Cortical V/S Subcortical Dementias- A Comparative Review of Cognitive Functions
Barun Kumar*1, Ravi Prakash2
BACKGROUND: The typical clinical features of AD are indicative of cortical dysfunction which are dyscalculia, dysphasias, dyspraxias and agnosias. Parallel to this, the clinical features of subcortical dementias, mainly reflect the subcortical areas affected which usually are personality changes and affective disorders and bradyphrenia. The neuropsychological deficits are also different in these dementias. In present review we will highlight these neuropsychological differences. METHODOLOGY: A detailed search of all the studies of cortical and subcortical dementias was done in all medical databases. All the studies involving neuropsychological aspects of cortical and subcortical dementias were included in the study. Major categories of neuropsychological aspects were separately categorized and compared between the subcortical and cortical dementias. RESULTS: Major neuropsychological categories identified were 1) Executive functions 2) Memory dysfunctions and 3) Perceptuo-motor dysfunctions. In memory, The differential effects of the test format is that in subcortical dementia the main difficulty is in retrieving information while in cortical dementia encoding or storage (or both) are thought to be defective. On the other hand, the visuo motor dysfunctions are far more severe in subcortical as compared to cortical dementias. Its cardinal features are: forgetfulness, i.e., difficulty in retrieving learned material; slowing of mental and motor processes; intellectual deterioration characterized by impaired ability to manipulate acquired knowledge to generate problem solving; impairment of arousal, attention, and motivation and affective changes (depression); and impairment of set-shifting. DISCUSSION: There are significant differences in various neuropsychological domains of cortical and subcortical dementias.
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