Connections define the functions of neurons: information flows along connections, as well as growth factors and viruses, and even neuronal death may progress through connections. Knowledge of how the various parts of the brain are interconnected to form functional systems is a prerequisite for the proper understanding of data from all fields in the neurosciences.

Clinical Neuroanatomy: Brain Circuitry and Its Disorders bridges the gap between neuroanatomy and clinical neurology. It emphasizes human and primate data in the context of disorders of brain circuitry which are so common in neurological practice. In addition, numerous clinical cases demonstrate how normal brain circuitry may be interrupted and to what effect. Following an introduction into the organization and vascularisation of the human brain and the techniques to study brain circuitry, the main neurofunctional systems are discussed, including the somatosensory, auditory, visual, motor, autonomic and limbic systems, the cerebral cortex and complex cerebral functions.

"Flashcards in a book" provide a comprehensive yet concise review for the psychiatry clerkship

Maximum retention in minimum time

Deja Review: Psychiatry boils down your coursework to just the critical concepts you need to know for exam success. This unbeatable guide features a quick-read, two-column, “flashcard in a book” Q&A format. – specifically designed to help you remember a large amount of pertinent information in the least amount of time possible. The format allows you to zero-in on only the correct answers to promote memory retention and get the most out of your study time. Great for last minute review of high-yield facts, Deja Review provides a straightforward way for you to assess your strengths and weaknesses so you can excel on the clerkship and the USMLE Step 2 CK.

The second edition of this landmark title has been extensively revised and updated to reflect the latest developments in the field.

The Desk Reference to the Diagnostic Criteria From DSM-IV-TR® is a concise, affordable companion to the ultimate psychiatric reference, DSM-IV-TR®. It includes all the diagnostic criteria from DSM-IV-TR® in an easy-to-use, spiralbound format. It includes a pull-out chart of the DSM-IV-TR Classification.

Changes were made to the following diagnostic criteria:

• Personality Change Due to a General Medical Condition
• Paraphilias
• Tic Disorders


Spiral-bound: 370 pages
Company: American Psychiatric Publishing, Inc. (2000-09)
ISBN: 0890420270
List Price: $63.00
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New edition features: Empirically supported, evidence-based treatment interventions Organized around 43 main presenting problems, including anger management, chemical dependence, depression, financial stress, low self-esteem, and Obsessive-Compulsive Disorder Over 1,000 prewritten treatment goals, objectives, and interventions - plus space to record your own treatment plan options Easy-to-use reference format helps locate treatment plan components by behavioral problem Designed to correspond with the The Adult Psychotherapy Progress Notes Planner, Third Edition and the Adult Psychotherapy Homework Planner, Second EditionIncludes a sample treatment plan that conforms to the requirements of most third-party payors and accrediting agencies (including CARF, JCAHO, and NCQA).

Author: Arthur E. Jongsma Jr., L. Mark Peterson
Paperback: 368 pages
Company: Wiley (2006-06-30)
ISBN: 0471763462
List Price: $55.00
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A comprehensive overview of basic and clinical neurology using a symptom-oriented approach

A Doody's Core Title ESSENTIAL PURCHASE!

"The book is presented as a teaching tool for students and practitioners. The focus of the book and its easy readability will appeal to a full spectrum of healthcare providers....This edition of the classic book has been updated and revised to make it even more clinically relevant. A quick overview of each topic is provided to be translated into advanced patient therapy. Besides its quality, focus, and easy readability, the book is light and convenient to hold, read, and access at a moment's notice. 3 Stars."--Doody's Review Service

No other book makes the link between basic neuroscience and current approaches in diagnosis and treatment easier to understand than Clinical Neurology. Distinguished by its practice-oriented approach to neurology based on the patients' presenting symptoms, this classic has been updated and revised to make it even more clinically-relevant and enjoyable to read.

Features:
Essential concepts are presented within the framework of problems encountered in a clinical setting for greater relevance to real-world practice Chapter outlines provide a quick overview of each topic Treatment protocols reflect the most recent advances in the field Advances in molecular biology and genetics are incorporated throughout to enhance understanding of neurologic disease A step-by-step description of the neurologic examination More than 200 tables and figures

Author: Roger Simon, David Greenberg, Michael Aminoff
Paperback: 400 pages
Company: McGraw-Hill Professional (2009-03-09)
ISBN: 0071546448
List Price: $59.00
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This text clearly presents a multitude of variables that potentially affect the results of neuropsychological tests. THe chapter authors, all noted experts in their respective fields, begin with a general discussion of neuropsychological constructs known to impact performance on neuropsychological tests, including demographics, personality, and sociocultural factors. They then present an empirical approach to assessment. They focus on the disorders under discussion (not solely the tests that might be used in diagnosis) and reflect the contributions the field has made to detecting differences in disorders that have neurological underpinnings.

The disorders reviewed include dementia, HIV-related syndromes, adult seizure disorders, toxic exposure, mild to severe brain injury, and chronic fatigue syndrome.

People with mood disorders often have simultaneous problems with addiction, and those with substance abuse problems are especially susceptible to mood disorder. The treatment of such patients can be particularly complicated, and many receive treatment for only one of their disorders.

In this book, fourteen clinicians discuss the extent of the problem, methods of assessment, typical courses, and treatments—including both psychotherapy and pharmacotherapy. They address the all-too-frequent necessity of proceeding with treatment before a clear diagnosis is known, and they claim that distinguishing between primary and secondary disorders is initially less critical than previously assumed. Contending that clinicians treating comorbid mood / substance problems must be both more flexible and more watchful than those treating either disorder alone, the authors also describe various models of care. Throughout the book, they provide differing points of view on such issues as the value of pharmacotherapy for those still abusing psychoactive substances. Written for those who treat addictions, including counselors, clergy, and employee assistance staff, as well as for traditional mental health professionals, Integrated Treatment for Mood and Substance Use Disorders is an invaluable reference for any clinician who works with dually diagnosed clients.

Section 1: A compilation of the major brain lesions typically seen in PD

Section 2: Treatment options in PD

Section 3: 25 cases designed to test the reader and the practical application of the information supplied in the other sections.

Paperback: 208 pages
Company: Wiley-Blackwell (2009-06-02)
ISBN: 1405196017
List Price: $77.95
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Targeted to patients, their families and allied health students, The “Gale Encyclopedia of Neurological Disorders” provides in-depth coverage of neurological diseases and disorders, including stroke, multiple sclerosis, Parkinson disease, Tourette Syndrome, Alzheimer's disease, cerebral palsy, vertigo, amnesia and epilepsy. Related topics include communication aids, electric personal assistive mobility devices, medications for treating neurological diseases and conditions, understanding the needs of Alzheimer patient caregivers and more. This two-volume set provides an alternative to resources that either fail to explore neurological disease in any depth and or do so at a level not appropriate for students and general readers.

