Association of British Neurologists Autumn Meeting, Newcastle University meeting at Durham, 12−14 September 2001
A COMPARISON OF NEUROPSYCHOLOGICAL ASSESSMENT AND MRI IMAGING SCORES IN THE EARLY DIAGNOSIS OF ALZHEIMER'S DISEASE
CJ Galton, R Swainson, R Vessy, BJ Sahakian, JR Hodges Addenbrookes Hospital, Cambridge, UK
The aim of this study is to address whether neuropsychological measures or imaging scores best predict which patients with questionable dementia progress to fulfil criteria for Alzheimer's disease (AD). MRI images of 50 subjects (18 with early AD, mean MMSE 21.4, and 32 with memory complaints, mean MMSE 27.3) were examined using the temporal lobe rating scale. Subjects underwent a standard battery of neuropsychological tests at baseline, and were clinically followed up for a mean of 19 months. Patients who converted to AD (converters n=11), relative to non-converters, were impaired at baseline assessment on general cognitive tests (Addenbrookes cognitive examination (ACE) and ADAS cog), measures of episodic memory, category fluency, and the graded naming test. The mean scores of the temporal lobe rating scale demonstrated that converters had more hippocampal and parahippocampal atrophy than non-converters. Discriminant analysis demonstrated that the best test for distinguishing the converters from the questionable group, was the ACE score. In combination, the medial temporal lobe rating and graded naming test were also contributory.
MRI imaging measures may be valuable if used in conjunction with neuropsychology, but progression to dementia is best predicted by performance on neuropsychological tests.
EARLY COGNITIVE DECLINE IN CREUTZFELDT-JAKOB DISEASE OCCURRING IN RECIPIENTS OF PITUITARY-DERIVED HUMAN GROWTH HORMONE
RJ Cordery, M Hall, L Cipolotti, L Davidson, P Adlard, MN Rossor National hospital for Neurology and Neurosurgery, London, UK
Most cases of Creutzfeldt-Jakob disease (CJD) in recipients of human cadaveric growth hormone, present with a cerebellar syndrome. Dementia is thought to occur late and as a minor feature of the illness. However, neuropsychology data published on these cases is largely qualitative and anecdotal. The first published case, of a 22 year old woman, does include neuropsychology performed 7 months after the onset of a cerebellar syndrome. This showed evidence of intellectual decline, with …