RESUMO
The authors assessed a consecutive series of 196 patients with probable Alzheimer's disease (AD) for the presence of aggressive behavior, using a standardized neurological, neuropsychiatric, and neuropsychological battery that included both the Overt Aggression Scale and the Irritability Scale. Twelve percent of patients showed aggressive episodes (5% with verbal aggression, 7% with physical aggression) during the 4 weeks preceding the psychiatric evaluation. Physical aggression was significantly associated with more frequent delusions and more severe irritability.
Assuntos
Agressão/psicologia , Doença de Alzheimer/psicologia , Idoso , Doença de Alzheimer/tratamento farmacológico , Antidepressivos/uso terapêutico , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Transtornos da Personalidade/psicologia , Testes de Personalidade , Escalas de Graduação Psiquiátrica , Desempenho Psicomotor/fisiologiaRESUMO
We examined the prevalence of major depression and dysthymia in 78 patients with the classic variant of Parkinson's disease (PD) (that is, tremor plus rigidity and/or bradykinesia), and in 34 patients with the akinetic-rigid variant. Although the prevalence of dysthymia was similar in both groups (classic PD, 31%; and akinetic-rigid PD, 32%), patients with akinetic-rigid PD had a significantly higher prevalence of major depression (38% versus 15%, respectively; p < 0.01). A stepwise regression analysis demonstrated that bradykinesia was the extrapyramidal sign with the highest correlation with Hamilton depression scale scores. Our findings demonstrate a significant association between major depression and the akinetic-rigid type of PD.
Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Doença de Parkinson/epidemiologia , Idoso , Distribuição de Qui-Quadrado , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipocinesia/epidemiologia , Masculino , Pessoa de Meia-Idade , Rigidez Muscular/epidemiologia , Doença de Parkinson/classificação , Prevalência , Tremor/epidemiologiaRESUMO
OBJECTIVE: To examine neurological, neuropsychological, psychiatric, and cerebral perfusion correlates of leukoaraiosis in Alzheimer's disease. METHODS: A consecutive series of patients with probable Alzheimer's disease was assessed with a comprehensive neuropsychological battery, a structured psychiatric evaluation, the unified Parkinson's disease rating scale, MRI, and single photon emission computed tomography with technetium 99m hexamethylpropyleneamine oxime (HMPAO) and regional cerebral perfusion measurements. RESULTS: Patients with Alzheimer's disease and leukoaraiosis were significantly more apathetic and had significantly more extrapyramidal signs than patients with Alzheimer's disease without leukoaraiosis. Patients with Alzheimer's disease with leukoaraiosis also had significantly lower bilateral perfusion in the basal ganglia, thalamus, and frontal lobes than patients with Alzheimer's disease without leukoaraiosis. On the other hand, there were no significant differences between groups in age, duration of illness, depression scores, severity of delusions, or deficits on specific neuropsychological tasks. CONCLUSIONS: Leukoaraiosis in Alzheimer's disease may produce significant basal ganglia, and thalamic and frontal lobe dysfunction, which may be associated with more severe apathy and extrapyramidal signs.
Assuntos
Doença de Alzheimer/diagnóstico , Encefalopatias/diagnóstico , Encéfalo/patologia , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Análise de Variância , Doenças dos Gânglios da Base/diagnóstico , Doenças dos Gânglios da Base/patologia , Encéfalo/diagnóstico por imagem , Encefalopatias/diagnóstico por imagem , Encefalopatias/patologia , Circulação Cerebrovascular , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Exame Neurológico , Testes Neuropsicológicos , Compostos de Organotecnécio , Oximas , Escalas de Graduação Psiquiátrica , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
BACKGROUND: The aim was to examine the longitudinal evolution of depression and anosognosia in patients with probable Alzheimer's disease (AD). METHOD: Sixty-two of a consecutive series of 116 AD patients that were examined with a structured psychiatric interview had a follow-up evaluation between one and two years after the initial evaluation. RESULTS: At the initial evaluation 19% of the 62 patients had major depression, 34% had dysthymia, and 47% were not depressed. After a mean follow-up of 16 months, 58% of patients with major depression at the initial evaluation were still depressed, whereas only 28% of patients with initial dysthymia and 21% of the non-depressed patients were depressed at follow-up. During the follow-up period, all three groups showed similar declines in cognitive status and activities of daily living. At the initial evaluation, 39% of the patients had anosognosia, and there was a significant increment of anosognosia during the follow-up period. CONCLUSIONS: While dysthymia in AD is a brief emotional disorder, major depression is a longer-lasting mood change. Anosognosia is another prevalent disorder among AD patients, and increases with the progression of the illness.
