Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease
In vivo neuroimaging studies have generally indicated a greater involvement of posterior cortical areas in early-stage dementia of the Alzheimer type (DAT) relative to frontal involvement. By contrast, some recent neuropsychological studies have shown that DAT patients perform poorly in frontal lobe...
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| Format: | Article |
| Language: | English |
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Wiley
1996-01-01
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| Series: | Behavioural Neurology |
| Online Access: | http://dx.doi.org/10.3233/BEN-1996-93-405 |
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| author | P. Broks C. Lines L. Atchison J. Challenor M. Traub C. Foster H. Sagar |
| author_facet | P. Broks C. Lines L. Atchison J. Challenor M. Traub C. Foster H. Sagar |
| author_sort | P. Broks |
| collection | DOAJ |
| description | In vivo neuroimaging studies have generally indicated a greater involvement of posterior cortical areas in early-stage dementia of the Alzheimer type (DAT) relative to frontal involvement. By contrast, some recent neuropsychological studies have shown that DAT patients perform poorly in frontal lobe tasks even in the early stages of the disease, although there is disagreement as to whether this necessarily implicates frontal pathology. The main aim of this study was to examine the hypothesis prompted by both neuroimaging studies and the traditional clinical conception of the disease, that, compared with the functioning of posterior association cortex, executive functions (thought to depend on frontal lobe integrity) are relatively spared in the early stages of DAT. A group of patients with a diagnosis of early-stage, probable DAT (n = 17) was compared with age- and IQ-matched controls (n = 17) across a range of neuropsychological tasks presumed to exercise frontal or temporoparietal functions. A profile of strengths and weaknesses was observed across ‘anterior’ and ‘posterior’ cognitive tests, including dissociations among some tests of temporoparietal function, in particular visual object perception (impaired) and spatial analysis skills (intact). Thus there was little support for the notion that the disease progresses cortically in a posterior-to-anterior direction. Possible reasons for the discrepancy between neurophysiological and neuropsychological observations are discussed, including the possibility that neuropsychological tests do not provide a valid indication of regional brain function when used in the context of DAT. Caution is urged in the clinical application of ‘frontal lobe tests’ for the differential diagnosis of DAT. |
| format | Article |
| id | doaj-art-c45c9430be9245ad9968fe5ddf45f802 |
| institution | OA Journals |
| issn | 0953-4180 1875-8584 |
| language | English |
| publishDate | 1996-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Behavioural Neurology |
| spelling | doaj-art-c45c9430be9245ad9968fe5ddf45f8022025-08-20T02:18:48ZengWileyBehavioural Neurology0953-41801875-85841996-01-0193-413514810.3233/BEN-1996-93-405Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s DiseaseP. Broks0C. Lines1L. Atchison2J. Challenor3M. Traub4C. Foster5H. Sagar6School of Psychology, University of Birmingham, and Neuropsychology Unit, Royal Hallamshire Hospital, Sheffield, UKMerck Sharp and Dohme Research Laboratories, Harlow, UKDepartment of Clinical Neurology, University of Sheffield, UKMerck Sharp and Dohme Research Laboratories, Harlow, UKMerck Sharp and Dohme Research Laboratories, Harlow, UKQueen Mary's Hospital, Sidcup, UKDepartment of Clinical Neurology, University of Sheffield, UKIn vivo neuroimaging studies have generally indicated a greater involvement of posterior cortical areas in early-stage dementia of the Alzheimer type (DAT) relative to frontal involvement. By contrast, some recent neuropsychological studies have shown that DAT patients perform poorly in frontal lobe tasks even in the early stages of the disease, although there is disagreement as to whether this necessarily implicates frontal pathology. The main aim of this study was to examine the hypothesis prompted by both neuroimaging studies and the traditional clinical conception of the disease, that, compared with the functioning of posterior association cortex, executive functions (thought to depend on frontal lobe integrity) are relatively spared in the early stages of DAT. A group of patients with a diagnosis of early-stage, probable DAT (n = 17) was compared with age- and IQ-matched controls (n = 17) across a range of neuropsychological tasks presumed to exercise frontal or temporoparietal functions. A profile of strengths and weaknesses was observed across ‘anterior’ and ‘posterior’ cognitive tests, including dissociations among some tests of temporoparietal function, in particular visual object perception (impaired) and spatial analysis skills (intact). Thus there was little support for the notion that the disease progresses cortically in a posterior-to-anterior direction. Possible reasons for the discrepancy between neurophysiological and neuropsychological observations are discussed, including the possibility that neuropsychological tests do not provide a valid indication of regional brain function when used in the context of DAT. Caution is urged in the clinical application of ‘frontal lobe tests’ for the differential diagnosis of DAT.http://dx.doi.org/10.3233/BEN-1996-93-405 |
| spellingShingle | P. Broks C. Lines L. Atchison J. Challenor M. Traub C. Foster H. Sagar Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease Behavioural Neurology |
| title | Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease |
| title_full | Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease |
| title_fullStr | Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease |
| title_full_unstemmed | Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease |
| title_short | Neuropsychological Investigation of Anterior and Posterior Cortical Function in Early-Stage Probable Alzheimer’s Disease |
| title_sort | neuropsychological investigation of anterior and posterior cortical function in early stage probable alzheimer s disease |
| url | http://dx.doi.org/10.3233/BEN-1996-93-405 |
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