Frontalinės planavimo ir sprendimo funkcijos sergant Alzheimerio liga, remiantis kompiuterizuotų kognityvinių testų rezultatais.

Background. Alzheimer's disease in early stages is known as mainly amnestic disorder. Common paper-pencil tests usually don't show frontal dysfunction in mild Alzheimer's dementia, but PET studies indicate heavy beta-amyloid load in temporal and frontal lobes even in early Alzheimer's disease. Having in mind that frontal dysfunction could have even more disastrous effect on daily activities than medial temporal amnestic syndrome, there is need for more sensitive frontal functions testing which could allow to assess mild decline in frontal cognitive functions. Possible methods for this purpose are computerized cognitive tests. Aim. To evaluate frontal functions in both, Alzheimer's disease (AD) patients and healthy individuals, compare them and relate to demographic characteristics, severity of dementia and depression. Materials and methods. A prospective research was performed in Vilnius University Hospital, Santari~kiq Klinikos, Centre of Neurology in 2009 -2010. There were 66 subjects participating, 30 of which had mild or moderate AD (76.93 ± 5.01 year old; 40% men, 60% women) and 36 were control subjects (74.81 ± 5.51 year old; 39% men, 61% women). Every subject was given CANTAB (Cambridge Neuropsychological Test Automated Battery) tests, evaluating visual memory, learning (PAL, PRM tests) and frontal functions (SOC test). The degree of dementia was assesed using MMSE, severity of depression Yesavage geriatric depression scale. Statistical analysis was made using Student t test, χ² test, Pearson correlation. Results. MMSE score in AD and control groups (C) was 20.1 ± 2.8 and 28.2 ± 1.9 points respectively (p < 0.00 1). The measures of visual memory, recognition and new learning (PAL, PRM tests) were significantly worse in AD group (p < 0.05). The significant difference between groups in Soc test (spatial planning and spatial working memory) was found for these measures: mean moves made by the subject to solve problems where the solution could be reached in a minimum number of 3 moves (AD: 3.71 ± 0.59; C: 3.43 ± 0.52; p = 0.0464) and problems solved in minimum (2) moves (AD: 1.67 ± 0.55; C: 1.92 ± 0.28; p = 0.0201). A significant positive correlation of MMSE score with problems solved in minimum (4) moves (SOC test) was deterniined in AD group (p = 0.002, r = 0.55 197). There was no significant relation of frontal function and age of the subjects. Severity of depression significantly correlated with these frontal measures (SOC test): problems solved in minimum (4) moves (r = -0.35 97; p = 0.003) and mean moves made by the subject to solve problems where the solution could be reached in a minimum number of 4 moves (r = -0.2568; p = 0.0439). Conclusions. Episodic, visual recognition memory and new learning were significantly worse in AD group. Impairment of spatial planning and decision making frontal functions in AD gronp was detected only for some of the measures when compared with the control group. Further and more detail investigations of greater sample size are necessary to assess the characteristics of early frontal dysfunction in AD. [ABSTRACT FROM AUTHOR]