Assuntos
Doença de Alzheimer/psicologia , Conscientização , Negação em Psicologia , Transtorno Depressivo/etiologia , Idoso , Análise de Variância , Transtorno Distímico/etiologia , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Escalas de Graduação PsiquiátricaRESUMO
OBJECTIVES: To examine the clinical correlates of catatonia in depression, to validate a scale for catatonia, and to assess the validity of the DSM-IV criteria of the catatonic features specifier for mood disorders. METHODS: A series of 79 consecutive patients with depression and 41 patients with Parkinson's disease without depression were examined using the modified Rogers scale (MRS), the unified Parkinson's disease rating scale (UPDRS), and the structured clinical interview for DSM-III-R (SCID). RESULTS: Sixteen of the 79 depressed patients (20%) had catatonia. Depressed patients with catatonia had significantly higher scores on the MRS than non-catatonic depressed patients matched for severity of depression, or non-depressed patients with Parkinson's disease matched for severity of motor impairment. Depressed patients with catatonia were older, had a significantly higher frequency of major depression, more severe cognitive impairments, and more severe deficits in activities of daily living than depressed non-catatonic patients. The DSM-IV criteria of catatonia separated depressed catatonic patients from patients with Parkinson's disease matched for motor impairment, with a specificity of 100%. Catatonic signs did not improve after apomorphine. CONCLUSIONS: catatonia is most prevalent among elderly patients with severe depression. The study showed the validity of the MRS for the diagnosis of catatonia in depressed patients, as well as the specificity of the DSM-IV criteria of the catatonic features specifier.
Assuntos
Catatonia/diagnóstico , Catatonia/etiologia , Transtorno Depressivo/complicações , Escalas de Graduação Psiquiátrica/normas , Idoso , Apomorfina/uso terapêutico , Estudos de Casos e Controles , Catatonia/tratamento farmacológico , Dopaminérgicos/uso terapêutico , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
BACKGROUND AND PURPOSE: Psychiatric, neuropsychological, and cerebral blood flow differences between patients with ischemic vascular dementia (IVD) or Alzheimer's disease (AD) were examined. METHODS: A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association for probable AD or the State of California AD Diagnostic and Treatment Centers criteria for probable IVD were included in the study. Twenty consecutive patients with IVD were matched for age, sex, and Mini-Mental State Examination scores with 40 consecutive patients with probable AD. Patients underwent a psychiatric interview, a neuropsychological assessment, and single-photon emission CT imaging with 99mTc-hexamethylpropyleneamine oxime. RESULTS: Patients with IVD showed significantly more severe anosognosia (P<.05) and emotional lability (P<.01) than AD patients, but no significant between-group differences were found in the frequency and severity of depression. IVD patients showed significantly more severe deficits in tests of planning, sequencing (P<.05), and verbal fluency (P<.05) as well as significantly more severe cerebral blood flow deficits in the basal ganglia (P<.01) and the frontal lobes (P<.001) than AD patients. CONCLUSIONS: Patients with IVD showed a relatively more severe dysfunction of the frontal lobes as demonstrated by single-photon emission CT and expressed in specific psychiatric and neuropsychological changes than AD patients matched for age, sex, and severity of dementia.
Assuntos
Doença de Alzheimer/fisiopatologia , Doença de Alzheimer/psicologia , Circulação Cerebrovascular , Demência Vascular/fisiopatologia , Demência Vascular/psicologia , Idoso , Doença de Alzheimer/diagnóstico por imagem , Gânglios da Base/irrigação sanguínea , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/psicologia , Estudos de Casos e Controles , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Demência Vascular/diagnóstico por imagem , Depressão/psicologia , Emoções , Feminino , Lobo Frontal/irrigação sanguínea , Humanos , Entrevista Psicológica , Masculino , Saúde Mental , Testes Neuropsicológicos , Neuropsicologia , Compostos de Organotecnécio , Oximas , Autoimagem , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton Único , Comportamento VerbalRESUMO
Twenty-one depressed patients with probable Alzheimer's disease (AD) were randomized to receive a 6-week treatment with clomipramine or placebo in a study with a double-blind crossover design. Main outcome measures were Hamilton Depression, Mini-Mental State (MMSE), and Functional Independence Measure (FIM) scores. Mood improved significantly on both clomipramine and placebo, but clomipramine was significantly more effective than placebo during the first 6-week treatment period. Patients started on clomipramine maintained improvement during the washout and placebo periods, whereas patients started on placebo worsened during the washout period. However, patients on clomipramine showed significantly lower MMSE scores overall than patients on placebo. No significant drug effects were found on FIM scores. Clomipramine proved to be a useful treatment of depression in patients with probable AD.
