Stereotypies and Repetitive Motor Behavior in Patients with Alzheimer Disease who Present Spared vs. Impaired Executive Functioning

ANABEL CHADE; MARÍA ROCA; ALICIA LISCHINSKY; TERESA TORRALVA; FACUNDO MANES; EZEQUIEL GLEICHGERRCHT

Honolulu

Encuentro; 63rd AAN 2011 Annual Meeting; 2011

American Academy of Neurology

OBJECTIVE: To evaluate the severity of neuropsychiatric symptoms in patients with early Alzheimer disease (AD) who present impaired executive functioning. BACKGROUND: Patients with AD have major deficits in memory, but cognitive symptoms may further expand to other domains, including language, visuospatial abilities, attention, and executive functions. Some authors have proposed an AD subgroup of patients characterized by their early impairment on executive functioning. Such dysexecutive AD group seems to differ from patients diagnosed with AD but who present no executive dysfunction, also, in terms of their frequency of psychiatric symptoms (e.g. delirium). Nonetheless, little research has been conducted concerning the behavioral disturbances in this subgroup of dysexecutive AD patients. DESIGN/METHODS: Thirty patients with early (CDR 1) AD diagnosis were assessed with a battery of executive tasks and clustered into groups depending on whether they showed impaired (IEF: z score < -2 on two or more executive tasks) or spared (SEF: z score < -2 on one or none of the tests)executive functioning. Their closest relatives or caregivers completed the Cambridge Behavioral Inventory (CBI) which assesses behavioral symptoms grouped into 13 categories. The frequency of behavioral disturbances was compared between SEF and IEF patients. RESULTS: A significant difference was found between SEF and IEF in terms of the frequency of stereotypies and repetitive motor behavior (U = 1.0, p = 0.019). As well, significant differences were found between the groups on executive tasks with strong motor components, while no performance differences were observed in the case for verbal tasks of executive function. CONCLUSIONS: The presence of stereotypies could be associated with a dysexecutive profile in AD patients, therefore affecting cognitive performance, especially executive functions. These results shed light on the role of frontal circuitry in the expression of motor symptoms in AD.