0000000000642290
AUTHOR
Watt H
Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI
Gradient echo T2*-weighted MRI has high sensitivity in detecting cerebral microbleeds, which appear as small dot-like hypointense lesions. Microbleeds are strongly associated with intracerebral haemorrhage, hypertension, lacunar stroke and ischaemic small vessel disease, and have generated interest as a marker of bleeding-prone microangiopathy. Microbleeds have generally been considered to be clinically silent; however, since they are located in widespread cortical and basal ganglia regions and are histologically characterized by tissue damage, we hypothesized that they would cause cognitive dysfunction. We therefore studied patients with microbleeds (n = 25) and a non-microbleed control gr…
The natural history of Alzheimer disease: a longitudinal presymptomatic and symptomatic study of a familial cohort
BACKGROUND: Knowledge of the evolution of cognitive deficits in Alzheimer disease is important for our understanding of disease progression. Previous reports, however, have either lacked detail or have not covered the presymptomatic stages. OBJECTIVE: To delineate the onset and progression of clinical and neuropsychological abnormalities in familial Alzheimer disease. METHODS: Nineteen subjects with familial Alzheimer disease underwent serial clinical and neuropsychological assessments. Eight of these had undergone presymptomatic assessments. The follow-up period was 1 to 10 years (mean, 5 years). The relative timing of the occurrence of 3 markers of disease onset and progression (onset of …
Survival in Alzheimer disease
We thank Dr Lesser for his comments. We agree that deaths in older populations with AD are often from comorbid conditions, and we would not wish to overinterpret the limited survival data from this study. We also accept that determining symptom onset is an inexact science. However, we would suggest that in this small cohort the disease course of about a decade cannot be considered an aggressive one. Since publication of our study, 2 additional subjects have died 8.9 and 16.8 years after onset thereby increasing the mean time from onset to death to 9.4 years. We agree, however, that further study is required to resolve these issues and in particular to assess genetic factors that may influen…