Subcortical dementia. Review of an emerging concept

J. L. Cummings and D. F. Benson

Subcortical dementia is a clinical syndrome characterized by slowness of mental processing, forgetfulness, impaired cognition, apathy, and depression. First recognized in progressive supranuclear palsy and Huntington's disease, the concept has been extended to account for the intellectual impairment of Parkinson's disease, Wilson's disease, spinocerebellar degenerations, idiopathic basal ganglia calcification, the lacunar state, and the dementia syndrome of depression. Disorders manifesting subcortical dementia have pathologic changes that involve primarily the thalamus, basal ganglia, and related brain-stem nuclei with relative sparing of the cerebral cortex. Recent studies of neuropsychologic deficits following focal subcortical lesions also support a role for these structures in arousal, attention, mood, motivation, language, memory, abstraction, and visuospatial skills. The clinical characteristics of subcortical dementia differ from those of dementia of Alzheimer's type where prominent cerebral cortical involvement produces aphasia, amnesia, agnosia, and apraxia.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Comparison of Self-Report and Caregiver Assessment of Depression, Apathy, and Irritability in Huntington's Disease
Chatterjee et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:378-383.
ABSTRACT | FULL TEXT  

The Natural History of Cognitive Dysfunction in Late-Onset GM2 Gangliosidosis
Frey et al.
Arch Neurol 2005;62:989-994.
ABSTRACT | FULL TEXT  

HIV Dementia Scale and Psychomotor Slowing--The Best Methods in Screening for Neuro-AIDS
von Giesen et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:185-191.
ABSTRACT | FULL TEXT  

The seven minute screen: a neurocognitive screening test highly sensitive to various types of dementia
Meulen et al.
J. Neurol. Neurosurg. Psychiatry 2004;75:700-705.
ABSTRACT | FULL TEXT  

Visual association test to detect early dementia of the Alzheimer type
Lindeboom et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:126-133.
ABSTRACT | FULL TEXT  

Prefrontal Dysfunction and Treatment Response in Geriatric Depression
Kalayam and Alexopoulos
Arch Gen Psychiatry 1999;56:713-718.
ABSTRACT | FULL TEXT  

Cognitive functioning after pallidotomy for refractory Parkinson's disease
Perrine et al.
J. Neurol. Neurosurg. Psychiatry 1998;65:150-154.
ABSTRACT | FULL TEXT  

A clinical role for 99mTc-HMPAO SPECT in the investigation of dementia?
Talbot et al.
J. Neurol. Neurosurg. Psychiatry 1998;64:306-313.
ABSTRACT | FULL TEXT  

Cerebral Blood Flow and Dementia in Parkinson's Disease
Kawabata et al.
J Geriatr Psychiatry Neurol 1991;4:194-203.
ABSTRACT  

Remote Memory for Visuospatial Information in Patients with Alzheimer's Disease
Beatty and Salmon
J Geriatr Psychiatry Neurol 1991;4:14-17.
ABSTRACT  

Binswanger's Disease (Part I): The Clinical Recognition of Subcortical Arteriosclerotic Encephalopathy in Elderly Neuropsychiatric Patients
Summergrad and Peterson
J Geriatr Psychiatry Neurol 1989;2:123-133.
ABSTRACT  

Lexical Processing in Parkinson's Disease and Multiple Sclerosis
Beatty and Monson
J Geriatr Psychiatry Neurol 1989;2:145-152.
ABSTRACT  

Geographical Knowledge in Patients With Alzheimer's Disease
Beatty and Bernstein
J Geriatr Psychiatry Neurol 1989;2:76-82.
ABSTRACT  

Cognitive Disturbances in Parkinson's Disease
Beatty et al.
J Geriatr Psychiatry Neurol 1989;2:22-33.
ABSTRACT  

The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex
Price et al.
Science 1988;239:586-592.
ABSTRACT  

Intellectual Impairment in Parkinson's Disease: Clinical, Pathologic, and Biochemical Correlates
Cummings
J Geriatr Psychiatry Neurol 1988;1:24-36.
ABSTRACT  

Alzheimer's Disease--What the Practicing Clinician Needs to Know
Jenike
J Geriatr Psychiatry Neurol 1988;1:37-46.