Neuropsychological profile of mild cognitive impairment of different etiology / 中华神经科杂志

Objective To determine the cognitive profile of mild cognitive impairment due to subcortieal small vessel disease(MCI-SSVD)and mild cognitive impairment caused by Alzheimer's disease(MCI-AD)and to establish the best way of differentiating.Methods Extensive neuropsychological tests covenng 5 cognitive domains were performed on 45 MCI-SSVD patients,30 MCI-AD patients,and 61healthy controls.The impaired domains in patient groups were determined.Tests valuable in discriminating MCI-SSVD and MCI-AD were established using logistie regression analysis.Results Both patient groups showed impairments in multiple cognitive domains.The auditory verbal learning test immediate recall(control group 55.48±5.33;MCI-SSVD group 38.55±8.04;MCI-AD group 34.93±8.79;F=113.407,P=0.000),short time delayed recall(control group 13.34±1.38;MCI-SSVD group 8.47±2.18;MCI-AD group 4.06±2.87;F=216.284,P=0.000),and long time delayed recall(control group13.18±1.19;MCI-SSVD group 8.58±2.02;MCI-AD group 3.93±2.84;F=239.394,P=0.000)impaired most.Compared with MCI-SSVD,MCI-AD patients did worse in memory assessments(P=0.000),but better in mental processing and visuoconstruction(P=0.000-0.023).Two tests tapping memory and processing speed in combination could identify 93.3%MCI-SSVD patients and 93.3% MCI-AD patients correctly.Conclusions Current study indicates that both MCI-SSVD and MCI-AD,varying significantly in memory and mental processing speed,have a multiple-domain cognitive deficit,with memory impaired most seriously.Tests involving these 2 domains might be useful in differentiating MCI-SSVD from MCI-AD.

Correlation of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy / 中华神经科杂志

Objective To compare the differences of cognitive dysfunction and hippocampal atrophy among patients with temporal lobe epilepsy (TLE) and healthy controls and probe into the relativity of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy. Methods Forty-nine TLE cases and 20 healthy individuals were randomly selected. The WAMS-R and WAIS-R scales were adopted to assess the memory and intelligence of all the subjects. Hippocampal volumes were measured by semiautomatic measurement on the head magnetic resonance imaging (MRI). The degree of hippocampal atrophy (DHA) and asymmetry index (AsI) were caculated by adjusting hippocampal volumes and ratio of difference of two lateral hippocampal volumes. Results Compared with the healthy controls, not only did the TLE patients exhibit more memory deficits (83.2±21.0,t=-3.365 ,P=0.001 ), but also more fullscale intelligence (91.0±12.3, t=- 4.291, P=0.000). The bilateral hippocampi of all TLE patients significantly decreased in volume ( P=0.000 ) and increased in AsI ( t=3.975, P=0.000 ). The MQ of TLE patients was significantly negatively related to the duration of the illness ( r=-0.339, P=0.017 ). The bilateral DHA and the hippocampal AsI were negatively related to Z scores (left: r=-0.297, P= 0.038, right: r=-0.305, P=0.033, AsI: r=-0.441, P=0.002), repectively. Conclusions The more the DHA and asymmetry of bilateral hippocampi, the worse the cognitive dysfunction. The quantitative measurements of hippocampal volume could be used as a clinically effective factor for evaluating the decrease of the intelligence of TLE patients.

The clinical models of memory impairment in mild Alzheimer’s disease / 中华老年医学杂志

0 05)between AD and aging c ontrol subjects or MCI patients. Conclusions Episodic memory impairment and semantic memory impairment beside the immediat ely recall and naming are the earliest and most pervasive memory deficit in mild AD patients, and episodic memory impairment is more specific than semantic memo ry impairment for the diagnosis of AD.