Computed tomography evaluations of brain-behavior relationships in senile d dementia of the Alzheimer's type

doi:10.1016/0197-4580(80)90027-5

Neurobiology of Aging

Volume 1, Issue 1, Summer 1980, Pages 69-79

https://doi.org/10.1016/0197-4580(80)90027-5 Get rights and content

Abstract

Neuropathological investigations have demonstrated brain-behavior relationships in senile dementia of the Alzheimer's type (SDAT), but CT studies have not produced consistent findings. We hypothesized that these discouraging results were in part due to limitations in the methods of CT scan evaluations, and to non-homogeneity of patient populations. The present study examined 43 out-patients with the presumptive diagnosis of SDAT using 37 cognitive test measures and 3 independent CT evaluation strategies. The CT methods included a new rank ordering procedure and two previously used techniques, physical measurement and 4-point rating. Highly significant (p≤0.01) brain-behavior correlations were attained using the ranking and rating procedures for evaluation of ventricular and cortical pathology. It was found that rank ordering has high interrater reliability and is superior to the other methods for the evaluation of the ventricular system. The physical measurement of the third ventricle is the single most powerful linear correlate of cognitive impairment. Measurement of cortical sulci are of no correlational significance. Multiple regression analyses indicated that global assessments are the best cognitive predictors of both ventricular and cortical pathology. Thus the present study has demonstrated brain-behavior relationships in vivo in SDAT.

References (29)

B.E. Tomlinson et al.
Observations of brains of demented old people
J. Neurol. Sci.
(1970)
W.F. Battig et al.
Category norms for verbal items in 56 categories
J. exp. Psychol. Monogr.
(1969)
G. Blessed et al.
The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects
Br. J. Psychiat.
(1968)
J. Buschke et al.
Evaluating storage, retention and retrieval in disordered memory and learning
Neurology
(1974)
L.E. Claveria et al.
The clinical significance of “cerebral atrophy” as shown by C.A.T.
J.A.N. Corsellis
Aging and the dementias
A. Engeset et al.
Third ventricles of 12 mm width or more: a preliminary report
Acta radiol. Diag.
(1958)
P.M. Farmer et al.
Correlations among numbers of neuritic plaques, neurofibrillary tangles, and the severity of senile dementia
S.H. Ferris et al.
Reaction time as a diagnostic measure of cognitive impairment in senility
J. Am. Geriat. Soc.
(1976)
J.W. French et al.
First and last names test

J.G. Gilbert et al.

Patterns of declining memory

J. Geront.

(1971)

M. Gado et al.

Atrophy versus aging

R.H. Gosling

The association of dementia with radiologically demonstrated cerebral atrophy

J. Neurol. Neurosurg. Psychiat.

(1955)

B. Gurland

The borderlands of dementia: The influence of sociocultural characteristics on rates of dementia occurring in the senium

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^☆: Supported in part by USPHS Grant MH29590.

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Computed tomography evaluations of brain-behavior relationships in senile d dementia of the Alzheimer's type☆

Abstract

J. Neurol. Sci.

Category norms for verbal items in 56 categories

J. exp. Psychol. Monogr.

The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects

Br. J. Psychiat.

Evaluating storage, retention and retrieval in disordered memory and learning

Neurology

The clinical significance of “cerebral atrophy” as shown by C.A.T.

Aging and the dementias

Third ventricles of 12 mm width or more: a preliminary report

Acta radiol. Diag.

Correlations among numbers of neuritic plaques, neurofibrillary tangles, and the severity of senile dementia

Reaction time as a diagnostic measure of cognitive impairment in senility

J. Am. Geriat. Soc.