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Comparative Neuropsychology of Cortical and Subcortical Dementia

Published online by Cambridge University Press:  18 September 2015

Morris Freedman  and
Marlene Oscar-Berman
Morris Freedman*
Affiliation:
Department of Medicine (Division of Neurology), University of Toronto, Mount Sinai Hospital, and Baycrest Centre for Geriatric Care
Marlene Oscar-Berman
Affiliation:
Psychology Service, Boston Veterans Administration Medical Centre, and Department of Neurology and Division of Psychiatry, Boston University School of Medicine
*
Mount Sinai Hospital, Suite 433, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5
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Abstract:

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The terms “cortical” and “subcortical” dementia are controversial; however, the clinical distinction between them is real. For example, although Alzheimer's and Parkinson's disease (prototypical of cortical and subcortical dementia, respectively) share clinical features, they differ in the presence of aphasia, apraxia, and agnosia in Alzheimer's disease but not in Parkinson's dementia. We review our studies aimed at clarifying the mechanisms underlying the differences between these neurological disorders. Experimental paradigms adopted from animal models were used to study the functional anatomy and neuropsychological characteristics of Alzheimer's and Parkinson's disease. The tasks administered include delayed alternation (DA) and delayed response (DR), which are sensitive to frontal system damage, and tactile discrimination learning (TOL) and reversal (TRL) paradigms sensitive to parietal system damage. Alzheimer's patients were significantly impaired on all tasks whereas Parkinsonians with dementia were impaired only on DR and TRL. Consideration of neuroanatomical and neuropsychological mechanisms involved in DA, DR, TOL, and TRL appears to have sharpened the distinction between Alzheimer's and Parkinson's dementia. Dementia in Alzheimer's disease may involve dorsolateral frontal, orbitofrontal and parietal systems. In contrast, dementia in Parkinson's disease may involve prominent dorsolateral frontal system damage.

Type
Neuropsychological Challenges
Information
Canadian Journal of Neurological Sciences , Volume 13 , Issue S4 , November 1986 , pp. 410 - 414
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

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