Heterogeneidade cognitiva na doença de Alzheimer

Brito-Marques, Paulo Roberto De; Joanette, Yves; Ska, Bernadette; Poissant, Arlete; Melaçon, Laurence; Giroux, Francine

doi:10.1590/S0004-282X1995000300014

Resumos

Os autores relatam e discutem aspectos neuro-psicológicos relacionados à organização funcional do cérebro ligados à cognição em 81 pacientes com doença de Alzheimer. Confrontam aspectos clínicos da homogeneidade com os da heterogeneidade, dentro da organização funcional do cérebro. Foram utilizados para diagnóstico os critérios do NINCDS-ADRDA. Todos os pacientes estavam no início da evolução, nos estágios 3 ou 4 de Reisberg (Functional Assessement Staging-FAST). A conclusão mostra que existem dois perfis cognitivos: o perfil não recorrente formado da maioria dos pacientes, o qual testemunha a heterogeneidade dependente dos fatores genéticos e ambientais de cada indivíduo; e o outro, perfil recorrente formado por grupo menor de pacientes, retrata alterações na heterogeneidade de formas clínicas, nosológicas, patológicas e senescentes.

Alzheimer; demência

The authors describe and discuss neuropsichological aspects related to the functional organization of the brain connected to cognition in 81 Alzheimer's disease patients in the Laboratoire Théophile-Alajouanine du Centre de Recherche du Centre hospitalier Côte-des-Neiges in the University of Montreal. They confront the clinical of homogeneity against the heterogeneity within functional organization of the brain. The criteria used for diagnosis were those of the NINCDS-ADRDA. All of the patients were in the begining of the evolution, in stages 3 and 4 of Reiberg (Functional Assessement Staging, FAST). The conclusion shows that there are two cognitive profiles: a non-recurrent profile, made up by the majority of the patients, and the heterogeneity depends on the genetic background of each individual; a recurrent profile, made up by a small group of patients that show changes in the heterogeneity of clinical, nosological, pathological and normal aging forms.

Alzheimer; dementia

Heterogeneidade cognitiva na doença de Alzheimer

Cognitive heterogeneity in Alzheimer's disease

Paulo Roberto De Brito-Marques^I; Yves Joanette^II; Bernadette Ska^II; Arlete Poissant^II; Laurence Melaçon^II; Francine Giroux^II

^IProfessor Assistente da Disciplina de Neurologia do Departamento de Medicina Clínica da Faculdade de Ciências Médicas da Universidade de Pernambuco (UPE). Ambulatório de Demências da Seção de Neurologia do Hospital Oswaldo Cruz da UPE

^IILaboratoire Théophile-Alajouanine, Centre de Recherche du Centre hospitalier Côte-des-Neiges, Montreal (Quebec), Canada

RESUMO

Os autores relatam e discutem aspectos neuro-psicológicos relacionados à organização funcional do cérebro ligados à cognição em 81 pacientes com doença de Alzheimer. Confrontam aspectos clínicos da homogeneidade com os da heterogeneidade, dentro da organização funcional do cérebro. Foram utilizados para diagnóstico os critérios do NINCDS-ADRDA. Todos os pacientes estavam no início da evolução, nos estágios 3 ou 4 de Reisberg (Functional Assessement Staging-FAST). A conclusão mostra que existem dois perfis cognitivos: o perfil não recorrente formado da maioria dos pacientes, o qual testemunha a heterogeneidade dependente dos fatores genéticos e ambientais de cada indivíduo; e o outro, perfil recorrente formado por grupo menor de pacientes, retrata alterações na heterogeneidade de formas clínicas, nosológicas, patológicas e senescentes.

Palavras-chave: Alzheimer, demência.

SUMMARY

The authors describe and discuss neuropsichological aspects related to the functional organization of the brain connected to cognition in 81 Alzheimer's disease patients in the Laboratoire Théophile-Alajouanine du Centre de Recherche du Centre hospitalier Côte-des-Neiges in the University of Montreal. They confront the clinical of homogeneity against the heterogeneity within functional organization of the brain. The criteria used for diagnosis were those of the NINCDS-ADRDA. All of the patients were in the begining of the evolution, in stages 3 and 4 of Reiberg (Functional Assessement Staging, FAST). The conclusion shows that there are two cognitive profiles: a non-recurrent profile, made up by the majority of the patients, and the heterogeneity depends on the genetic background of each individual; a recurrent profile, made up by a small group of patients that show changes in the heterogeneity of clinical, nosological, pathological and normal aging forms.

Key-words: Alzheimer, dementia.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 17-janeiro-1995.

Dr. Paulo Roberto de Brito Marques - Rua Santa Terezinha 58, Jardim Atlântico - 53140-170 Olinda PE -Brasil.