The Quick Reference to the Diagnostic Criteria From DSM-IV-TR® is a handy, low priced companion to the ultimate psychiatric reference, DSM-IV-TR®. It includes all the diagnostic criteria from DSM-IV-TR® in an easy-to-use, paperback format.

In making DSM-IV diagnosis, clinicians and researchers may find it convenient to consult the Quick Reference to the Diagnostic Criteria From DSM-IV-TR®, a pocket sized book that contains the classification, the diagnosis criteria, and a listing of the most important conditions to be considered in a differential diagnosis for each category.

Clinical Guide to the Diagnosis and Treatment of Mental Disorders - Second Edition combines clinically-relevant information about each of theDSM-IV-TR diagnoses with clear, detailed information on treatment options, giving full clinical management advice. Once again, the editors, both leading psychiatrists, have condensed the chapters on Disorders from Tasman et al’s acclaimed two volume textbook of Psychiatry (now in its Third Edition), retaining only the content they deem particularly relevant to the clinician for ease of use.

Each disorder is discussed under the headings of Diagnosis (including Assessment Issues, Comorbidity, Course, and Differential Diagnosis, giving diagnostic decision trees where relevant) and Treatment (listing all therapeutic options, giving practical advice for patient management, summarising treatment specifics with tables and treatment flowcharts).

The original edition established itself as the first point of reference for any clinician or mental health practitioner needing expert advice on therapeutic options for any psychiatric disorder. This edition features an additional chapter on the psychiatric interview and assessment of mental status to increase its utility.

It echoes the progress in psychiatry regarding the establishment of an evidenced-based model of taxonomy, diagnosis, etiology, and treatment. Indeed, from a psychologist's perspective, the equal consideration provided to empirically supported psychosocial treatments versus somatic treatment is a significant development in the field of psychiatry.

Jonathan Weinand in PsycCritiques, the American Psychological Association Review of Books

Author: Michael B. First, Allan Tasman
Paperback: 558 pages
Company: Wiley (2010-03-16)
ISBN: 0470745207
List Price: $104.95
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The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

New this spring, the third edition of this Hazelden best-seller has been updated to include the latest research, information about new medications, and an explanation of new diagnostic criteria.

Key features and benefits outlines the relationship between chemical dependency and psychiatric disorders contains important resources for chemically dependent individuals and their families presents practical relapse prevention strategies

Author: Dennis C Daley Ph.D., Howard B. Moss M.D.
Paperback: 499 pages
Company: Hazelden (2002-04) (2002-03-07)
ISBN: 1568388020
List Price: $32.95
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This authoritative work comprehensively examines all aspects of addictive disorders and their treatment. Leading researchers and practitioners identify best practices in assessment and diagnosis and provide tools for working with users of specific substances. Issues in working with particular populations--including polysubstance abusers, culturally diverse patients, women, and older adults--are addressed, and widely used psychosocial and pharmacological treatment approaches are reviewed. An indispensable text for anyone studying or treating these prevalent, challenging disorders, the book describes ways to tailor interventions to each patient’s needs while delivering compassionate, evidence-based care.

"Clinical Manual of Neuropsychiatry" focuses on the assessment, diagnosis, and treatment of the full spectrum of neuropsychiatric disorders, as well as those conditions that have significant neuropsychiatric components.

With the help of this highly practical manual, clinicians are empowered to evaluate patients and treat the neuropsychiatric aspects of a host of disorders. The manual: - Sets forth a concise, step-by-step approach to assessing patients, by beginning with the indications for a neuropsychological evaluation, and progressing through the patient interview, physical examination, and measures that are useful diagnostic indicators, such as psychological testing and structural and functional neuroimaging.- Offers complete physiological and epidemiological information about each condition, by providing much-needed context and helping the clinician to identify the focal neurological symptoms to look for, potential contributing factors, and the course a disease is likely to follow.- Covers the general neuropsychiatric and neuropsychological considerations the clinician must take into account when attempting to understand the factors that influence presenting symptoms and behavioral changes. For example, intracranial pressure can be and elusive consequence of central nervous system (CNS) tumors and has been implicated in behavior changes such as apathy and depression.- Aids the clinician in making a clinical diagnosis through the precise evaluation of a patient's neurological and psychiatric signs and symptoms, through taking a careful history, and through a directed physical examination the patient.- Addresses the full range of available treatment options, including psychopharmacological, psychotherapeutic, and cognitive rehabilitation modalities. - Presents an utterly up-to-date chapter on psychopharmacological treatment of patients with neuropsychiatric disorders, and includes an abundance of tables that compare indications, efficacy, and side effect profiles for the full range of drugs that are likely to be prescribed.

While acknowledging the ongoing dialogue on the nature of neuropsychiatry, "Clinical Manual of Neuropsychiatry" focuses on the paramount duty of the physician, whether psychiatrist or neurologist: to understand each patient's underlying disease and to ease the suffering it causes. This meticulously referenced, thoughtfully illustrated, and elegantly structured volume deserves a place in both the beginning and seasoned clinician's library.

Paperback: 427 pages
Company: Amer Psychiatric Pub (2011-12-07)
ISBN: 1585624292
List Price: $79.00
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Within neuropsychology, localization refers to the relationship between the anatomical structures of the brain and their corresponding psychological or behavioral function. There has long been considerable debate over localization. How widespread is it? Are some functions more localized than others? By the mid-20th century, a formidable amount of evidence seemed to strongly support the "modularity hypothesis" that psychological functions such as language and memory reside in specific neuroanatomical areas. More recently, neuroimaging studies seem to suggest a more holisitc view--that psychological functions are distributed and dynamically organized across multiple brain regions.

This book by two senior figures in clinical neuropsychology sets out to reconcile these two approaches, arguing that newer imaging techniques must be used in conjunction with, rather than replace, traditional neuropsychology approaches such interviewing, testing, and autopsy exams. Only by triangulating these various approaches can neuropsychologists begin to understand the complex relationship between brain structure and mental function that is exhibited across the spectrum of neurological disorders. The book's "big picture" perspective on a long running debate will usefully counterbalance current research that emphasizes imaging studies to the exclusion of other useful techniques.

