The authors studied language performance patterns in early stages of vascular dementia and Alzheimer disease. The objective was to clarify to what extent dissolution of language in vascular dementia is similar to that in Alzheimer disease. Both structured language tests (comprehension, repetition, reading, and naming tasks) and nonstructured language tests (object and picture description) were employed. The structured tasks evidenced impairment on complex auditory comprehension and on picture naming for both dementia groups, whereas oral reading and single word repetition did not differentiate the patients from matched control subjects. On the unstructured narrative tasks, both patient groups showed normal fluency, but content analysis revealed that the patients with dementia produced fewer semantic units (themes) than the control subjects. In summary, both patient groups showed impairment, specifically on semantically mediated language tasks. According to the present results, language impairment in vascular dementia resembles that observed in Alzheimer disease. Semantically mediated functions are among the most sensitive language measures in differentiating early stages of both vascular dementia and Alzheimer disease from normal aging.
Picture naming deficits in Alzheimer's disease (AD) have been extensively studied but less is known about anomia in vascular dementia (VaD). We tested sources of anomia in these two dementia types by administering an extensive naming battery to 10 patients with VaD, 13 patients with probable AD, and 20 healthy age- and education-matched controls. Both dementia groups evidenced a semantic component in their anomia but the semantic deficit was more clearcut in the patients with AD than in the patients with VaD even though the groups were matched on dementia severity. Case-by-case analyses showed considerable performance variability but confirmed that when anomia is present, it commonly has a semantic component in both VaD and AD.
Tractography-based measurements have sufficient reproducibility for demonstration of severe abnormalities of the cingulum. TBCA is preferential for clinical FA analysis, because it measures corresponding areas in patients and controls without inaccuracies due to trauma-induced structural changes.
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