1. Brito-Marques PR, Joanette Y, Poissant A, Ska B. Avaliação neuropsicológica adequada às demências. Arq Neuropsiquiatr 1995, 1:147-152.
2. Caramazza A. On drawing inferences about the structure of cognitive systems from the analysis of patterns of impaired performance: the case for single-patient studies. Brain and Cognition 1986, 5:565-582.
3. Crystal HA, Horoupian DS, Katzman R, Jotkowitz S. Biopsy-proved Alzheimer disease presenting as right parietal lobe syndrome. Ann Neurol 1981, 12:186-188.
4. Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a praticai method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12:189-198.
5. Joanette Y, Ska B, Poissant A, Béland R. Neuropsychological aspects of Alzheimer's disease: evidence for inter and intra -function heterogeneity. In Boiler F, Forette F, Khachaturian Z, Poncet M, Christien Y(eds). Heterogeneity of Alzheimer's disease New York: Springer-Verlag . 1992, p 33-42.
6. Joanette Y, Ska B, Poissant A, Giroux F. Multiple neuropsy- etiological profiles among early demented patients of the Alzheimer type. TENNET IV 1993, Montreal, 12-14 mai.
7. Joanette Y, Ska B, Poissant A, Melançon L. Manifestations neuropsychologiques dans les démences de type Alzheimer: de l'homogénéité à 1'hétérogénéité. Alzheimer Actualités 1992, 92:4-7.
8. Joanette Y, Poissant A, Valdois S. Neuropsychological dissociations in dementia of the Alzheimer type: a multiple single case study. J Clin Exp Neuropsychol 1989, 11:91.
9. Martin A, Brouwers P, Lalonde F, Cox C, Teleska P, Fedio P, Foster NL, Chase TN. Toward a behavioral typology of Alzheimer's patients. J Clin Exp Neuropsychol 1986, 8:594-610.
10. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Departament of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984, 34:939-944.
11. Neary D, Snowden JS, Bowen DM, Sims NR, Mann D, Benton JS, Northen B, Yates P, Avision D. Neuropsychogical syndromes in presenile dementia due to cerebral atrophy. J Neurol Neurosurg Psychiatry 1986, 49:163-174.
12. Reisberg B, Ferris SH, DeLeon MJ, Crook T. The global deterioration scale for assessement of primary degenerative dementia. Am J Psychiatry 1982, 139:1136-1139.
13. Richard J, Constantinidis J. Les démences de la vieillesse: notions acquises et problèmes cliniques actuels. Confront Psychiatrique 1970, 3:39-61.
14. Schwartz MF. Introduction to chapter 5: Neuropsychology of Alzheimer's disease: the case for subgrups by A. Martib. In Schwartz MJ (ed): Modular deficits in Alzheimer-type Dementia. Cambridge (Mass): MIT Press, 1990, p 143.
15. Ska B, Joanette Y, Poissant A, Béland R, Lecours AR. Language disorders in dementia of the Alzheimer type: contrastive patterns from a multiple single case study (Abstr). Academy of Aphasia 28th Annual Meeting. Baltimore (USA), 1990, October 21-23.

Datas de Publicação

Publicação nesta coleção
09 Dez 2010
Data do Fascículo
Set 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Brito-Marques PR, Joanette Y, Poissant A, Ska B. Avaliação neuropsicológica adequada às demências. Arq Neuropsiquiatr 1995, 1:147-152.

[2] 2. Caramazza A. On drawing inferences about the structure of cognitive systems from the analysis of patterns of impaired performance: the case for single-patient studies. Brain and Cognition 1986, 5:565-582.

[3] 3. Crystal HA, Horoupian DS, Katzman R, Jotkowitz S. Biopsy-proved Alzheimer disease presenting as right parietal lobe syndrome. Ann Neurol 1981, 12:186-188.

[4] 4. Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a praticai method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12:189-198.

[5] 5. Joanette Y, Ska B, Poissant A, Béland R. Neuropsychological aspects of Alzheimer's disease: evidence for inter and intra -function heterogeneity. In Boiler F, Forette F, Khachaturian Z, Poncet M, Christien Y(eds). Heterogeneity of Alzheimer's disease New York: Springer-Verlag . 1992, p 33-42.

[6] 6. Joanette Y, Ska B, Poissant A, Giroux F. Multiple neuropsy- etiological profiles among early demented patients of the Alzheimer type. TENNET IV 1993, Montreal, 12-14 mai.

[7] 7. Joanette Y, Ska B, Poissant A, Melançon L. Manifestations neuropsychologiques dans les démences de type Alzheimer: de l'homogénéité à 1'hétérogénéité. Alzheimer Actualités 1992, 92:4-7.

[8] 8. Joanette Y, Poissant A, Valdois S. Neuropsychological dissociations in dementia of the Alzheimer type: a multiple single case study. J Clin Exp Neuropsychol 1989, 11:91.

[9] 9. Martin A, Brouwers P, Lalonde F, Cox C, Teleska P, Fedio P, Foster NL, Chase TN. Toward a behavioral typology of Alzheimer's patients. J Clin Exp Neuropsychol 1986, 8:594-610.

[10] 10. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Departament of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984, 34:939-944.

[11] 11. Neary D, Snowden JS, Bowen DM, Sims NR, Mann D, Benton JS, Northen B, Yates P, Avision D. Neuropsychogical syndromes in presenile dementia due to cerebral atrophy. J Neurol Neurosurg Psychiatry 1986, 49:163-174.

[12] 12. Reisberg B, Ferris SH, DeLeon MJ, Crook T. The global deterioration scale for assessement of primary degenerative dementia. Am J Psychiatry 1982, 139:1136-1139.

[13] 13. Richard J, Constantinidis J. Les démences de la vieillesse: notions acquises et problèmes cliniques actuels. Confront Psychiatrique 1970, 3:39-61.

[14] 14. Schwartz MF. Introduction to chapter 5: Neuropsychology of Alzheimer's disease: the case for subgrups by A. Martib. In Schwartz MJ (ed): Modular deficits in Alzheimer-type Dementia. Cambridge (Mass): MIT Press, 1990, p 143.

[15] 15. Ska B, Joanette Y, Poissant A, Béland R, Lecours AR. Language disorders in dementia of the Alzheimer type: contrastive patterns from a multiple single case study (Abstr). Academy of Aphasia 28th Annual Meeting. Baltimore (USA), 1990, October 21-23.