scholarly journals Distinguishing Depressive Pseudodementia from Alzheimer Disease: A Comparative Study of Hippocampal Volumetry and Cognitive Tests

2017 ◽  
Vol 7 (2) ◽  
pp. 230-239 ◽  
Author(s):  
Sevki Sahin ◽  
Tugba Okluoglu Önal ◽  
Nilgun Cinar ◽  
Meral Bozdemir ◽  
Rahmi Çubuk ◽  
...  

Background and Aim: Depressive pseudodementia (DPD) is a condition which may develop secondary to depression. The aim of this study was to contribute to the differential diagnosis between Alzheimer disease (AD) and DPD by comparing the neurocognitive tests and hippocampal volume. Materials and Methods: Patients who met criteria of AD/DPD were enrolled in the study. All patients were assessed using the Wechsler Memory Scale (WMS), clock-drawing test, Stroop test, Benton Facial Recognition Test (BFRT), Boston Naming Test, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Hippocampal volume was measured by importing the coronal T1-weighted magnetic resonance images to the Vitrea 2 workstation. Results: A significant difference was found between the AD and DPD groups on the WMS test, clock-drawing test, Stroop test, Boston Naming Test, MMSE, GDS, and left hippocampal volume. A significant correlation between BFRT and bilateral hippocampal volumes was found in the AD group. No correlation was found among parameters in DPD patients. Conclusions: Our results suggest that evaluation of facial recognition and left hippocampal volume may provide more reliable evidence for distinguishing DPD from AD. Further investigations combined with functional imaging techniques including more patients are needed.

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Reem Mohamed Sabry ELbedewy ◽  
Mohamed ELOKL

Abstract Background Early symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone. Participants Community-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category. Results We recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT. Conclusion From the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.


2003 ◽  
Vol 16 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Deborah A. Cahn-Weiner ◽  
Karren Williams ◽  
Janet Grace ◽  
Geoffrey Tremont ◽  
Holly Westervelt ◽  
...  

2019 ◽  
Vol 33 (5) ◽  
pp. 384-394 ◽  
Author(s):  
Eman M. Khedr ◽  
Ragaa H. Salama ◽  
Mohamed Abdel Hameed ◽  
Noha Abo Elfetoh ◽  
Peater Seif

Objective. To explore the neuropsychological effects and levels of tau protein (TAU), amyloid β 1-42 (Aβ 1-42), and lipid peroxidase after 10 sessions of anodal transcranial direct current stimulation (tDCS) in patients with mild to moderate Alzheimer disease (AD). Patients and methods. A total of 46 consecutive patients with probable AD participated in this study. They were classified randomly into 2 equal groups: active versus sham. Each patient received 10 sessions of anodal tDCS over the left and right temporoparietal region for 20 minutes for each side with the cathode on the left arm. Patients were assessed using the Modified Mini Mental State Examination (MMMSE), clock drawing test, Montreal Cognitive Scale (MoCA), and the Cornell Scale for depression. Serum TAU, Aβ 1-42, and lipid peroxidase were measured before and after the 10th session. Results. There was a significant improvement in the total score of each cognitive rating scale (MMMSE, clock drawing test, and MoCA) in the real group, whereas no such change was observed in the sham group. The Cornell depression score improved significantly in both groups. There was a significant increase in serum Aβ 1-42 ( P = .02) in the real but not in the sham group, with a significant Treatment condition × Time interaction ( P = .009). There was no significant effect on tau or lipid peroxidase in either group but a significant positive correlation between changes of Aβ1-42 and MMMSE ( P = .005) and MoCA ( P = .02). Conclusion. The observed cognitive improvements were complemented by parallel changes in serum levels of Aβ 1-42.


2021 ◽  
Vol 82 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Anis Davoudi ◽  
Catherine Dion ◽  
Shawna Amini ◽  
Patrick J. Tighe ◽  
Catherine C. Price ◽  
...  