Author: Joseph M. Tonkonogy, Antonio E. Puente
Hardcover: 864 pages
Company: Springer Publishing Company (2009-01-23)
ISBN: 0826119670
List Price: $125.00
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Over the last decade, the literature on therapy addressing trauma in children has expanded considerably, as has the literature on dissociation. Unfortunately, very little of this literature has addressed the issue of dissociation in children. At the same time, therapists working with children and adolescents have become increasingly aware of the occurrence of trauma and dissociation in their clients.

Dissociation in Traumatized Children and Adolescents is a groundbreaking text for the study of dissociation in young people. In eight unique and compelling case studies, the authors lay out detailed narratives that illustrate both therapy progression as well as the therapist’s reactions and thought process during case development. These case studies present many aspects of working with traumatized children who dissociate—trauma processing, attachment work, work with the family, interactions with the community—and give frank analysis of the difficulties clinicians encounter in various therapeutic situations and how and why they arrived at particular therapeutic decisions. While the book includes intensive analysis of each author’s theoretical framework as well as that of dissociation in general, it also shows clinicians, in the most practical terms, how to translate the theories of dissociation into action. No clinician interested in trauma and dissociation in children will want to be without this text.

The cognitive disorders that follow brain damage are an important source of insights into the neural bases of human thought. This second edition of the widely acclaimed Patient-Based Approaches to Cognitive Neuroscience offers state-of-the-art reviews of the patient-based approach to central issues in cognitive neuroscience by leaders in the field.The second edition has been thoroughly updated, with new coverage of methods from imaging to transcranial magnetic stimulation to genetics and topics from plasticity to executive function to mathematical thought. Part I, on the history and methods of cognitive neuroscience and behavioral neurology, includes two new chapters on imaging, one covering the basics of fMRI in normal humans and the other on the functional imaging of brain-damaged patients, as well as updated chapters on electrophysiological methods and computer modeling. Part II, on perception and attention, includes new chapters on visual perception and spatial cognition as well as attention, visual, tactile, and auditory recognition, music perception, body concept, and delusions. Part III, on language, covers many aspects of language processing in adults and children, including reading. Part IV discusses memory and prefrontal function, including semantic memory and executive functions. Part V covers dementias and developmental disorders, among them Alzheimer's and Parkinson's diseases, mental retardation, ADHD, and autism, and includes a chapter on the molecular genetics of cognitive disorders.

In this sweeping synthesis, Neal J. Cohen and Howard Eichenbaum bring together converging findings from neuropsychology, neuroscience, and cognitive science that provide the critical clues and constraints for developing a more comprehensive understanding of memory. Specifically, they offer a cognitive neuroscience theory of memory that accounts for the nature of memory impairment exhibited in human amnesia and animal models of amnesia, that specifies the functional role played by the hippocampal system in memory, and that provides further understanding of the componential structure of memory.The authors' central thesis is that the hippocampal system mediates a capacity for declarative memory, the kind of memory that in humans supports conscious recollection and the explicit and flexible expression of memories. They argue that this capacity emerges from a representation of critical relations among items in memory, and that such a relational representation supports the ability to make inferences and generalizations from memory, and to manipulate and flexibly express memory in countless ways. In articulating such a description of the fundamental nature of declarative representation and of the mnemonic capabilities to which it gives rise, the authors' theory constitutes a major extension and elaboration of the earlier procedural-declarative account of memory.Support for this view is taken from a variety of experimental studies of amnesia in humans, nonhuman primates, and rodents. Additional support is drawn from observations concerning the neuroanatomy and neurophysiology of the hippocampal system. The data taken from divergent literatures are shown to converge on the central theme of hippocampal involvement in declarative memory across species and across behavioral paradigms.Neal J. Cohen is Assistant Professor in the Amnesia Research Laboratory at Beckman Institute for Advanced Science and Technology, and in the Department of Psychology at the University of Illinois. Howard Eichenbaum is Professor of Psychology and Neurobiology at the University of North Carolina, Chapel Hill.

Additional resources in the PracticePlanners™ series:

Brief Therapy Homework Planner (Paper3-1/2" Disk), by Gary M. Schultheis ISBN 0-471-24611-5
Homework Planners feature behaviorally based, ready-to-use assignments to speed tratment and keep clients engaged between sessions.

The Clinical Documentation Sourcebook: A Comprehensive Collection of Mental Health Practice Forms, Handouts, and Records, 2nd Edition (Paper3-1/2" Disk), by Donald E. Wiger ISBN 0-471-32692-5,
Documentation Sourcebooks provide the forms and records that mental health professionals need to efficiently run their practice.

For more information on our PracticePlanners™ products, including our full line of Treatment Planners, visit us on the web at: www.wiley.com/practiceplanners

Author: Jr. Arthur E. Jongsma, L. Mark Peterson
Paperback: 277 pages
Company: John Wiley & Sons (1999-02-04)
ISBN: 0471319244
List Price: $49.95
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With an easy-to-read approach and unmatched learning support, Physical Examination & Health Assessment, 6th Edition offers a clear, logical, and holistic approach to physical exam across the lifespan. Detailed illustrations, summary checklists, and new learning resources ensure that you learn all the skills you need to know. This gold standard in physical exam reflects what is going on in nursing today with coverage of emerging trends and new evidence-based content. It's easy to see why this text is, far and away, #1 in this market!

Understanding the neuropsychology of various conditions is important clinically and theoretically. This authoritative book is the first to fully explore the subject in a single volume. It provides a ready reference of the nature, extent, location and putative causes of cognitive dysfunction in major brain disorders. Experts provide a volume of reviews of all the principal neurological and psychiatric disorders. Each section focuses on a particular disease, and each section begins with ata summary of the key details of that disorder. Cognitive Deficits in Brain Disorders will prove invaluable to clinicians and trainees, as well as to trainee psychologists and postgraduates.

"I think this book is something many clinicians worldwide have been waiting for for many years…" MARIO MAJ, UNIVERSITY OF NAPLES, ITALY

Invaluable to psychiatrists, clinical psychologists, clinical social workers and practicing mental health professionals.

