Claudio Villardita

Alzheimer's disease compared with cerebrovascular dementia. Neuropsychological similarities and differences.

Forty‐eight patients with a clinical diagnosis of Alzheimers disease, 30 patients with cerebrovascular dementia, and 48 normal controls were assessed with a battery of neuropsychological tests designed to measure the following cognitive processes: orientation to time and place, memory, visual‐perceptual and constructional skills, language, conceptualization, attention, and executive functions (planning, self‐regulation and fine motor coordination). The differences detected were in orientation to time and place, in immediate and delayed recall of a short story, and in naming in which the patients with Alzheimers disease were significantly disadvantaged. Vice versa, in attention processes, self‐regulation, planning, and fine motor coordination tasks the patients with cerebrovascular dementia were more severely impaired; these disturbances resemble some of those occurring in frontal lobe syndromes.

Influence of different paths on spatial memory performance in the block-tapping test

In a group of 83 normal adults, spatial memory performance in the Block-Tapping Test depended not only on path length but also on digit sequence, which, for a given path length, generates different spatial configurations. Sequences of homogeneous difficulty are proposed for defining the spatial span.

Verbal memory and semantic clustering in right brain-damaged patients

Twenty-four right brain-damaged patients without ostensive signs of intellectual impairment or disturbances of verbal comprehension, and 20 normal control subjects were given two lists of words, one (the Reys Auditory) in which 15 words were semantically unrelated and a second in which 15 two-syllable words belonged to one of three categories. The results demonstrated no difference between the two subject groups, either in the immediate or the delayed recall sections of the Reys test. The immediate recall section of the semantic verbal memory task, on the contrary, showed significantly poor performance by the right brain-damaged patients. These results suggest an impairment of semantic clustering processes after right hemisphere damage.

Mental deterioration, visuoperceptive disabilities and constructional apraxia in Parkinson's disease

20 patients with Parkinsons disease were tested for visuoperceptive disabilities and constructional apraxia versus a group of 20 controls. The visuoperceptive disabilities in the parkinsonians were relatively independent of mental deterioration, where present. The visuoperceptive dis‐abilities were responsible for constructional apraxia.

Neuropsychological test performances and normal aging.

This study was designed to assess the relevance of normal aging to performance in a variety of neuropsychological tests, in a wide range of age groups. The battery included tests of several cognitive abilities of varying complexity (attention, orientation, memory, self-regulation, categorial ability and so on). The results showed that some tests (Orientation, Attention, Digit Span, Naming, Block Design, Self-regulation, Calculation, Weigl) are not significantly affected by aging while in others performance clearly declines with age. However, the age at onset of the decline is far from uniform. In some tests (Logical Memory, delayed recall section of Supraspan Test, Hooper Test, Finger Tapping Test) it is manifest in early middle age while in others (Faces Recognition, Set Test, Reproduction of Geometric Designs) it does not appear until much later in life.

Raven's Colored Progressive Matrices and Intellectual Impairment in Patients with Focal Brain Damage

To assess the validity of Ravens Colored Progressive Matrices (RCPM) as a measure of intellectual impairment after focal brain damage, we compared the performance of 24 right brain-damaged patients, 24 left brain-damaged patients (10 non-aphasic and 15 aphasic) and 20 controls on the RCPM. In addition to the total, we analyzed the scores obtained on each of the three sets in which the 36 items of the test could be categorized on the grounds of the cognitive ability mainly involved for their solution. The first set, which calls for the identification of sameness, posed special problems to RBD patients. The second set, which involves the principle of symmetry, was selectively failed by aphasic patients. The third set, which is more demanding in terms of analogical and conceptual thinking, was poorly performed by left brain-damaged patients, aphasics as well as non-aphasics. The implications of these findings for the relation of focalized brain damage to intelligence is discussed.

Concreteness/Abstractness of Stimulus-Words and Semantic Clustering in Right Brain-Damaged Patients

Fifteen right brain-damaged patients and 15 normal controls were tested for learning, delayed recall and semantic clustering abilities using two lists of two/three-syllable words. The first list consisted of 12 familiar, concrete, high-imageability nouns belonging to three semantic categories and the second of 12 abstract, low-imageability, familiar nouns also belonging to three semantic categories. The right brain-damaged patients proved to have a learning and semantic clustering deficit for concrete but not for abstract words. This was interpreted as evidence for a selective right hemisphere capability for processing concrete, high-imageability words.

Aniracetam (Ro 13-5057) in the treatment of senile dementia of Alzheimer type (SDAT): results of a placebo controlled multicentre clinical study

One hundred and nine elderly patients suffering from mild to moderate cognitive impairment fulfilling NINCDS-ADRDA criteria for probable dementia of the Alzheimer type were treated for 6 months with a new nootropic drug, aniracetam (Ro 13-5057) in a double-blind randomized study versus placebo. The two treatment groups were comparable at baseline for demographic and behaviourial parameters and symptomatology. Patients underwent clinical, behaviourial and psychometric evaluation every other month. The aniracetam group differed significantly from the placebo group by the end of the study and also showed a statistically significant improvement versus baseline in the psychobehavioural parameters, while in the placebo group a steady deterioration was observed. Tolerability to aniracetam was excellent.

Clinical Studies with Oxiracetam in Patients with Dementia of Alzheimer Type and Multi-lnfarct Dementia of Mild to Moderate Degree

The cognitive and behavioral effects and the safety of oxiracetam therapy during a placebo-controlled trial and the relevant follow-up up to 1 year in patients with senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID) of mild to moderate degree were studied. Sixty male and female outpatients participated in the double-blind, placebo-controlled, parallel-group, randomized trial, comparing the effects of oxiracetam 800 mg b.i.d. and placebo during 90 days of treatment. At the end of therapy, statistical analysis evidenced significant improvements in the group receiving oxiracetam in respect to the placebo group on Mini Mental State Examination, Auditory Continuous Performance Test, Reys 15 Words Test, Block Tapping Test, Mattis Word Fluency, Luria Alternating Series and Instrumental Activities of Daily Living. Afterwards, 29 of the 30 patients who received oxiracetam, participated in the open follow-up study, receiving 800 mg b.i.d. oxiracetam for a total standard period of 1 year. Statistical improvements in comparison to baseline were again found on the same tests of the first 90 days (except for Reys 15 Words Test) and on the Memory item of the Inventory of Psychic and Somatic Complaints Elderly. During the late phase of the follow-up, statistically significant worsenings in comparison to baseline were observed on Digit Span Backward, Gibsons Spiral and some non-memory items of IPSC-E. Neither severe adverse events were observed during the whole study, nor changes in routine laboratory examinations. In conclusion, in the present population of patients with mild to moderate degree dementia, the safety of 1,600 mg/day of oxiracetam also up to 1 year of treatment was confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Pyroglutamic acid improves the age associated memory impairment

Summary— Pyroglutamic acid (PCA) was compared with placebo in a randomized, double blind trial for assessing its efficacy in treating memory deficits in 40 aged subjects. Twenty subjects were treated with PCA and 20 with placebo over a period of 60 d. Memory functions were evaluated at baseline and after 60 d of treatment by means of a battery made up of 6 memory tasks. The results suggest that PCA is effective in improving some verbal memory functions in subjects affected by age‐related memory decline.