Dysexecutive syndrome in amnesic mild cognitive impairment: a multicenter study.
BACKGROUND
Executive functions (EF) in Alzheimer's disease (AD), classically related to the prefrontal cortex, have been forgotten in mild stages, given more importance to temporal lobe associated disorders, such as memory. The study of disexecutive syndrome (DS) has been relegated to advanced stages of the disease. Our goal is to demonstrate that EF are already present in amnesic mild cognitive impairment (aMCI). Furthermore, we are interested in knowing whether poor scores in EF tests are related to the progression to AD or another kind of dementia.


METHODS
We studied patients with aMCI (n = 81) and healthy controls (n = 142) from neurological departments of several centers of Basque Country with a cross-sectional design. Patients underwent a complete neuropsychological evaluation, neuroimaging testing APOE genotype and 3 year of prospective follow-up.


RESULTS
In the first visit, patients with aMCI showed more alterations in tests that evaluate EF such as Stroop, trail-making and categorical verbal fluency. More alterations were also found in NPI scale (P <0.05). Stroop and Trail-Making test were not associated with the future development of AD, but fluency (p = 0.01) and apathy (p = 0.031) did. No patient developed a different kind of dementia different from AD.


CONCLUSIONS
DS is a broad concept not confined to frontal lobes, and can be found in early stages of aMCI. DS impacts negatively on patient autonomy and may have prognostic value.
Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain. eblanco@neuronak.com.|BioCruces Health Research Institute, Barakaldo, Vizcaya, Spain. eblanco@neuronak.com.
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Blanco Martín
Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
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I
Ugarriza Serrano
Genetracer Biotech, Santander, Cantabria, Spain.
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Elcoroaristizabal Martín
Hospital Universitario Álava, Vitoria-Gasteiz, Álava, Spain.
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Galdos Alcelay
Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
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Molano Salazar
Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
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R
Bereincua Gandarias
Hospital Universitario Álava, Vitoria-Gasteiz, Álava, Spain.
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Inglés Borda
Department of Neurology, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain.
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Uterga Valiente
Department of Neurology, Hospital Universitario Donostia, Donostia-San Sebastian, Guipúzcoa, Spain.|Biodonostia Health Research Institute, Donostia-San Sebastian, Guipúzcoa, Spain.
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MB
Indakoetxea Juanbeltz
Hospital Universitario Álava, Vitoria-Gasteiz, Álava, Spain.
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Moraza Lopez
Department of Neurology, Hospital Universitario Donostia, Donostia-San Sebastian, Guipúzcoa, Spain.|Biodonostia Health Research Institute, Donostia-San Sebastian, Guipúzcoa, Spain.
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Barandiarán Amillano
Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.|BioCruces Health Research Institute, Barakaldo, Vizcaya, Spain.
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Fernández-Martínez
D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology*; D000647:Amnesia / Q000523:psychology*; D057565:Apathy; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000523:psychology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000503:physiopathology; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies
Amnesic mild cognitive impairment Alzheimer’s disease; Disexecutive syndrome; Executive functions