Author: Michael B. First, Allan Tasman
Hardcover: 1382 pages
Company: Wiley (2004-06-28)
ISBN: 0470860898
List Price: $277.00
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Despite dramatic advances in neuroimaging techniques, patient-based analyses of brain disorders continue to offer important insights into the functioning of the normal brain. Bridging the gap between the work of neurologists studying clinical disorders and neuroscientists studying the neural mechanisms underlying normal cognition, this book reviews classical neurobehavioral syndromes from both neurological and cognitive scientific perspectives.The contributors are all practicing neurologists who also conduct cognitive neuroscience research. Each chapter begins with a case study, describing the patient's symptoms and the cognitive processes involved. The clinical descriptions are followed by historical background on the neurobehavioral syndromes and discussion of the methods used to understand the underlying neural mechanisms. In their attempts to reconcile conflicting data derived from different methodologies, many of the authors shed new light on the cognitive mechanisms they discuss. The syndromes include neglect, Balint's syndrome, amnesia, semantic dementia, topographical disorientation, acquired dyslexia, acalculia, transcortical motor aphasia, Wernicke's aphasia, apraxia, and lateral prefrontal syndrome.

New Case Studies, Images, and Clinical Findings

With updated case studies and new images from functional MRI, PET scans, and MR Spectroscopy, this edition places more emphasis on mild traumatic brain injury, including expanded information on sports injuries in children and athletes. It brings up-to-date the neuroanatomical and neuroimaging bases of cognitive domains of the brain and includes new findings on the epidemiology and pathophysiology of brain injury, as well as acquired psychopathology following injury. It also investigates the physical effects and psychiatric ramifications of blast over-pressure as seen in combat veterans and civilians in Kosovo, Lebanon, and Iraq.

Practical, Applicable Guidelines

Providing practical guidelines for using state-of-the-art, brain-based assessment techniques, this volume establishes a neuropsychiatric schema for the evaluation of traumatic brain injury and provides tools for designing a treatment plan. Although geared toward forensic evaluation with chapters on the detection of brain-injury malingering, determination of impairment, methods of neurobehavioral analysis, and the presentation of evidence at trial, the methods in this book can be used to evaluate and treat any neuropsychiatric disorder with the addition of appropriate laboratory studies and pathology specific treatment.

Author: Robert P. Granacher Jr.
Hardcover: 584 pages
Company: CRC Press (2007-12-20)
ISBN: 084938138X
List Price: $162.95
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Biol Psychiatry. 2012 Jan 24;
Mouton-Liger F, Paquet C, Dumurgier J, Lapalus P, Gray F, Laplanche JL, Hugon J,

BACKGROUND: The pathological hallmarks of Alzheimer's disease (AD) include accumulation of amyloid-β (Aß) peptide forming extracellular senile plaques, neurofibrillary tangles made of hyperphosphorylated tau protein with neuronal loss. Aβ peptide (1-42), total tau (T-tau), and phosphorylated tau at threonine 181 (p181tau) levels in the cerebrospinal fluid (CSF) are now validated biomarkers. The proapoptotic kinase R (PKR), is activated by Aβ accumulates in degenerating neurons in AD brains and controls protein synthesis and indirectly tau phosphorylation. METHODS: In a prospective cohort study, the CSF of 91 patients were studied (AD: 45; amnestic mild cognitive impairment: 11; neurological disease control subjects [NDC]: 35). The levels of total PKR (T-PKR), phosphorylated PKR (pPKR), Aß 1-42, T-tau, and p181tau were assessed by immunoblotting or enzyme-linked immunosorbent assay methods. Receivers operating characteristic curves were used to examine the discriminatory power of T-PKR, pPKR, and pPKR/T-PKR ratio between AD and NDC patients. RESULTS: Total PKR and pPKR concentrations were elevated in AD and amnestic mild cognitive impairment subjects. We have determined a pPKR value (optical density units) that could discriminate AD patients from control subjects with a sensitivity of 91.1% and a specificity of 94.3%. Among AD patients, T-PKR and pPKR levels correlate with CSF p181tau levels. Some AD patients with normal CSF Aß, T-tau, or p181tau levels had abnormal T-PKR and pPKR levels. CONCLUSIONS: The evaluation of CSF T-PKR and pPKR can discriminate between AD patients and NDC and could help to improve the biochemical diagnosis of AD.

Neurology. 2012 Jan 31; 78(5): 352-60
Jacobs HI, Van Boxtel MP, Heinecke A, Gronenschild EH, Backes WH, Ramakers IH, Jolles J, Verhey FR

Parietal lobe dysfunction is an important characteristic of early Alzheimer disease (AD). Functional studies have shown conflicting parietal activation patterns indicative of either compensatory or dysfunctional mechanisms. This study aimed at examining activation differences in early AD using a visuospatial task. We focused on functional characteristics of the parietal lobe and examined compensation or disconnection mechanisms by combining a fMRI task with effective connectivity measures from Granger causality mapping (GCM).Eighteen male patients with amnestic mild cognitive impairment (aMCI) and 18 male cognitively healthy older individuals were given a mental rotation task with different rotation angles.There were no behavioral group differences on the fMRI task. Separate measurements at each angle revealed widespread activation group differences. More temporal and parietal activation in the higher angle condition was observed in patients with aMCI. The parametric modulation, which identifies regions associated with increasing angle, confirmed these results. The GCM showed increased connectivity within the parietal lobe and between parietal and temporal regions in patients with aMCI. Decreased connectivity was found between the inferior parietal lobule and posterior cingulate gyrus. Connectivity patterns correlated with memory performance scores in patients with aMCI.Our results demonstrate increased effective temporoparietal connectivity in patients with aMCI, while maintaining intact behavioral performance. This might be a compensational mechanism to counteract a parietal-posterior cingulate gyrus disconnection. These findings highlight the importance of connectivity changes in the pathophysiology of AD. In addition, effective connectivity may be a promising method for evaluating interventions aimed at the promotion of compensatory mechanisms.

J Neurol Sci. 2012 Jan 24;
Zhang H, Sachdev PS, Wen W, Kochan NA, Crawford JD, Brodaty H, Slavin MJ, Reppermund S, Draper B, Zhu W, Kang K, Trollor JN

Mild cognitive impairment (MCI) is a heterogeneous neurocognitive disorder that can be classified into various subtypes. The present study aims to examine the gray matter (GM) atrophy patterns of MCI subtypes in comparison with a cognitively healthy group. Participants, including 135 MCI subjects and 120 cognitively healthy controls, were drawn from the Sydney Memory and Ageing Study. The MCI subjects were first categorized into amnestic (aMCI) and non-amnestic (naMCI) subtypes, which were then divided into single-domain (aMCI-SD and naMCI-SD) and multiple-domain subtypes (aMCI-MD and naMCI-MD). Furthermore, naMCI-SD was divided into three subgroups (language, processing speed, and executive function) according to individual cognitive impairment. Voxel-wise GM volumes were then compared between MCI subtypes and controls. The aMCI group had significantly lower GM volumes in the bilateral hippocampi and temporal cortices than the controls. This was mainly due to GM reduction of aMCI-MD but not aMCI-SD, as the latter did not show any significant GM reduction. GM reduction of naMCI and its two subdivisions was shown in widespread brain regions compared to controls. GM volumes of the multiple-domain subtypes (aMCI-MD and naMCI-MD) were lower than their single-domain counterparts (aMCI-SD and naMCI-SD) in the frontal and temporal lobes, respectively. Moreover, the language subgroup of naMCI-SD showed GM reduction in the frontal and temporal lobes compared to controls. MCI subtypes displayed specific patterns of GM atrophy that appear to be related to their various clinical presentations, which implies that underlying mechanisms of MCI subtypes are different.

