Avaliação neuropsicológica no diagnóstico diferencial das demências infecto parasitárias e degenerativas
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2010-06-08
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Universidade Federal de Goiás
Resumo
Neuropsychological assessment and differential diagnosis between infective and degenerative dementias..
There are no studies comparing the neuropsychological profile of patients with parasitic infectious dementia (DIP) and other forms of primarily degenerative dementia. The objectives were to compare the
neuropsychological deficits present in three groups of patients with dementia and a normal control group in
relation to the DIP group. For this purpose, we prospectively evaluated 130 individuals with dementia from
Dementia Unit, Hospital das Clinicas, Federal University of Goias and from the Tropical Diseases
Hospital, Goiânia, aged above 18 years, divided in the following groups: infectious dementia (DIP),
Alzheimer's disease (AD) , frontotemporal lobar degeneration(DLFT) , parkinsonism plus (PP) and normal
controls. All underwent extensive neuropsychological assessment, addressing all cognitive domains (verbal
and visual memory, attention, executive functions, gnosis, praxis, visuospatial skills, language). The
productions were transcribed into tables and quantified by specific tests (Stroop, Trail Making A / B,
Cancelation Test, Maze, Digit Span, Rey Figure, RAVLT, Logical Memory, Verbal Fluency, Hooper and
Proverbs from WAIS). The DIP group generally presented with severe neuropsychological deficits present
in multiple cognitive domains, and possibly even higher than those presented by primarily degenerative
dementia in the elderly. These cognitive deficits can signal that the functional and / or lesional disturbances
in DIP group undertake extensive brain areas or even that are impaired basic neuropsychological functions
(attention, executive functions) that support the other functions with which are interdependent (memory,
visuospatial functions). The DIP group had a higher run time, and committed more errors in the bell
cancellation test than the control group (p <0.001), indicating deficits in selectivity and planning
suggestive of involvement of fronto-subcortical areas. Overall, the DIP group had a performance in
memory tasks higher than the AD group, equal to the DLFT group and lower than the PP group, suggesting
the presence of heterogeneous hippocampal pathology in DIP group. The results emphasize that the
neuropsychological assessments aid in the differential diagnosis of dementia and the topographic location
of lesions associated with the predominant profile of cognitive dysfunction.
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SOARES, Vânia Lúcia Dias. Avaliação neuropsicológica no diagnóstico diferencial das demências infecto parasitárias e degenerativas. 2010. 61 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2010.