Subcortical dementia

Small vessel dementia (subcortical vascular dementia)... 

Moore DJ, Masliah E, Rippeth JD, Gonzalez R, Carey CL, Cherner M, Ellis RJ, Achim CL, Marcotte TD, Heaton RK, Grant I (2006) Cortical and subcortical neurodegeneration is associated with HIV neurocognitive impairment. Aids 20(6) 879-887 Nath A (2002) Human immunodeficiency virus (HIV) proteins in neuropathogenesis of HIV dementia. J Infect Dis 186(Suppl 2) S193-S198... 

Frontotemporal dementias occur as familial forms and, more commonly, as sporadic diseases. They are characterized by a remarkably circumscribed atrophy of the frontal and temporal lobes of the cerebral cortex, often with additional, subcortical changes. In 1994, an autosomal-dominantly inherited form of frontotemporal dementia with parkinsonism was linked to chromosome 17q21.2. Subsequently, other forms of frontotemporal dementia were linked to this region, resulting in the denomination frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17) for this class of disease. All cases of FTDP-17 have so far shown a filamentous pathology made of hyperphosphorylated tau protein (Fig. 45-7). In 1998, mutations in tau were reported in FTDP-17 patients [29-31]. Since then, more than 30 different mutations have been described in over 80 families with FTDP-17 (Fig. 45-6). 

Degenerative Dementias Cortical and Mixed Cortical/Subcortical Types Alzheimer s Disease... 

Frontotemporal dementias are characterized by gross structural changes in the frontal and anterior temporal lobes, metabolic disturbances, and involvement of certain subcortical structures as well (Ishii et al. 1998). Whereas in Alzheimer s disease the early cognitive disturbances are in memory, in frontotemporal dementias the early manifestations are in executive and behavioral function (Pfeffer et al. 1999 Varma et al. 1999). This relative cognitive distinction persists throughout the course of the two disorders (Pachana et al. 1996). Disinhibition and disorganization are common, and psychotic symptoms may be prominent in frontotemporal dementia. 

Frontal and subcortical lacunar infarcts typically affect attention, language, visuospatial function, and motor programming (Babikian et al. 1990). Compared to patients with Alzheimer s disease, those with vascular dementia show better orientation, recall, and language ability. On... 

The deficit of cortico-striatal innervation that is presumably responsible for reported losses of striatal glutamate uptake sites (Aparicio-Legarza et al., 1997 Simpson et al., 1992), is likely to contribute to the cognitive dysfunction of schizophrenia. These have been described as having similarities to the subcortical dementia (Pantelis et al., 1992) seen in a variety of neurodegenerative disorders disturbances of corticostriatal function are thought to underlie this pattern of cognitive deficits that include disturbances of attention, executive function and short-term memory. 

Moretti R, Torre P, Antonello RM, et al Rivastigmine in subcortical vascular dementia an open 22-month study. J Neurol Sci 203 141-146, 2002... 

Wilcock GK, Esiri MM, Bowen DM, Hughes AO (1988) The differential involvement of subcortical nuclei in senile dementia of Alzheimer s type. J. Neurol. Neurosurg. Psychiatry 51 842-849. 

Subcortical Ischemic Cerebrovascular Dementia Uma Menon and Roger E. Kelley... 

Many individuals with LA also harbor lacunar and/or cortical infarcts. Presence of LA serves as an intermediate surrogate both for ischemic stroke and intracerebral hemorrhage as they all share similar risk factors and similar pathophysiological mechanisms (Inzitari 2003). LA is widely found in dementing illnesses, such as Alzheimer s disease, vascular dementia, and cerebral autosomal dominant arteri-opathy with subcortical infarcts and leukoencepha-lopathy (CADASIL). Failure of blood supply in the... 

Table 13.1. Subcortical ischemic vascular dementia. [Reprinted with permission from Roman et al. (2002)]...

Roman GC, Royall DR (1999) Executive control function a rational basis for the diagnosis of vascular dementia. Alzheimer Dis Assoc Disord 13 [Suppl 3] S69-S80 Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC (2002) Subcortical ischaemic vascular dementia. Lancet Neurol 1 426-436... 

I. The clinical recognition of subcortical arteriosclerotic encephalopathy in elderly neuropsychiatric patients. J Geriatr Psychiatry Neurol 2 123-133 Szabo K, Bazner H, Kern R, Blahak C, Hennerici MG, Gass A (2004) Lack of incidental DWI hyperintensity in healthy elderly individuals. Cerebrovasc Dis [Suppl] 5 75 Tanaka Y, Tanaka O, Mizuno Y, Yoshida M (1989) A radiologic study of dynamic processes in lacunar dementia. Stroke 20 1488-1493... 

Huber, S.J., Paulson, G. W. (1985). The concept of subcortical dementia. American Journal of Psychiatry 142, 1312-1317. 

Chronic neurological sequelae of intoxication included two patients with a persistent cerebellar syndrome and severe cerebellar atrophy (175), one with subcortical dementia (176), and one with a diffuse sensorimotor peripheral neuropathy (177). 

---