Neuroimage. 2012 Jan 8;
Meda SA, Narayanan B, Liu J, Perrone-Bizzozero NI, Stevens MC, Calhoun VD, Glahn DC, Shen L, Risacher SL, Saykin AJ, Pearlson GD

The underlying genetic etiology of late onset Alzheimer's disease (LOAD) remains largely unknown, likely due to its polygenic architecture and a lack of sophisticated analytic methods to evaluate complex genotype-phenotype models. The aim of the current study was to overcome these limitations in a bi-multivariate fashion by linking intermediate magnetic resonance imaging (MRI) phenotypes with a genome-wide sample of common single nucleotide polymorphism (SNP) variants. We compared associations between 94 different brain regions of interest derived from structural MRI scans and 533,872 genome-wide SNPs using a novel multivariate statistical procedure, parallel-independent component analysis, in a large, national multi-center subject cohort. The study included 209 elderly healthy controls, 367 subjects with amnestic mild cognitive impairment and 181 with mild, early-stage LOAD, all of them Caucasian adults, from the Alzheimer's Disease Neuroimaging Initiative cohort. Imaging was performed on comparable 1.5T scanners at over 50 sites in the USA/Canada. Four primary "genetic components" were associated significantly with a single structural network including all regions involved neuropathologically in LOAD. Pathway analysis suggested that each component included several genes already known to contribute to LOAD risk (e.g. APOE4) or involved in pathologic processes contributing to the disorder, including inflammation, diabetes, obesity and cardiovascular disease. In addition significant novel genes identified included ZNF673, VPS13, SLC9A7, ATP5G2 and SHROOM2. Unlike conventional analyses, this multivariate approach identified distinct groups of genes that are plausibly linked in physiologic pathways, perhaps epistatically. Further, the study exemplifies the value of this novel approach to explore large-scale data sets involving high-dimensional gene and endophenotype data.

Dement Geriatr Cogn Disord. 2012 Feb 3; 32(5): 351-361
Silveira de Souza A, de Oliveira-Souza R, Moll J, Tovar-Moll F, Andreiuolo PA, Bottino CM

Background/Aims: The diagnosis of mild or questionable Alzheimer's disease (AD) depends on clinical criteria that often leave a margin for doubt. We aim to verify the diagnostic accuracy of amnestic mild cognitive impairment (aMCI) and AD with proton spectroscopy ((1)H-MRS) combined with brief cognitive-functional scales. Methods: The relationship between (1)H-MRS of the posterior cingulate cortex and the cognitive performance in Mini Mental State Examination, Blessed-Roth Dementia Rating and Functional Assessment Staging of Alzheimer Disease scales were investigated in 25 AD, 10 aMCI and 33 normal control (NC) individuals. Results: The N-acetylaspartate (NAA)/creatine and myoinositol/NAA ratios distinguished AD patients from NC (p < 0.005), and added value in diagnostic accuracy and specificity by discriminant function analysis when combined to clinical diagnosis and simple neuropsychiatric scales; an increase of 3.7% (for aMCI patients) and of 5% (for AD individuals) was observed in diagnostic accuracy, and one of 5.5% (aMCI) and of 11.1% (AD) in specificity. Conclusion:(1)H-MRS combined with brief cognitive-functional scales provided maximum diagnostic accuracy of AD patients, and can be useful when subtle cognitive and memory dysfunction is present.

J Alzheimers Dis. 2012 Feb 1;
Reiner P, Jouvent E, Duchesnay E, Cuingnet R, Mangin JF, Chabriat H

Differences of cortical morphology between healthy controls (HC), amnestic mild cognitive impairment (MCI), and Alzheimer's disease (AD) have been repeatedly investigated using voxel-based morphometry (VBM). However, the results obtained using mainly VBM remain difficult to interpret as they can be explained by various mechanisms. The aim of the present study was to evaluate the differences of cortical morphology between HC, MCI, and AD patients using a new post-processing method based on reconstruction and identification of cortical sulci. Thirty HC, 33 MCI, and 30 AD patients were randomly selected from the ADNI database. For each subject, cortical sulci were reconstructed and automatically identified using Brainvisa software. Depth and fold opening of nine large sulci were compared between HC, MCI, and AD patients. Fold opening of parietaloccipital fissure and intraparietal sulcus on both sides strongly differed between the 3 groups, with gradual increase from HC to MCI of about 1 mm and from MCI to AD of about 2 mm (right intraparietal: p = 0.005; left intraparietal: p = 0.004; right parietaloccipital: p = 0.003; left parietaloccipital: p = 0.0009). Results were left unchanged after adjustment for age, gender, and level of education. These variables were also strongly linked to neuropsychological scores, independent of age, gender, and level of education. In the present study, we found important regional differences of cortical morphology with gradual deterioration from HC to MCI to AD. The most important differences were found in parietaloccipital fissure and intraparietal sulcus. Further studies are needed to understand the involved underlying mechanisms.

Conf Proc IEEE Eng Med Biol Soc. 2011 Aug; 2011: 7808-11
Preti MG, Lagana MM, Baglio F, Griffanti L, Nemni R, Cecconi P, Baselli G

The damage of specific bundles in the brain white matter (WM) is currently assessed in Alzheimer Disease (AD) and amnestic Mild Cognitive Impairment (aMCI) by tractography based on diffusion tensor imaging (DTI) and the consequent evaluation of diffusion parameters in reconstructed tracts. Controversial results may be due to the use of different techniques. This work aims at comparing an atlas-based technique to compute fractional anisotropy (FA) in specific tracts with the voxelwise approach of Tract-Based Spatial Statistics (TBSS). FA was evaluated in 7 portions of the corpus callosum (CC) of 10 elderly healthy controls (HC), 10 aMCI and 10 mild AD patients with both approaches. Atlas-based tractography revealed concordant results with TBSS, displaying the same significant differences between AD and HC and no significant difference between aMCI and HC. However, as regards the AD to aMCI contrast only the atlas-based method was able to find significantly lowered FA in AD in frontal and parietal CC portions. This finding shows that a proper analysis which considers a higher number of voxels, not restricting the observation to the skeleton in the assessment of CC damages, could be useful for AD to aMCI differential diagnosis and prognosis.