Assuntos
Doença de Alzheimer/psicologia , Antidepressivos Tricíclicos/uso terapêutico , Clomipramina/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Atividades Cotidianas , Idoso , Doença de Alzheimer/complicações , Antidepressivos Tricíclicos/efeitos adversos , Clomipramina/efeitos adversos , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/psicologia , Estudos Cross-Over , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Escalas de Graduação PsiquiátricaRESUMO
This study examined the prevalence and correlates of pathological affect in Alzheimer's disease. A consecutive series of 103 patients with Alzheimer's disease were examined with a comprehensive psychiatric assessment that included the pathological laughing and crying scale (PLACS). Forty patients (39%) showed pathological affect: 25% showed crying episodes, and 14% showed laughing or mixed (laughing and crying) episodes. Patients with pathological affect crying showed significantly higher depression scores and a significantly higher frequency of major depression and dysthymia than patients with no pathological affect. Patients with mixed pathological affect showed significantly more subcortical atrophy on CT than patients with pathological affect crying. Forty seven per cent of the patients with pathological affect had no congruent mood disorder, and they showed a significantly longer duration of illness and more severe anosognosia than patients with pathological affect that was congruent with an underlying mood disorder. The study validates the PLACS, and shows the high prevalence of pathological affect in Alzheimer's disease.
Assuntos
Afeto , Doença de Alzheimer/psicologia , Choro , Riso , Idoso , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico por imagem , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
We examined the prevalence, phenomenology, and clinical correlates of delusions in a consecutive series of 103 patients with probable Alzheimer's disease (AD). Patients were examined with the Present State Exam and the Dementia-Psychosis Scale. Twenty-one patients (20%) met DSM-III-R criteria for a delusional disorder. The most frequent delusion type was paranoid (71%), followed by hypochondriacal (67%), the Capgras syndrome (29%), house misidentification (29%), and grandiose delusions (29%). Out of the 21 AD patients with delusions, 76% had three or more different types of delusions simultaneously. The frequency of delusions was not significantly associated with age, education, or age at dementia onset, and the type and severity of cognitive impairments was similar for AD patients with and without delusions. However, AD patients with delusions had significantly higher mania and anosognosia scores.
Assuntos
Doença de Alzheimer/diagnóstico , Delusões/diagnóstico , Transtornos Neurocognitivos/diagnóstico , Testes Neuropsicológicos , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Agnosia/diagnóstico , Agnosia/psicologia , Doença de Alzheimer/psicologia , Doenças dos Gânglios da Base/diagnóstico , Doenças dos Gânglios da Base/psicologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Delusões/psicologia , Feminino , Avaliação Geriátrica , Humanos , Masculino , Transtornos Neurocognitivos/psicologia , Transtornos Paranoides/diagnóstico , Transtornos Paranoides/psicologia , Escalas de Graduação PsiquiátricaRESUMO
OBJECTIVE: To examine the presence of specific regional cerebral blood flow correlates of anosognosia in patients with probable Alzheimer's disease. DESIGN: Case series, group comparisons. SETTING: Ambulatory care referral center. PATIENTS: Twelve patients with probable Alzheimer's disease and anosognosia and 12 patients with probable Alzheimer's disease without anosognosia who were matched for age, duration of illness, and cognitive impairments. MAIN OUTCOME MEASURES: Single-photon emission computed tomographic scan studies with technetium Tc 99m hexamethylpropylene-amine oxime and regional cerebral blood flow measurements. RESULTS: Patients with Alzheimer's disease and anosognosia showed significant blood flow deficits in the frontal inferior and superior (dorsal) areas of the right hemisphere. On the other hand, no significant between-group differences were found in depression scores and neuropsychological tasks that assessed verbal and visual memory, verbal comprehension, naming, verbal fluency, auditory attention, abstract reasoning, and set-shifting abilities. CONCLUSIONS: Our study demonstrates that anosognosia may not be related to deficits in specific cognitive domains, but it may result from dysfunction of the right frontal lobe.
Assuntos
Agnosia/diagnóstico por imagem , Doença de Alzheimer/diagnóstico por imagem , Idoso , Agnosia/complicações , Agnosia/fisiopatologia , Agnosia/psicologia , Doença de Alzheimer/complicações , Doença de Alzheimer/fisiopatologia , Doença de Alzheimer/psicologia , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
OBJECTIVE: The purpose of this study was to examine the prevalence, risk factors, and correlates of depression among patients with Alzheimer's disease. METHOD: A consecutive series of 103 patients with probable Alzheimer's disease were examined with a structured psychiatric interview and were assessed for the presence of cognitive impairments, deficits in activities of daily living, social functioning, and anosognosia. RESULTS: Fifty-one percent of the patients had depression (28% had dysthymia and 23% major depression). Women had a significantly higher prevalence of both major depression and dysthymia than men. Depressed and nondepressed patients had a similar frequency of family and personal histories of depression, a similar frequency of personality disorders before the onset of depression, and no significant differences in cognitive deficits and impairment in activities of daily living. Dysthymia usually started after the onset of dementia and was significantly more prevalent in the early stages of dementia; patients with dysthymia had a significantly better awareness of intellectual deficits than patients with major or no depression. On the other hand, patients with major depression had an earlier onset of depression (half of them before the onset of dementia), and the prevalence of major depression was similar across the different stages of the illness. CONCLUSIONS: This study demonstrates a high prevalence of dysthymia and major depression among patients with probable Alzheimer's disease. While dysthymia may be an emotional reaction to the progressive cognitive decline, major depression may be related to biological factors.
Assuntos
Doença de Alzheimer/epidemiologia , Transtorno Depressivo/epidemiologia , Atividades Cotidianas , Idoso , Doença de Alzheimer/diagnóstico , Assistência Ambulatorial , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Comorbidade , Transtorno Depressivo/diagnóstico , Família , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Testes Neuropsicológicos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores SexuaisRESUMO
The authors examined the presence of significant regional cerebral blood flow (rCBF) differences between Alzheimer's disease (AD) patients with and without extrapyramidal signs (EPS). Nine patients with probable AD and EPS (resting tremor or rigidity and bradykinesia) and 9 AD patients without EPS, comparable in age, duration of illness, and global cognitive decline, were studied with [99mTc]HMPAO SPECT. Patients with AD and EPS showed significantly lower rCBF in the superior frontal, superior temporal, and parietal regions of the left hemisphere than AD patients without EPS. Rigidity and bradykinesia independently accounted for the decreased rCBF in these areas. These findings suggest that the presence of EPS in AD may result from dysfunction in specific brain regions.
Assuntos
Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Idoso , Doença de Alzheimer/complicações , Doença de Alzheimer/psicologia , Circulação Cerebrovascular/fisiologia , Feminino , Humanos , Masculino , Transtornos dos Movimentos/diagnóstico por imagem , Transtornos dos Movimentos/etiologia , Rigidez Muscular/diagnóstico por imagem , Rigidez Muscular/etiologia , Exame Neurológico , Testes Neuropsicológicos , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Escalas de Graduação Psiquiátrica , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
The authors examined the prevalence and correlates of anosognosia in a consecutive series of patients with probable Alzheimer's disease (AD). Patients were examined with the Anosognosia Questionnaire-Dementia (AQ-D), which showed good reliability and validity. On the basis of the AQ-D scores, patients were divided into those with anosognosia (n = 21) and those without anosognosia (n = 52). Patients with anosognosia showed a significantly longer duration of illness, more severe cognitive impairments and deficits in activities of daily living, and higher mania and pathological laughing scores than AD patients without anosognosia. These findings suggest that anosognosia in AD may be part of a specific neuropsychiatric syndrome.
Assuntos
Agnosia/psicologia , Doença de Alzheimer/psicologia , Autoimagem , Idoso , Agnosia/complicações , Doença de Alzheimer/complicações , Análise de Variância , Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Negação em Psicologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Inquéritos e QuestionáriosRESUMO
We examined the prevalence and correlates of apathy and irritability in a consecutive series of 101 patients with probable Alzheimer's disease (AD). Based on clinical criteria, 46 (46%) patients had apathy, and 13 (13%) patients had irritability. Apathy was significantly associated with more severe impairments in activities of daily living, significantly more severe extrapyramidal signs, and a significantly higher frequency of both major depression and dysthymia. Patients with irritability had significantly more severe impairments in activities of daily living and significantly higher depression and anosognosia scores. On the other hand, neither apathy nor irritability were significantly associated with deficits in specific cognitive domains.
RESUMO
The prevalence and clinical correlates of extrapyramidal signs in a consecutive series of 78 patients with Alzheimer's disease attending a neurology clinic, and 20 age comparable normal controls, were examined. Based on the unified Parkinson's disease rating scale (UPDRS) findings, 18 patients (23%) met criteria for parkinsonism, 44 (56%) had isolated extrapyramidal signs, and 16 (21%) had no extrapyramidal signs. Whereas the control group showed a similar prevalence of isolated extrapyramidal signs (57%), none of them showed parkinsonism. No significant differences were found for age, sex, duration of illness, and severity of dementia among the three Alzheimer's disease groups. Patients with Alzheimer's disease-parkinsonism, however, showed a significantly higher frequency of major depression and dysthymia and significantly higher Hamilton depression scores than patients with isolated or no extrapyramidal signs. Patients with Alzheimer's disease-parkinsonism also showed significantly more deficits on frontal lobe related tasks such as the Wisconsin card sorting test, trail making test, and verbal fluency, as well as on tests of constructional praxis and abstract reasoning than patients with Alzheimer's disease but no extrapyramidal signs. In conclusion, the study showed a specific association between Alzheimer's disease and parkinsonism, as well as significant relations between parkinsonism, deficits in executive functions, and depression among patients with Alzheimer's disease.
Assuntos
Doença de Alzheimer/complicações , Doença de Alzheimer/psicologia , Demência/etiologia , Transtorno Depressivo/etiologia , Tratos Extrapiramidais/fisiopatologia , Doença de Parkinson Secundária/etiologia , Idoso , Doença de Alzheimer/fisiopatologia , Apomorfina , Estudos de Casos e Controles , Demência/diagnóstico , Demência/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Testes Neuropsicológicos , Doença de Parkinson Secundária/diagnóstico , Doença de Parkinson Secundária/epidemiologia , Doença de Parkinson Secundária/fisiopatologia , Prevalência , Índice de Gravidade de DoençaRESUMO
Although delusions are a frequent finding in patients with Alzheimer's disease (AD), their mechanism is not well known. We carried out Tc 99m HMPAO single-photon emission computed tomography studies in 16 AD patients with delusions and 29 AD patients without delusions comparable in age, years of education, duration of illness, and severity of dementia. Although we found no significant between-group differences in performance on neuropsychological tasks, AD patients with delusions had significantly lower mean cerebral blood flow in both the left and right temporal lobes.
Assuntos
Doença de Alzheimer/complicações , Encéfalo/diagnóstico por imagem , Delusões/etiologia , Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Delusões/diagnóstico , Feminino , Humanos , Masculino , Testes NeuropsicológicosRESUMO
Eight patients with a clinical diagnosis of probable Alzheimer's disease, eight patients with the clinical diagnosis of frontal lobe dementia, and eight controls were examined with single photon emission tomography (SPECT) using 99Tc-HMPAO. Patients with Alzheimer's disease and those with frontal lobe dementia met DSM-III-R criteria for mild dementia and were in the early stages of the illness. Compared with patients with Alzheimer's disease, the group with frontal lobe dementia had significantly lower blood flow in the frontal lobes (dorsolateral and orbital), the anterior temporal cortex, and the basal ganglia. Within the frontal lobe dementia group, blood flow was significantly lower in the orbital than in the dorsal frontal cortex, and in the anterior temporal than in the dorsal temporal cortex. The present study shows the specificity of changes in regional cerebral blood flow in the diagnosis of different types of dementia, and supports the importance of orbitofrontal, anterior temporal, and basal ganglia dysfunction in the production of the psychiatric syndrome of frontal lobe dementia.
Assuntos
Circulação Cerebrovascular/fisiologia , Demência/fisiopatologia , Lobo Frontal/irrigação sanguínea , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Doença de Alzheimer/psicologia , Análise de Variância , Demência/diagnóstico por imagem , Demência/psicologia , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios XRESUMO
While depression is one of the most frequent psychiatric problems among patients with probable Alzheimer's disease (AD), its mechanism is not well known. We performed quantified EEGs in a consecutive series of seven patients with mild dementia and depression, six patients with mild dementia and no depression, eight patients with moderate dementia and depression, and eight patients with moderate dementia and no depression. Regardless of the severity of dementia, depressed patients had a significantly higher percent theta in posterior brain areas. Moreover, depressed patients with mild AD showed a similar theta frequency as non-depressed patients with moderate AD. These findings suggest that the presence of depression may contribute to the qEEG changes of AD.
Assuntos
Doença de Alzheimer/fisiopatologia , Transtorno Depressivo/fisiopatologia , Eletroencefalografia/métodos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Análise de Variância , Transtorno Depressivo/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Five patients with a manic episode and 7 age-comparable control subjects were studied with single-photon emission computed tomography and [99mTc]d,l-hexamethylpropyleneamine oxime. Manic patients showed significantly lower blood flow in the basal portion of the right temporal lobe compared with normal control subjects. Moreover, manic patients showed a left-right asymmetry (a significantly lower perfusion in the right versus left temporal basal cortex), as well as a dorsal-ventral asymmetry (a significantly lower perfusion in the right temporal basal versus dorsal cortex). These findings suggest that the right basotemporal cortex may play an important role in the production of primary mania.