Lobar Dementia due to Extreme Widening of Virchow-Robin Spaces in One Hemisphere.

Widened perivascular spaces known as Virchow-Robin spaces (VRS) are often seen on MRI and are usually incidental findings. It is unclear if enlarged VRS can be associated with neurological deficits. In this report, we describe a case of lobar dementia associated with unusual VRS widening in one cerebral hemisphere. A 77-year-old woman, seen at a memory clinic, presented with progressive cognitive decline, left hemianopsia, and mild pyramidal signs on the left side. On MRI, unusually wide VRS were visible, predominantly in the right centrum semiovale and the right temporo-occipital white matter. The clinical syndrome was consistent with the extent and location of the abnormally dilated VRS. The high MR signal in white matter bridges between the VRS suggested parenchymal damage, possibly representing gliotic white matter. No evidence for another etiology was found on cerebral MRI and rCBF SPECT. As a conclusion, enlarged VRS in one cerebral hemisphere may be associated with cognitive change and neurological deficits.

CSF-tau and CSF-Abeta(1-42) in posterior cortical atrophy.

OBJECTIVE: Our purpose was to measure Abeta(1-42), T-tau and P-tau(181) in the cerebrospinal fluid (CSF) of patients with posterior cortical atrophy (PCA), a presenile dementia likely to represent a variant of Alzheimer's disease (AD). METHODS: CSF samples from 34 subjects including 9 patients with PCA, 11 age-matched patients with AD and 14 age-matched cognitively healthy controls were analyzed using commercially available ELISA kits. RESULTS: The Abeta(1-42), T-tau and P-tau(181) levels in PCA patients differed significantly (p < 0.02) from those in healthy controls but were indistinguishable from subjects with a clinical diagnosis of AD. CONCLUSION: High T-tau and P-tau(181) and low Abeta(1-42) levels in PCA - typically observed in AD - indicate that the underlying pathology of PCA is usually AD. If these findings are replicated in PCA patients with autopsy-confirmed AD neuropathology, PCA patients may be eligible for disease-modifying AD treatments.

Clinical characteristics of dementia associated with argyrophilic grain disease.

BACKGROUND/AIMS: We aimed at characterizing the clinical features of dementia associated with argyrophilic grain disease (AgD). METHODS: Relatives or close friends of 24 individuals with autopsy-confirmed AgD and 29 patients with autopsy-confirmed Alzheimer's disease (AD) were administered a novel Retrospective Dementia Inventory to assess the cognitive, behavioral and affective symptoms of the deceased patients. RESULTS: AgD patients showed less severe impairments in memory, language, attention and executive function than AD patients. CONCLUSION: Compared to AD patients, individuals suffering from AgD appear to present with comparable deficits in behavior and affect but relatively spared cognitive functioning.