Neurodegener Dis. 2012 Feb 1;
Thurfjell L, Lötjönen J, Lundqvist R, Koikkalainen J, Soininen H, Waldemar G, Brooks DJ, Vandenberghe R

Background:The New National Institute on Aging-Alzheimer's Association diagnostic guidelines for Alzheimer's disease (AD) incorporate biomarkers in the diagnostic criteria and suggest division of biomarkers into two categories: Aβ accumulation and neuronal degeneration or injury. Objective:It was the aim of this study to compute hippocampus volume from MRI and a neocortical standard uptake value ratio (SUVR) from [(18)F]flutemetamol PET and investigate the performance of these biomarkers when used individually and when combined. Methods: Fully automated methods for hippocampus segmentation and for computation of neocortical SUVR were applied to MR and scans with the investigational imaging agent [(18)F]flutemetamol in a cohort comprising 27 AD patients, 25 healthy volunteers (HVs) and 20 subjects with amnestic mild cognitive impairment (MCI). Clinical follow-up was performed 2 years after the initial assessment. Results:Hippocampus volumes showed extensive overlap between AD and HV cases while PET SUVRs showed clear group clustering. When both measures were combined, there was a relatively compact cluster of HV scans and a less compact AD cluster. MCI cases had a bimodal distribution of SUVRs. [(18)F]Flutemetamol-positive MCI subjects showed a large variability in hippocampus volumes, indicating that these subjects were in different stages of neurodegeneration. Some [(18)F]flutemetamol-negative MCI scans had hippocampus volumes that were well below the HV range. Clinical follow-up showed that 8 of 9 MCI to AD converters came from the [(18)F]flutemetamol-positive group. Conclusion:Combining [(18)F]flutemetamol PET with structural MRI provides additional information for categorizing disease and potentially predicting shorter time to progression from MCI to AD, but this has to be validated in larger longitudinal studies.

J Alzheimers Dis. 2012 Feb 1;
Schmand B, Eikelenboom P, van Gool WA

Using the database of the Alzheimer's Disease Neuroimaging Initiative, we examined the value of neuropsychological assessment, structural magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) biomarkers, and FDG-PET scanning with respect to prediction of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). We tested the hypothesis that CSF biomarkers and FDG-PET would lose prognostic value when applied in patients older than 75 years, whereas MRI and neuropsychological testing would not. At baseline 175 patients had MCI, mostly amnestic. They were followed during a mean of 2.7 years, and 81 patients converted to AD after a mean of 1.6 years. Logistic regression analyses showed that neuropsychological assessment and MRI variables predicted conversion with 63 to 67% classification success both in patients younger and older than 75 years, while CSF biomarkers attained this success rate only in patients younger than 75 years. For FDG-PET, this rate was 57% in the total sample. We conclude that the diagnostic yield of different techniques in predicting conversion from MCI to AD is moderate, and that it is affected by age of the subject under study. MRI and neuropsychological assessment remain informative in patients older than 75 years, unlike CSF biomarkers.

Neuroimage. 2012 Jan 25;
Devanand DP, Bansal R, Liu J, Hao X, Pradhaban G, Peterson BS

OBJECTIVE: Using MRI surface morphometry mapping, to evaluate local deformations of the hippocampus, parahippocampal gyrus, and entorhinal cortex in predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). METHODS: Baseline brain MRI with surface morphological analysis was performed in 130 outpatients with MCI, broadly defined, and 61 healthy controls followed for an average of 4years in a single site study. RESULTS: Patients with MCI differed from controls in several regions of the hippocampus and entorhinal cortex, and to a lesser extent in the parahippocampal gyrus. In the MCI sample, Cox regression models were conducted for time to conversion comparing converters to AD (n=31) and non-converters (n=99), controlling for age, sex and education. Converters showed greater atrophy in the head of the hippocampus, predominantly in the CA1 region and subiculum, and in the entorhinal cortex, especially in the anterior-inferior pole bilaterally. When distances of specific points representing localized inward deformation were entered together with the corresponding hippocampal or entorhinal cortex volume in the same Cox regression model, the distances remained highly significant whereas the volumes of the corresponding structures were either marginally significant or not significant. Inclusion of cognitive or memory measures or apolipoprotein E ε4 genotype as covariates, or restricting the sample to patients with amnestic MCI (24 converters and 81 non-converters) did not materially change the findings. In the 3-year follow-up sample of patients with MCI, logistic regression analyses using the same measures and covariates yielded similar results. INTERPRETATION: These findings indicate selective early involvement of the CA1 and subiculum regions of the hippocampus and provide new information on early anterior pole involvement in the entorhinal cortex in incipient AD. Fine-grained surface morphometry of medial temporal lobe structures may be superior to volumetric assessment in predicting conversion to AD in patients clinically diagnosed with MCI.

J Int Neuropsychol Soc. 2012 Feb 3; 1-11
Westerberg CE, Mander BA, Florczak SM, Weintraub S, Mesulam MM, Zee PC, Paller KA

Whereas patients with Alzheimer's disease (AD) experience difficulties forming and retrieving memories, their memory impairments may also partially reflect an unrecognized dysfunction in sleep-dependent consolidation that normally stabilizes declarative memory storage across cortical areas. Patients with amnestic mild cognitive impairment (aMCI) exhibit circumscribed declarative memory deficits, and many eventually progress to an AD diagnosis. Whether sleep is disrupted in aMCI and whether sleep disruptions contribute to memory impairment is unknown. We measured sleep physiology and memory for two nights and found that aMCI patients had fewer stage-2 spindles than age-matched healthy adults. Furthermore, aMCI patients spent less time in slow-wave sleep and showed lower delta and theta power during sleep compared to controls. Slow-wave and theta activity during sleep appear to reflect important aspects of memory processing, as evening-to-morning change in declarative memory correlated with delta and theta power during intervening sleep in both groups. These results suggest that sleep changes in aMCI patients contribute to memory impairments by interfering with sleep-dependent memory consolidation. (JINS, 2012, 18, 1-11).

