPM analysis. Results: Demographic findings of patients were as follows: mean age, 68.465.7 years; education level, 7.264.8 years; MMSE scores, 19.963.8; CDR scores, 1.260.7; GDS scores, 4.0260.92;HIS, 8.462.9. Hypertension and previous stroke history were the most common risk factors. An SPM analysis revealed that, compared with age/sex matched 11 normal controls, the patients with SVD showed hypometabolism involving mainly posterior cortical regions (left superior parietal, left inferior parietal lobule, right superior parietal lobule, and both superior temporal gyrus) and less strongly frontal (both cingulate gyrus andmiddle frontal gyrus) and thalamic regions. Conclusions: Cognitive domains primarily affected in SVD have been regarded as frontal-executive and memory functions. Our findings, however, indicated that glucose hypometabolism in SVD is primarily located in parieto-temporal area followed by frontal-subcortical circuit, a result arguing against the previous notion. Alternatively, the hypometabolism in parietotemporal area in SVD may represent the co-morbidity of Alzheimer’s disease or "retrogenesis" hypothesis of default mode network of overuse.