Clinical, Neuropsychological , And Radiological Findings In Alzheimer's Disease And Vascular Dementia

Objective: To understand the differences of clinical manifestations, cognitive changes, brain CT(MRI) and single photon emission computed tomography (SPECT) images between Alzheimer' disease(AD) and Vascular dementia(VD) , in order to assist the work-up of patients with these two kinds of disease. Methods: 27 patients with AD, 26 patients with VD and 25 controls were studied with clinical manifestation, brain CT(MRI) , neuropsychological testing and SPECT scanning . Results:① Most of patients with VD had focal positive sign, while AD had none. AD had a significantly high frequency of psychiatric symptoms(85.2%), which was compared to 46.2% of VD. There was great statistic difference between them(P<0.01). ② focal deficit or multi-bilateral subcortical deficits were found in CT(MRI) images of patients with VD, while atrophy were found in most patients with AD . The CT(MRI) findings of AD and VD were significantly difference (p<0.01). ③ VD and AD showed significantly lower scores in intelligence and memory testing than normal controls(NA). In performance intelligence and working memory: AD was obviously worse than VD. In AD itself: performance intelligence was found worse than language Intelligence.④ cerebral blood flow hypoperfusion lesions spread widely in cortical and subcortical structures of patients with VD. Most VD patients' cortical hypoperfusion lesions were scattered and unsymmetrical, the frequency was 59.32%. While it is different to 68.89% bilateral-symmetrical cortical hypoperfusion lesions of AD, further more hypoperfusion lesions of AD were found only in cortical structure.⑤Neuropsychological testing scores of AD and VD showed correlation with the changes of cerebral blood perfusion. Conclusion: clinical manifestations, neuropsychological testing, brain CT(MRI) and SPECT scanning contribute to the work-up of patients with AD and VD, combing all these methods it can be more useful.