Proc Natl Acad Sci U S A. 2012 Jan 30;
Nedelska Z, Andel R, Laczó J, Vlcek K, Horinek D, Lisy J, Sheardova K, Bures J, Hort J

Cognitive deficits in older adults attributable to Alzheimer's disease (AD) pathology are featured early on by hippocampal impairment. Among these individuals, deterioration in spatial navigation, manifested by poor hippocampus-dependent allocentric navigation, may occur well before the clinical onset of dementia. Our aim was to determine whether allocentric spatial navigation impairment would be proportional to right hippocampal volume loss irrespective of general brain atrophy. We also contrasted the respective spatial navigation scores of the real-space human Morris water maze with its corresponding 2D computer version. We included 42 cognitively impaired patients with either amnestic mild cognitive impairment (n = 23) or mild and moderate AD (n = 19), and 14 cognitively intact older controls. All participants underwent 1.5T MRI brain scanning with subsequent automatic measurement of the total brain and hippocampal (right and left) volumes. Allocentric spatial navigation was tested in the real-space version of the human Morris water maze and in its corresponding computer version. Participants used two navigational cues to locate an invisible goal independent of the start position. We found that smaller right hippocampal volume was associated with poorer navigation performance in both the real-space (β = -0.62, P < 0.001) and virtual (β = -0.43, P = 0.026) versions, controlling for demographic variables, total brain and left hippocampal volumes. In subsequent analyses, the results were significant in cognitively impaired (P ≤ 0.05) but not in cognitively healthy (P > 0.59) subjects. The respective real-space and virtual scores strongly correlated with each other. Our findings indicate that the right hippocampus plays a critical role in allocentric navigation, particularly when cognitive impairment is present.

J Alzheimers Dis. 2012 Jan 9;
Liu Z, Zhu H, Fang GG, Walsh K, Mwamburi M, Wolozin B, Abdul-Hay SO, Ikezu T, Leissring MA, Qiu WQ

Sporadic Alzheimer's disease (AD) patients have low amyloid-β peptide (Aβ) clearance in the central nervous system. The peripheral Aβ clearance may also be important but its role in AD remains unclear. We aimed to study the Aβ degrading proteases including insulin degrading enzyme (IDE), angiotensin converting enzyme (ACE) and others in blood. Using the fluorogenic substrate V (a substrate of IDE and other metalloproteases), we showed that human serum degraded the substrate V, and the activity was inhibited by adding increasing dose of Aβ. The existence of IDE activity was demonstrated by the inhibition of insulin, amylin, or EDTA, and further confirmed by immunocapture of IDE using monoclonal antibodies. The involvement of ACE was indicated by the ability of the ACE inhibitor, lisinopril, to inhibit the substrate V degradation. To test the variations of substrate V degradation in humans, we used serum samples from a homebound elderly population with cognitive diagnoses. Compared with the elderly who had normal cognition, those with probable AD and amnestic mild cognitive impairment (amnestic MCI) had lower peptidase activities. Probable AD or amnestic MCI as an outcome remained negatively associated with serum substrate V degradation activity after adjusting for the confounders. The elderly with probable AD had lower serum substrate V degradation activity compared with those who had vascular dementia. The blood proteases mediating Aβ degradation may be important for the AD pathogenesis. More studies are needed to specify each Aβ degrading protease in blood as a useful biomarker and a possible treatment target for AD.

Med Tr Prom Ekol. 2011; 27-32

Vibration disease patients with chronic uranium intoxication in after contact period demonstrate moderate cognitive disorders of amnestic multifunctional type in 100% of cases. Individuals having occupational diseases due to physical, toxic and radiation hazards, associated with cardiovascular problems, in after contact period manifest mostly with visual-spatial functions, short-term, operative, visual and aural memory disorders. Visual-spatial functions, short-term, operative, visual and aural memory are decreased more in patients with remote period of chronic uranium intoxication.

Brain Cogn. 2012 Jan 17;
Dewar M, Pesallaccia M, Cowan N, Provinciali L, Della Sala S

Impairment on standard tests of delayed recall is often already maximal in the aMCI stage of Alzheimer's Disease. Neuropathological work shows that the neural substrates of memory function continue to deteriorate throughout the progression of the disease, hinting that further changes in memory performance could be tracked by a more sensitive test of delayed recall. Recent work shows that retention in aMCI patients can be raised well above floor when the delay period is devoid of further material - 'Minimal Interference'. This memory enhancement is thought to be the result of improved memory consolidation. Here we used the minimal interference/interference paradigm (word list retention following 10min of quiet resting vs. picture naming) in a group of 17 AD patients, 25 aMCI patients and 25 controls. We found (1) that retention can be improved significantly by minimal interference in patients with aMCI and patients with mild to moderate AD; (2) that the minimal interference paradigm is sensitive to decline in memory function with disease severity, even when performance on standard tests has reached floor; and (3) that this paradigm can differentiate well (80% sensitivity and 100% specificity) between aMCI patients who progress and do not progress to AD within 2years. Our findings support the notion that the early memory dysfunction in AD is associated with an increased susceptibility to memory interference and are suggestive of a gradual decline in consolidation capacity with disease progression.

Neuropsychologia. 2012 Jan 13;
Plancher G, Tirard A, Gyselinck V, Nicolas S, Piolino P

Most neuropsychological assessments of episodic memory bear little similarity to the events that patients actually experience as memories in daily life. The first aim of this study was to use a virtual environment to characterize episodic memory profiles in an ecological fashion, which includes memory for central and perceptual details, spatiotemporal contextual elements, and binding. This study included subjects from three different populations: healthy older adults, patients with amnestic mild cognitive impairment (aMCI) and patients with early to moderate Alzheimer's disease (AD). Second, we sought to determine whether environmental factors that can affect encoding (active vs. passive exploration) influence memory performance in pathological aging. Third, we benchmarked the results of our virtual reality episodic memory test against a classical memory test and a subjective daily memory complaint scale. Here, the participants were successively immersed in two virtual environments; the first, as the driver of a virtual car (active exploration) and the second, as the passenger of that car (passive exploration). Subjects were instructed to encode all elements of the environment as well as the associated spatiotemporal contexts. Following each immersion, we assessed the patient's recall and recognition of central information (i.e., the elements of the environment), contextual information (i.e., temporal, egocentric and allocentric spatial information) and lastly, the quality of binding. We found that the AD patients' performances were inferior to that of the aMCI and even more to that of the healthy aged groups, in line with the progression of hippocampal atrophy reported in the literature. Spatial allocentric memory assessments were found to be particularly useful for distinguishing aMCI patients from healthy older adults. Active exploration yielded enhanced recall of central and allocentric spatial information, as well as binding in all groups. This led aMCI patients to achieve better performance scores on immediate temporal memory tasks. Finally, the patients' daily memory complaints were more highly correlated with the performances on the virtual test than with their performances on the classical memory test. Taken together, these results highlight specific cognitive differences found between these three populations that may provide additional insight into the early diagnosis and rehabilitation of pathological aging. In particular, neuropsychological studies would benefit to use virtual tests and a multi-component approach to assess episodic memory, and encourage active encoding of information in patients suffering from mild or severe age-related memory impairment. The beneficial effect of active encoding on episodic memory in aMCI and early to moderate AD is discussed in the context of relatively preserved frontal and motor brain functions implicated in self-referential effects and procedural abilities.

