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Authors: Caltagirone, Carlo | Carlesimo, Giovanni Augusto | Fadda, Lucia | Roncacci, Sabina

Article Type: Research Article

Abstract: In order to evaluate cognitive impairment in multiple sclerosis (MS) neuropsychological tests were administered to 25 patients with clinically definite disease. Four (16%) showed diffuse cognitive impairment, whereas the others, compared with controls showed a specific deficit on tests known to be sensitive to frontal lobe damage. These results are interpreted in the light of current hypotheses relating to subcortical contributions in cognition.

DOI: 10.3233/BEN-1991-4301

Citation: Behavioural Neurology, vol. 4, no. 3, pp. 129-141, 1991

Authors: Perri, Roberta | Fadda, Lucia | Caltagirone, Carlo | Carlesimo, Giovanni Augusto

Article Type: Research Article

Abstract: Background: Different roles have been attributed to mesio-temporal areas and frontal lobes in declarative memory functioning, and qualitative differences have been observed in the amnesic symptoms due to pathological damage of these two portions of the central nervous system. Objective: The aim of the present study was to look for memory profiles related to pathological involvement in the temporal and frontal structures in patients with different dementia syndromes on word-list and prose memory tasks. Methods: 20 patients with Alzheimer’s disease (AD), 20 with frontal variant of FTD (fvFTD), 20 with subcortical ischemic vascular dementia (SIVD), and 20 with Lewy body …dementia (LBD) and 34 healthy subjects (NCs) were submitted to word-list and prose memory tasks. Results: All groups performed similarly on both the immediate and delayed recall of the word-list. Conversely, AD patients performed worse than all the other dementia groups on the immediate prose recall. On delayed prose recall, AD patients performed worse than fvFTD and SIVD patients but similar to LBD patients. Differential scores between word-list and prose tests were minimal in the AD group and very pronounced in fvFTD and SIVD groups. Conclusion: The combined use of the prose and word-list tasks evidenced a “mesio-temporal” memory profile in AD patients as opposed to a “frontal” one in fvFTD and SIVD patients and a mixed profile in the LBD patients. In particular, a differential score between the two tests can be useful in differentiating AD patients from patients with other forms of dementia. Show more

Keywords: Alzheimer's disease, frontotemporal dementia, Lewy body dementia, memory recall, subcortical ischemic vascular disease

DOI: 10.3233/JAD-130347

Citation: Journal of Alzheimer's Disease, vol. 37, no. 1, pp. 99-107, 2013

Authors: Serra, Laura | Fadda, Lucia | Buccione, Ivana | Caltagirone, Carlo | Carlesimo, Giovanni A.

Article Type: Research Article

Abstract: Psychogenic amnesia is a complex disorder characterised by a wide variety of symptoms. Consequently, in a number of cases it is difficult distinguish it from organic memory impairment. The present study reports a new case of global psychogenic amnesia compared with two patients with amnesia underlain by organic brain damage. Our aim was to identify features useful for distinguishing between psychogenic and organic forms of memory impairment. The findings show the usefulness of a multidimensional evaluation of clinical, neuroradiological, neuropsychological and psychopathological aspects, to provide convergent findings useful for differentiating the two forms of memory disorder.

Keywords: Amnesia, psychogenic origin, organic origin

Citation: Behavioural Neurology, vol. 18, no. 1, pp. 53-64, 2007

Authors: Palmer, Katie | Lupo, Federica | Perri, Roberta | Salamone, Giovanna | Fadda, Lucia | Caltagirone, Carlo | Musicco, Massimo | Cravello, Luca

