title: Patterns of neuropsychological impairment in MCI patients with small subcortical infarcts or hippocampal atrophy.
abstract: We investigated whether MCI patients with hippocampal atrophy or multiple subcortical infarcts demonstrate neuropsychological patterns and markers considered typical of Alzheimer's disease (AD) and of vascular dementia (VD), respectively. An extensive neuropsychological battery, including tests of memory, visual-spatial and executive functions, language, attention, praxis and psychomotor speed, was administered to 36 mild cognitive impairment (MCI) patients with hippocampal atrophy and 41 MCI patients with multiple subcortical infarcts. Both groups of MCI patients were very mildly impaired and well matched in terms of MMSE scores. A clear, disproportionately severe, episodic memory disorder was observed in MCI patients with hippocampal atrophy. A less specific neuropsychological profile, consisting of impairment on an Action Naming task that is sensitive to frontal lobe lesions, was observed in MCI patients with multiple subcortical infarcts. In MCI patients, a disproportionately severe episodic memory impairment strongly points to an Alzheimer's type brain pathology, whereas the prevalence of executive deficits and other frontal lobe symptoms are a much weaker diagnostic marker of small vessel subcortical disease.
authors.affiliation: Neuropsychology Service of the UCSC/Policlinico Gemelli, Catholic University of Rome, Rome, Italy. gainotti@rm.unicatt.it
authors.forename: Guido
authors.initials: G
authors.lastname: Gainotti
authors.forename: Monica
authors.initials: M
authors.lastname: Ferraccioli
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Vita
authors.forename: Camillo
authors.initials: C
authors.lastname: Marra
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D001284:Atrophy; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D015161:Dementia, Multi-Infarct / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006624:Hippocampus / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011340:Problem Solving / Q000502:physiology; D011594:Psychometrics