Arch Clin Neuropsychol. 2012 Jan 25;
Novitski J, Steele S, Karantzoulis S, Randolph C

The measurement of effort is now considered to be an important component of neuropsychological assessment. In addition to stand-alone measures, built-in, or embedded measures of effort have been derived for a limited number of standard neurocognitive tests. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief battery, employed as a core diagnostic tool in dementia and as a neurocognitive screening battery or tracking/outcome measure in a variety of other disorders. An effort index (EI) for the RBANS has been published previously (Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. 2007. An EI for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical Neuropsychology, 21 (5), 841-854), but it has been reported to result in high false positive rates when applied to patients with "true" amnesia (e.g., Alzheimer's disease). We created a new effort scale (ES) for the RBANS based on the observation of patterns of free recall and recognition performance in amnesia versus inadequate effort. The RBANS ES was validated on a sample of patients with amnestic disorders and a sample of mild traumatic brain injury participants who failed a separate measure of effort. The sensitivity and specificity of the new ES was compared with the previously published EI. Receiver-operating characteristic analyses demonstrated much better sensitivity and specificity of the ES, with a marked reduction in false positive errors. Application and limitations of the RBANS ES, including indications for its use, are discussed.

Alzheimers Dement. 2012 Jan; 8(1): 14-21
Ward A, Arrighi HM, Michels S, Cedarbaum JM

The purpose of conducting this study was to identify areas of concordance and sources of variation for the published rates of prevalence and incidence associated with various definitions for mild cognitive impairment (MCI).The study used systematic review of studies published in English since 1984. Studies were identified by searching MEDLINE and EMBASE databases. Population-based observational studies of incidence or prevalence of MCI and related terms were eligible for inclusion.A total of 3,705 citations were identified, and 42 were accepted for inclusion; 35 included data on prevalence and 13 on incidence. The following four terms predominated: age-associated memory impairment (AAMI); cognitive impairment no dementia (CIND); MCI; and amnestic MCI (aMCI). Within each term, the operational definition varied. Substantial variation was observed for both incidence (MCI: 21.5-71.3; aMCI: 8.5-25.9 per 1,000 person-years) and prevalence of each definition of cognitive impairment (AAMI 3.6%-38.4%; CIND 5.1%-35.9%; MCI 3%-42%; aMCI 0.5%-31.9%). CIND and MCI showed increasing prevalence among older age groups, whereas age-specific rates of aMCI were lower and without any apparent age relationship.Prevalence and incidence estimates associated with MCI vary greatly both between definitions and within a definition across the 42 publications. These wide differences pose a significant challenge to our understanding of the social burden of this disease. Enhancement and standardization of operational definitions of the subtypes of cognitive impairment could improve estimates of disease burden and provide a mechanism to assist in the identification of individuals at risk for future Alzheimer's disease and other dementias.

BMC Geriatr. 2012 Feb 3; 12(1): 3
Malek-Ahmadi M, Davis K, Belden C, Jacobson S, Sabbagh MN

ABSTRACT: BACKGROUND: Differentiating amnestic mild cognitive impairment (aMCI) from normal cognition is difficult in clinical settings. Self-reported and informant-reported memory complaints occur often in both clinical groups, which then necessitates the use of a comprehensive neuropsychological examination to make a differential diagnosis. However, the ability to identify cognitive symptoms that are predictive of aMCI through informant-based information may provide some clinical utility in accurately identifying individuals who are at risk for developing Alzheimer's disease (AD). METHODS: The current study utilized a case-control design using data from an ongoing validation study of the Alzheimer's Questionnaire (AQ), an informant-based dementia assessment. Data from 51 cognitively normal (CN) individuals participating in a brain donation program and 47 aMCI individuals seen in a neurology practice at the same institute were analyzed to determine which AQ items differentiated aMCI from CN individuals. RESULTS: Forward stepwise multiple logistic regression analysis which controlled for age and education showed that 4 AQ items were strong indicators of aMCI which included: repetition of statements and/or questions [OR 13.20 (3.02, 57.66)]; trouble knowing the day, date, month, year, and time [OR 17.97 (2.63, 122.77)]; difficulty managing finances [OR 11.60 (2.10, 63.99)]; and decreased sense of direction [OR 5.84 (1.09, 31.30)]. CONCLUSIONS: Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.

Dement Geriatr Cogn Disord. 2012 Feb 1; 32(6): 379-386
Nagata T, Shinagawa S, Nukariya K, Nakayama R, Nakayama K, Yamada H

Background/Aims: To address the clinical neurocognitive roles of nerve growth factor (NGF) genetic polymorphism in early-stage Alzheimer's disease (AD) and amnestic mild cognitive impairment (A-MCI), we investigated the association between this single-nucleotide polymorphism (SNP) and executive dysfunction as a nonmemory cognitive impairment. Methods: Among 200 outpatients with dementia and MCI whose NGF SNP rs6330 genotype was identified, those with A-MCI (n = 35) and early-stage AD (n = 67) were recruited and divided into three groups according to genotype (C/C: n = 58, C/T: n = 39, T/T: n = 5). Then, the Frontal Assessment Battery (FAB) scores were compared among the three (C/C, C/T, T/T) or two (C/C, T carrier) genotype groups. Results: Among the subtests, a significant difference was only noted for the go/no-go scores (p < 0.01) between C/C and T carriers. However, no significant differences in the demographic variables and other neuropsychological subtest scores reflecting attentional and memory function were observed among the genotypes. Conclusion: Regarding the functional roles of neurotrophin polymorphisms as they relate to executive dysfunction, the NGF gene rs6330 might influence the inhibition task in Japanese patients with early-stage AD or A-MCI.