[Transitory topographical amnesia].
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Biomedical subjects
Publications and source records attributed to P Caffarra.
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Sixteen patients, who had suffered only one episode of transient global amnesia and showed no clinically evident abnormalities in their follow-up, were examined with psychometric and memory tests. Deficits in verbal long-term memory and in verbal IQ were found. These observations seem to demonstrate that in transient global amnesia patients regarded as being 'normal' in their follow-up there is no complete recovery and the sequelae seem to conform to a definite pattern. Problems of nosology and localization are discussed.
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Twenty-one patients showing memory deficits were submitted to neuropsychological battery, before and after treatment with Deanol. No significant effect has been found. Arguments suggesting further investigation are discussed.
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The Authors, considering the insufficiency of data in this condition, have studied the memory functions in patients who, in the follow up after an episode of TGA, did not show any clinical sign. A selective loss of a short-term "verbal" memory, without any psychometric alteration, is found out. The meaning of those observations is discussed with regard to the possible further differentiation of TGA syndrome in acute and chronic phases.
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We report the behavioural abnormalities, neuroimaging, and neuropsychological results of a 62-year-old patient, i.p., who shows a clinical profile that fulfils all characteristics of dementia of frontal lobe type. The patient has been followed up over 5 years with psychometric testing. Comparing her cognitive profiles across examinations, her performance was substantially unchanged apart from behavioural disturbances and performance on frontal tasks which showed a progressive worsening. MRI finding evidenced marked ventricular enlargement, prevalent frontal atrophy and hypertrophy of the genus of corpus callosum. SPECT investigation showed a considerable reduction of cerebral blood flow in the mesial parts of the frontal lobes, in the lateral surface of the right fronto-parietal lobe, and hypo-perfusion in the right thalamic area. The results are discussed with reference to the features (clinical and neuropsychological) which distinguish different profiles of dementia.
It is generally accepted that presenile Alzheimer's disease (AD) has faster progression and severer clinical manifestation than senile onset AD. Recently a relative left frontal hypoperfusion was only found in patients with presenile AD by using SPECT imaging. The aim of the present report was to ascertain whether the same conclusion could be drawn matching the population with respect to the severity of the cognitive profile and disease duration. Twenty subjects for each group were studied with SPECT and no differences emerged between groups. It is postulated that presenile and senile onset AD represent aspects of the same biological process.
The Fuld formula and the linear discriminant function applied to WAIS subtest scores were tested for their ability to identify Alzheimer's disease and senile dementia of the Alzheimer type in a group of 101 demented subjects. The sensitivity and specificity of Fuld's formula for Alzheimer dementia against other dementias were 44.2% and 73.8% respectively; when compared with an age-matched normal control group specificity was 91.4%. When the linear discriminant function was applied only WAIS subtest scores in "similarities and digit span" and "object assembly" significantly differentiated Alzheimer from other dementias (sensitivity 61.5% and specificity 63.3%). Specificity increased to 97.1% when the function was applied to discriminate Alzheimer from normal controls. Discriminant analysis applied to other WAIS subtests for the two demented groups revealed "picture completion" as significantly differentiating the groups but it did not contribute to diagnostic accuracy. WAIS scores are of limited value in the differential diagnosis of dementias.
The authors report two cases of motor apraxia, agraphia and tactile anomia on the left side, associated with bilateral constructive apraxia. These cases are discussed in relation to their unusual etiology and in relation to possible pathogenetic hypothesis other than classical Liepmann's scheme.
A case of permanent global amnesia resulting from a bilateral hippocampal lesion is reported, remarkable for its typical clinical picture and prolonged period of observation with repeated neuropsychological testing. No tendency toward spontaneous recovery was noted, even though extra-mnesic cognitive functions remained undamaged. No differences were observed between this amnesic syndrome and the neuropsychological picture during an acute episode of transient global amnesia.