Background: Advantages of digital clock drawing metrics for dementia subtype classification needs examination. Objective: To assess how well kinematic, time-based, and visuospatial features extracted from the digital Clock Drawing Test (dCDT) can classify a combined group of Alzheimer’s disease/Vascular Dementia patients versus healthy controls (HC), and classify dementia patients with Alzheimer’s disease (AD) versus vascular dementia (VaD). Methods: Healthy, community-dwelling control participants (n = 175), patients diagnosed clinically with Alzheimer’s disease (n = 29), and vascular dementia (n = 27) completed the dCDT to command and copy clock drawing conditions. Thirty-seven dCDT command and 37 copy dCDT features were extracted and used with Random Forest classification models. Results: When HC participants were compared to participants with dementia, optimal area under the curve was achieved using models that combined both command and copy dCDT features (AUC = 91.52%). Similarly, when AD versus VaD participants were compared, optimal area under the curve was, achieved with models that combined both command and copy features (AUC = 76.94%). Subsequent follow-up analyses of a corpus of 10 variables of interest determined using a Gini Index found that groups could be dissociated based on kinematic, time-based, and visuospatial features. Conclusion: The dCDT is able to operationally define graphomotor output that cannot be measured using traditional paper and pencil test administration in older health controls and participants with dementia. These data suggest that kinematic, time-based, and visuospatial behavior obtained using the dCDT may provide additional neurocognitive biomarkers that may be able to identify and tract dementia syndromes.


2014 ◽  
Vol 20 (9) ◽  
pp. 920-928 ◽  
Author(s):  
Jamie Cohen ◽  
Dana L. Penney ◽  
Randall Davis ◽  
David J. Libon ◽  
Rodney A. Swenson ◽  
...  

AbstractPsychomotor slowing has been documented in depression. The digital Clock Drawing Test (dCDT) provides: (i) a novel technique to assess both cognitive and motor aspects of psychomotor speed within the same task and (ii) the potential to uncover subtleties of behavior not previously detected with non-digitized modes of data collection. Using digitized pen technology in 106 participants grouped by Age (younger/older) and Affect (euthymic/unmedicated depressed), we recorded cognitive and motor output by capturing how the clock is drawn rather than focusing on the final product. We divided time to completion (TTC) for Command and Copy conditions of the dCDT into metrics of percent of drawing (%Ink) versus non-drawing (%Think) time. We also obtained composite Z-scores of cognition, including attention/information processing (AIP), to explore associations of %Ink and %Think times to cognitive and motor performance. Despite equivalent TTC, %Ink and %Think Command times (Copy n.s.) were significant (AgeXAffect interaction: p=.03)—younger depressed spent a smaller proportion of time drawing relative to thinking compared to the older depressed group. Command %Think time negatively correlated with AIP in the older depressed group (r=−.46; p=.02). Copy %Think time negatively correlated with AIP in the younger depressed (r=−.47; p=.03) and older euthymic groups (r=−.51; p=.01). The dCDT differentiated aspects of psychomotor slowing in depression regardless of age, while dCDT/cognitive associates for younger adults with depression mimicked patterns of older euthymics. (JINS, 2014, 20, 1–9)


2010 ◽  
Vol 106 (3) ◽  
pp. 941-948 ◽  
Author(s):  
April R. Wiechmann ◽  
James R. Hall ◽  
Sid O'bryant

The purpose of this study was to explore the sensitivity and specificity of the Clock Drawing Test by using a widely employed four-point scoring system to discriminate between patients with Alzheimer's disease or vascular dementia. Receiver operating characteristic analysis indicated that the Clock Drawing Test was able to distinguish between normal elders and those with a dementia diagnosis. The cutoff score for differentiating patients with Alzheimer's disease from normal participants was = 3. The cutoff score for differentiating those with vascular disease from normal participants was = 3. Overall, the four-point scoring system demonstrated good sensitivity and specificity for identifying cognitive dysfunction associated with dementia; however, the current findings do not support the utility of the four-point scoring system in discriminating Alzheimer's disease and vascular dementia.


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