Authors: Riancho, Javier | Pozueta, Ana | Santos, Miguel | Lage, Carmen | Carril, José M. | Banzo, Ignacio | Martínez-Rodriguez, Isabel | Gorno-Tempini, Marilu | Sánchez-Juan, Pascual
Article Type: Short Communication
Abstract: Among primary progressive aphasias (PPAs), logopenic variant PPA (lv-PPA) is usually related to Alzheimer’s disease. Although it has been widely clinically and pathologically evaluated, the topography in LPA is still controversial. We report a patient presenting with a logopenic syndrome due to a strategic lesion located in the superior and middle temporal gyrus and compare our findings with those of a PiB-PET positive lv-PPA patient matched by age, gender, and education. We consider that our study provides new anatomical clues to better understand the cognitive mechanisms underlying the logopenic syndrome.
Keywords: Logopenic aphasia, primary progressive aphasia, stroke
DOI: 10.3233/JAD-161267
Citation: Journal of Alzheimer's Disease, vol. 57, no. 3, pp. 717-721, 2017
Authors: Pozueta, Ana | Lage, Carmen | Martínez, María García | Kazimierczak, Martha | Bravo, María | López-García, Sara | Riancho, Javier | González-Suarez, Andrea | Vázquez-Higuera, José Luis | de Arcocha-Torres, María | Banzo, Ignacio | Bonilla, Julio Jimenez | Berciano, José | Rodríguez-Rodríguez, Eloy | Sánchez-Juan, Pascual
Article Type: Research Article
Abstract: Background: Semantic dementia (SD) is a subtype of frontotemporal lobe degeneration characterized by semantic loss, with other cognitive functions initially preserved. SD requires differential diagnosis with Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Semantic knowledge can be evaluated through different tests; however, most of them depend on language. Objective: We describe the development of a brief drawing task that may be helpful for the differential diagnosis of SD. Methods: Seventy-two patients, including 32 AD, 19 bvFTD, and 21 SD were asked to draw 12 items with different age of acquisition and familiarity, belonging to four different semantic categories. …We employed the drawings of healthy volunteers to build a scoring scheme. Results: Turtle, strawberry, train, and envelope were the items of each category that best discriminated between groups and were selected for the Brief drawing task. The discriminatory power of the Brief drawing task between SD versus AD and bvFTD patients, estimated through the area under the curve was 0.84 (95% CI = 0.72–0.96, p = 0.000007). In a logistic model, the Brief drawing task (p = 0.003) and VOSP “number location” subtest (p = 0.016) were significant predictors of the diagnosis of SD versus AD and bvFTD after adjustment by the main covariates. The Brief drawing task provided clinically useful qualitative information. SD drawings were characterized by loss of the distinctive features, intrusions, tendency to prototype, and answers like “I don’t know what this is”. Conclusion: The Brief drawing task appears to reveal deficits in semantic knowledge among patients with SD that may assist in the differential diagnosis with other neurodegenerative diseases. Show more
Keywords: Dementia, differential diagnosis, drawings, semantic dementia, semantic knowledge
DOI: 10.3233/JAD-190660
Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 151-160, 2019
Authors: Pozueta, Ana | Lage, Carmen | García-Martínez, María | Kazimierczak, Martha | Bravo, María | López-García, Sara | Riancho, Javier | González-Suarez, Andrea | Vázquez-Higuera, José Luis | de Arcocha-Torres, María | Banzo, Ignacio | Jiménez-Bonilla, Julio | Berciano, José | Rodríguez-Rodríguez, Eloy | Sánchez-Juan, Pascual
Article Type: Research Article
Abstract: Background: Semantic dementia (SD) is a subtype of frontotemporal dementia (FTD) characterized by semantic memory loss and preserved abilities of other cognitive functions. The clinical manifestations of SD require a differential diagnosis with Alzheimer’s disease (AD), especially those with early onset, and behavioral variant FTD (bvFTD). Objective: The present study aimed to compare cognitive performances and neuropsychiatric symptoms in a population of AD, bvFTD, and left and right SD defined with the support of molecular imaging (amyloid and 2-[18 F] fluoro-2-deoxy-D-glucose positron emission tomography) and assessed the accuracy of different neuropsychological markers in distinguishing these neurodegenerative diseases. Methods: Eighty-seven participants …(32 AD, 20 bvFTD, and 35 SD (17 Left-SD and 18 Right-SD) completed a comprehensive neuropsychological battery that included memory, language, attention and executive functions, visuospatial function, visuoconstructional skills, and tasks designed specifically to evaluate prosopagnosia and facial emotions recognition. The Neuropsychiatric Inventory was administered to assess neuropsychiatric symptoms. Results: An episodic memory test that included semantic cues, a visuospatial test (both impaired in AD), a naming test and a prosopagnosia task (both impaired in SD) were the four most valuable cognitive metrics for the differential diagnosis between groups. Several behavioral abnormalities were differentially present, of which aggression, self-care (both more frequent in bvFTD), and eating habits, specifically overeating and altered dietary preference (more frequent in SD), were the most valuable in group discrimination. Conclusion: Our study highlights the value of a comprehensive neuropsychological and neuropsychiatric evaluation for the differential diagnosis between FTD syndromes and AD. Show more
Keywords: Alzheimer’s disease, behavior, behavioral variant frontotemporal dementia, cognition, semantic dementia
DOI: 10.3233/JAD-190877
Citation: Journal of Alzheimer's Disease, vol. 72, no. 4, pp. 1129-1144, 2019
Authors: Lage, Carmen | Suarez, Andrea Gonzalez | Pozueta, Ana | Riancho, Javier | Kazimierczak, Martha | Bravo, Maria | Jimenez Bonilla, Julio | de Arcocha Torres, Marıa | Quirce, Remedios | Banzo, Ignacio | Vazquez-Higuera, Jose Luis | Rabinovici, Gil D. | Rodriguez-Rodriguez, Eloy | Sánchez-Juan, Pascual
Article Type: Research Article
Abstract: The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET. We assessed changes between the pre- and post-PET clinical diagnosis and Alzheimer’s disease treatment …plan. The association between PiB/FDG results and changes in management was evaluated using χ 2 and multivariate logistic regression. Concordance between classification based on scan readings and baseline diagnosis was 66% for PiB and 47% for FDG. The primary diagnosis changed after PET in 17.2% of cases. When examined independently, discordant PiB and discordant FDG were both associated with diagnostic change (p < 0.0001). However, when examined together in a multivariate logistic regression, only discordant PiB remained significant (p = 0.0002). Changes in treatment were associated with concordant PiB (p = 0.009) while FDG had no effect on treatment decisions. Based on our regression model, patients with diagnostic dilemmas, a suspected non-amyloid syndrome, and Clinical Dementia Rating <1 were more likely to benefit from amyloid PET due to a higher likelihood of diagnostic change. We found that changes in diagnosis after PET in our secondary center almost doubled those of our previous analysis of a tertiary unit (9% versus 17.2%). Our results offer some clues about the rational use of amyloid PET in a secondary care memory unit stressing its utility in mild cognitive impairment patients. Show more
Keywords: Alzheimer’s disease, amyloid, dementia, FDG, PET, PiB
DOI: 10.3233/JAD-170985
Citation: Journal of Alzheimer's Disease, vol. 63, no. 3, pp. 1025-1033, 2018
