The clinical significance of cerebral atrophy in dementia.
The clinical significance of cortical atrophy is reviewed in relationship to neuropsychological impairment in dementia of the Alzheimer type. The degree of cortical atrophy may vary independent of the degree of cognitive impairment. There is some tendency for greater amounts of cortical atrophy to be associated with greater cognitive deficits, but individual variations limit the linearity of this relationship. On an individual case basis, lateralized atrophy in some patients may be associated with greater lateralization of cognitive impairment. Cortical atrophy patterns do not differ substantially in the pre-senile and senile forms of Alzheimer's disease. Neuropsychological follow-up provides a better index of the speed of deterioration in Alzheimer's disease than does computerized tomography (CT) or magnetic resonance imaging (MRI). Various clinical guidelines are offered for the interpretation of neuropsychological impairment based upon CT or MRI findings of cerebral atrophy.
Bigler
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Austin Neurological Clinic and Department of Psychology, University of Texas at Austin, 78705, USA.