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Neuropsychological Patterns and Language Deficits in 20 Consecutive Cases of Autopsy-Confirmed Alzheimer's Disease
Bruce H. Price, MD;
Hakan Gurvit, MD;
Sandra Weintraub, PhD;
Changiz Geula, PhD;
Elizabeth Leimkuhler, PhD;
Marsel Mesulam, MD
Arch Neurol. 1993;50(9):931-937.
Abstract
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• A retrospective chart review of clinical symptoms was done for 20 consecutive patients in whom postmortem examination had revealed senile plaques and neurofibrillary tangles in a distribution consistent with Alzheimer's disease. All patients had met clinical diagnostic criteria for probable Alzheimer's disease. On initial examination, 1 to 14 years beyond putative onset of the dementia, all patients displayed at least some memory impairment. In 16 patients, disturbances of attention or recent memory were among the most salient features. In two patients, language disturbances, and in two others, visuospatial deficits, were more prominent than difficulties with memory and attention. On initial examination, 17 of the 20 patients displayed word-finding difficulties, characteristically in the context of a fluent, anomic aphasia. All of the 12 reexamined patients demonstrated progressive, although variable, deterioration. In general, the initial salient deficit remained salient during much of the disease course. Language comprehension was spared in the earlier stages but eventually deteriorated. Severe deficits emerged in all major cognitive domains as the disease reached the terminal stages. Nonfluent aphasias (eg, Broca's aphasia) were not observed even in the advanced stages of the disease.
Author Affiliations
From the Bullard and Denny-Brown Laboratories; Division of Behavioral Neurology and Neuroscience, Department of Neurology, Harvard Medical School, and the Charles A. Dana Research Institute, Beth Israel Hospital, Boston, Mass. Dr Gurvit is now with the Faculty of Medicine, Istanbul (Turkey) University.
Footnotes
Accepted for publication October 6, 1992.
Reprint requests to Neurologic Unit, K-225, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr Price).
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