Article Type: Research Article

Abstract: Patients with Alzheimer's disease (AD) have heterogeneous rates of disease progression. The aim of the current study is to investigate whether neuropsychiatric disturbances predict cognitive and functional disease progression in AD, according to failure theory. We longitudinally examined 177 memory-clinic AD outpatients (mean age = 73.1, SD = 8.1; 70.6% women). Neuropsychiatric disturbances at baseline were categorized into five syndromes. Patients were followed for up to two years to detect rapid disease progression defined as a loss of ≥ 1 abilities in Activities of Daily living (ADL) or a drop of ≥ 5 points on Mini-Mental State Examination (MMSE). Hazard …ratios (HR) were calculated with Gompertz regression, adjusting for sociodemographics, baseline cognitive and functional status, and somatic comorbidities. Most patients (74.6%) exhibited one or more neuropsychiatric syndromes at baseline. The most common neuropsychiatric syndrome was Apathy (63.8%), followed by Affective (37.3%), Psychomotor (8.5%), Manic (7.9%), and Psychotic (5.6%) syndromes. The variance between the observed (Kaplen Meier) and predicted (Gompertz) decline for disease progression in cognition (0.30, CI = 0.26–0.35), was higher than the variance seen for functional decline (0.22, CI = 0.18–0.26). After multiple adjustment, patients with the Affective syndrome had an increased risk of functional decline (HR = 2.0; CI = 1.1–3.6), whereas the risk of cognitive decline was associated with the Manic (HR = 3.2, CI = 1.3–7.5) syndrome. In conclusion, specific neuropsychiatric syndromes are associated with functional and cognitive decline during the progression of AD, which may help with the long-term planning of care and treatment. These results highlight the importance of incorporating a thorough psychiatric examination in the evaluation of AD patients. Show more

Keywords: Activities of daily living, anxiety, apathy, behavioral and psychological symptoms of dementia, failure theory, cognitive impairment, dementia, depression, disease progression, Gompertz

DOI: 10.3233/JAD-2010-101836

Citation: Journal of Alzheimer's Disease, vol. 24, no. 1, pp. 35-45, 2011

Authors: Caruso, Giulia | Perri, Roberta | Fadda, Lucia | Caltagirone, Carlo | Carlesimo, Giovanni Augusto

Article Type: Research Article

Abstract: Background: It has long been debated whether performance on recall and recognition tests depends on the same or different memory systems and whether performance on these two tasks is dissociated in clinical populations. According to Dual process theories of recall , performance on recall and recognition tests dissociates in the relative reliance on frontal lobe related activities; in fact, the recall test requires more strategic retrieval of memoranda than the recognition task. By contrast, Dual process theories of recognition posit that performance on these tests differs in the relative contribution of recollection and familiarity memory processes in the two tasks: …both recollection and familiarity contribute to recognition judgments, but only recollection supports recall performance. Objective: The aim of this study was to clarify the cognitive processes involved in recall and recognition in patients with dementia. Methods: We administered a 15-word recall task followed by a yes/no recognition paradigm to 28 patients with Alzheimer’s disease (AD), 22 patients with the behavioral variant of frontotemporal dementia (bvFTD), and 45 normal controls (NCs). Results: Results showed that on the delayed recall task, bvFTD patients performed much better than AD patients but the two groups did not differ on any index of recognition performance. Conclusion: The present data support the hypothesis that the performance of the two groups is expression of the different reliance on recollection (more impaired in the AD than in the bvFTD group) and familiarity (similarly impaired in the two groups) in performance on recall and recognition tasks. Show more

Keywords: Alzheimer’s disease, familiarity, frontotemporal dementia, recall, recognition, recollection

DOI: 10.3233/JAD-200126

Citation: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 655-666, 2020

Authors: Perri, Roberta | Monaco, Marco | Fadda, Lucia | Caltagirone, Carlo | Carlesimo, Giovanni Augusto

