Neuropsychological, psychiatric, and cerebral blood flow findings in vascular dementia and Alzheimer's disease.
OBJECTIVE
Psychiatric, neuropsychological, and cerebral blood flow differences between patients with ischemic vascular dementia (IVD) or Alzheimer's disease (AD) were examined.


METHODS
A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association for probable AD or the State of California AD Diagnostic and Treatment Centers criteria for probable IVD were included in the study. Twenty consecutive patients with IVD were matched for age, sex, and Mini-Mental State Examination scores with 40 consecutive patients with probable AD. Patients underwent a psychiatric interview, a neuropsychological assessment, and single-photon emission CT imaging with 99mTc-hexamethylpropyleneamine oxime.


RESULTS
Patients with IVD showed significantly more severe anosognosia (P<.05) and emotional lability (P<.01) than AD patients, but no significant between-group differences were found in the frequency and severity of depression. IVD patients showed significantly more severe deficits in tests of planning, sequencing (P<.05), and verbal fluency (P<.05) as well as significantly more severe cerebral blood flow deficits in the basal ganglia (P<.01) and the frontal lobes (P<.001) than AD patients.


CONCLUSIONS
Patients with IVD showed a relatively more severe dysfunction of the frontal lobes as demonstrated by single-photon emission CT and expressed in specific psychiatric and neuropsychological changes than AD patients matched for age, sex, and severity of dementia.
Starkstein
S E
SE
Department of Behavioral Neurology, Raul Carrea Institute of Neurological Research, Buenos Aires, Argentina.
Sabe
L
L
Vazquez
S
S
Teson
A
A
Petracca
G
G
Chemerinski
E
E
Di Lorenzo
G
G
Leiguarda
R
R
D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D001479:Basal Ganglia / Q000098:blood supply; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology; D015140:Dementia, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008603:Mental Health; D009483:Neuropsychological Tests; D009484:Neuropsychology; D015609:Organotechnetium Compounds; D010091:Oximes; D012649:Self Concept; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014705:Verbal Behavior
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime