[Longitudinal approaches to the problem of clinical heterogeneity of Alzheimer-type dementia]. / Longitudinal'nye podkhody k probleme klinicheskoi geterogennosti dementsii al'tsgeimerovskogo tipa.

A total of 160 patients with Alzheimer-type dementias (ATD), including 84 with Alzheimer's diseases (AD) and 76 with senile dementia (SD), were examined. The initial signs of the disease were analyzed by making a retrospective assessment of informative history data. The prospective follow-up involved clinical, neuropsychological and electrophysiological (EEC mapping, evoked potentials) studies by applying the standardized assessment of results. There was shown to be a set of clinical and paraclinical parameters for the status of ATD patients, indicating a distinct-quantitative and qualitative difference between patients with AD and those with SD and supporting the heterogeneity of ATD.

[Specificity of neuropsychological syndromes in disorders of higher mental functions in Alzheimer's disease and senile dementia]. / O spetsifichnosti neiropsikhologicheskikh sindromov narusheniia vysshikh psikhicheskikh funktsii pri bolezni Al'tsgeimera i senil'noi dementsii.

A comparative neuropsychological study was made of the two groups of patients: with Alzheimer's disease [AD] (n = 40) and senile dementia [SD] (n = 54). The correlation and role of different factors in the formation of syndromes of higher mental functions (HMF) impairment in AD and SD were determined. The analysis was based on the concept of the presence of operational and regulatory factors in the systemic organization of mental activity. The structure of the syndrome of HMF impairment in AD is specified by the deficiency of operational factors whereas in SD, the deficiency of regulatory factors plays the key role. The patients with AD manifest the combination of disordered operational and regulatory factors related to the work of brain blocks II and I respectively (according to Luria). In SD patients, the syndrome is marked by the predominance of the symptoms related to the deficiency of regulatory factors provided for by the structures of brain blocks III and I, with the interest of the brain areas entering block II being far less.

[Clinical heterogeneity of dementia of the Alzheimer type]. / O klinicheskoi geterogennosti dementsii al'tsgeimerovskogo tipa.

Using clinico-psychopathological, clinico-neuropsychological and computer-aided tomography approaches, material differences were ascertained between groups of patients with Alzheimer's disease (AD) and senile dementia (SD) in terms of the clinical parameters, including the age at which the disease sets in; the disease standing; the build-up features of the patients; the frequency of diverse exogenous and environmental actions at the premorbid stage and at the disease debut; the psychopathological structure of dementia and the initial disease manifestations. The clinical differences indicated were in agreement with different structures of the neuropsychological syndrome marked by the impairment of higher mental functions in AD and SD and with different structures and topography of alterations in the medulla, discovered by means of computer-aided studies. The differences in the clinical and morphofunctional characteristics of AD and SD allow a conclusion that AD and SD are clinically independent disease entities within the framework of the common group of the Alzheimer's type dementias.