Article Type: Research Article

Abstract: The aim of this study was to investigate the neuropsychological correlates of behavioral and psychological symptoms (BPSD) in patients affected by various forms of dementia, namely Alzheimer's disease (AD), frontal-variant frontotemporal dementia (fvFTD), Lewy body dementia (LBD), and subcortical ischemic vascular dementia (SIVD). 21 fvFTD, 21 LBD, 22 AD, and 22 SIVD patients matched for dementia severity received a battery of neuropsychological tests and the Neuropsychiatry Inventory (NPI). The possible association between performance on neuropsychological tests and severity of BPSD was assessed by correlational analysis and multivariate regression. BPSD were present in 99% of patients. Most behavioral symptoms were not …related to a particular dementia group or to a specific cognitive deficit. Euphoria and disinhibition were predicted by fvFTD diagnosis. Hallucinations correlated with the severity of visuospatial deficits in the whole sample of patients and were predicted by LBD diagnosis. Apathy, which was found in all dementia groups, correlated with executive functions and was predicted by both reduced set-shifting aptitude and fvFTD diagnosis. The results confirm the high prevalence of BPSD in the mild to moderate stages of dementia and show that most BPSD are equally distributed across dementia groups. Most of the cognitive and behavioral symptoms are independent dimensions of the dementia syndromes. Nevertheless, hallucinations in LBD and euphoria and disinhibition in fvFTD are related to the structural brain alterations that are responsible for cognitive decline in these dementia groups. Finally, apathy arises from damage in the frontal cortical areas that are also involved in executive functions. Show more

Keywords: Alzheimer's disease, behavioral disorders, cognitive deficits, dementia with Lewy bodies, frontotemporal dementia, vascular dementia

DOI: 10.3233/JAD-131337

Citation: Journal of Alzheimer's Disease, vol. 39, no. 3, pp. 669-677, 2014

Authors: Serra, Laura | Cercignani, Mara | Lenzi, Delia | Perri, Roberta | Fadda, Lucia | Caltagirone, Carlo | Macaluso, Emiliano | Bozzali, Marco

Article Type: Research Article

Abstract: This study investigates abnormalities of grey (GM) and white matter (WM) in Alzheimer's disease (AD), by modeling the AD pathological process as a continuous course between normal aging and fully developed dementia, with amnesic mild cognitive impairment (aMCI) as an intermediate stage. All subjects (9 AD, 16 aMCI patients, and 13 healthy controls) underwent a full neuropsychological assessment and an MRI examination at 3 Tesla, including a volumetric scan and diffusion tensor (DT)-MRI. The volumes were processed to perform a voxel-based morphometric analysis of GM and WM volume, while DT-MRI data were analyzed using tract based spatial statistics, to estimate …changes in fractional anisotropy and mean diffusivity data. GM and WM volume and mean diffusivity and fractional anisotropy were compared across the three groups, and their correlation with cognitive functions was investigated. While AD presented a pattern of widespread GM atrophy, tissue loss was more subtle in patients with aMCI. WM atrophy was mainly located in the temporal lobe, but evidence of WM microscopic damage, assessed by DT-MRI, was also observable in the thalamic radiations and in the corpus callosum. Memory and executive functions correlated with either GM volume or fractional anisotropy in fronto-temporal areas. In conclusion, this study shows a comprehensive assessment of the brain tissue damage across AD evolution, providing insights on different pathophysiological mechanisms (GM atrophy, Wallerian degeneration, and brain disconnection) and their possible association with clinical aspects of cognitive decline. Show more

Keywords: Alzheimer's disease, diffusion tensor MRI, mild cognitive impairment, neuropsychology, tract-based spatial statistics, voxel based morphometry

DOI: 10.3233/JAD-2010-1223

Citation: Journal of Alzheimer's Disease, vol. 19, no. 1, pp. 147-159, 2010

Authors: Costa, Alberto | Fadda, Lucia | Perri, Roberta | Brisindi, Marialuisa | Lombardi, Maria Giovanna | Caltagirone, Carlo | Carlesimo, Giovanni Augusto

Article Type: Short Communication

Abstract: This study was aimed at evaluating whether prospective memory (PM) assessment is able to assist the discrimination between amnestic mild cognitive impairment (aMCI) and healthy subjects (HCs) and between aMCI with single versus multiple domains impairment. Individuals with aMCI and HCs were administered an extensive neuropsychological tests battery and a time-based PM task. PM scores significantly improved the accuracy of the regression model in discriminating between aMCI multiple domains, but not aMCI single domain, and HCs. Moreover, the prospective score significantly contributed to the discrimination between the two aMCI subgroups. These findings indicate the usefulness of including the PM procedure …in evaluations of aMCI. Show more

Keywords: Dementia, mild cognitive impairment, neuropsychological assessment, prospective memory

DOI: 10.3233/JAD-142070

Citation: Journal of Alzheimer's Disease, vol. 44, no. 1, pp. 63-67, 2015

Authors: Pisano, Francesca | Caltagirone, Carlo | Satriano, Federica | Perri, Roberta | Fadda, Lucia | Marangolo, Paola

Article Type: Research Article

Abstract: Background: Recently, a growing body of evidence has shown that, from the early stage of impairment, Alzheimer’s patients (AD) present difficulties on a variety of tasks mostly relying on executive functions. These strongly impact their daily life activities causing a severe loss of independency and autonomy. Objective: To evaluate the efficacy of transpinal direct current stimulation (tsDCS) combined with cognitive trainings for improving attentional and executive function abilities in a group of AD patients. Methods: In a randomized-double blind design, sixteen AD patients underwent different cognitive trainings combined with tsDCS. During the treatment, each subject received tsDCS (20 min, 2 mA) over …the thoracic vertebrae (IX-X vertebrae) in two different conditions: 1) anodal, and 2) sham while performing three computerized tasks: alertness, selective attention, and executive functions. Each experimental condition was run in ten consecutive daily sessions over two weeks. Results: After anodal tsDCS, a greater improvement in executive functions compared to sham condition was found. More importantly, the follow-up testing revealed that these effects lasted over 1 month after the intervention and generalized to the different neuropsychological tests administered before, after the treatment and at one month after the end of the intervention. This generalization was present also in the attentional domain. Conclusion: This evidence emphasizes, for the first time, that tsDCS combined with cognitive training results efficacious for AD patients. We hypothesize that enhancing activity into the spinal sensorimotor pathways through stimulation improved cognitive abilities which rely on premotor activity, such as attention and executive functions. Show more

Keywords: Alzheimer’s disease, cognitive training, neuromodulation, transpinal stimulation, tsDCS

DOI: 10.3233/JAD-200695

Citation: Journal of Alzheimer's Disease, vol. 77, no. 4, pp. 1755-1764, 2020

Authors: Marra, Camillo | Gainotti, Guido | Fadda, Lucia | Perri, Roberta | Lacidogna, Giordano | Scaricamazza, Eugenia | Piccininni, Chiara | Quaranta, Davide

Article Type: Research Article

Abstract: Taking into the account both the severity and the consistency of performances obtained on memory tests by patients with amnestic mild cognitive impairment (aMCI) could improve the power to predict their progression to Alzheimer’s disease. For this purpose, we constructed the Episodic Memory Score (EMS), which is obtained by subdividing in tertiles performances obtained at baseline in verbal (RAVLT) and visual episodic memory (Rey-Osterrieth Figure-delayed recall) and giving a score ranging from 1 (worst result) to 3 (best result) to results falling within each tertile. The EMS was computed for each patient by summing the tertile score obtained on each …memory task, so that the total score ranged from 4 (worst performance) to 12 (best performance). The aMCI sample consisted of 198 subjects who completed the two-year follow-up, at the end of which 55 subjects had converted to dementia. The mean EMS score obtained by aMCI converters was significantly lower than that of aMCI-stable patients. In detecting conversion to dementia, the comparison between EMS and individual memory scores obtained at baseline was made by computing ROC curves, and estimating the respective area under the curve (AUC). The EMS had a larger AUC than the individual memory scores. At baseline aMCI converters performed worse than non-converters not only on memory tasks, but also on executive functions tasks. However, in a multiple variables logistic regression analysis in which all scores showing statistically significant differences between aMCI-converters and aMCI-stable were entered, the EMS was the only reliable predictor of progression from aMCI to dementia. Show more

Keywords: Alzheimer’s disease, amnestic mild cognitive impairment, conversion, integration of memory scores, neuropsychological markers, Rey-Osterrieth Complex Figure delayed reproduction, verbal immediate and delayed recall

DOI: 10.3233/JAD-150613

Citation: Journal of Alzheimer's Disease, vol. 50, no. 1, pp. 61-70, 2016