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Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype
Background: Alzheimer’s disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants. Objective: We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype. Methods: We performed a retrospective longitudinal c...
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| Published in: | Journal of Alzheimer's disease 2023-01, Vol.91 (1), p.363-388 |
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| creator | Abbate, Carlo Trimarchi, Pietro D. Fumagalli, Giorgio G. Gallucci, Alessia Tomasini, Emanuele Fracchia, Stefania Rebecchi, Isabella Morello, Elisabetta Fontanella, Anna Parisi, Paola M.R. Tartarone, Federica Giunco, Fabrizio Ciccone, Simona Nicolini, Paola Lucchi, Tiziano Arosio, Beatrice Inglese, Silvia Rossi, Paolo D. |
| description | Background:
Alzheimer’s disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants.
Objective:
We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype.
Methods:
We performed a retrospective longitudinal case-series study of 17 AD outpatients with the possible CM-phenotype (CM-ADs). Then, in a cross-sectional study, we compared the CM-ADs to a sample of 30 AD patients with the CA-phenotype (CA-ADs). The primary outcome was the frequency of cognitive and behavioral features. Data were analyzed as differences in percentage by non-parametric Chi Square and mean differences by parametric T-test.
Results:
Anterograde amnesia (100%) with early confabulation (88.2%), disorientation (88.2%) and non-infrequently retrograde amnesia (64.7%) associated with reduced insight (88.2%), moderate prefrontal executive impairment (94.1%) and attention deficits (82.3%) dominated the CM-phenotype. Neuropsychiatric features with striking misidentification (52.9%), other less-structured delusions (70.6%), and brief hallucinations (64.7%) were present. Marked behavioral disturbances were present early in some patients and very common at later stages. At the baseline, the CM-ADs showed more confabulation (p |
| doi_str_mv | 10.3233/JAD-220919 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9881034</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.3233_JAD-220919</sage_id><sourcerecordid>2742659622</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-4c08d6b6a8e70a0a3defa458f8981f43705ec74f65e27ede8ebb3c9e672cbc263</originalsourceid><addsrcrecordid>eNptkc1uFSEYhidGY2t14wUYEheaJqMMMMC4MDk5x1pNjV3UNWGYbzo0DExhprGuvA1vr1dS6qn1J64g8PDwwlsUTyv8ihJKX39cbUpCcFM194rdSoq6lA2W9_OcSlESKcRO8SilM4wxxY14WOxQzlg-gXeLrxsL3sA0aGcNuoCYloQO7TQFo8dJO7QaPSSrkfVo5b4NYEeIV99_JLSxCXSCN-hkAHQcUrKtA7QOvtft4vRsgy8_2WQ78LPtrfm5go4H8GG-nOBx8aDXLsGT23Gv-HLw7mR9WB59fv9hvToqDaNyLpnBsuMt1xIE1ljTDnrNatnLRlY9owLXYATreQ1EQAcS2paaBrggpjWE073i7dY7Le0InclponZqinbU8VIFbdXfO94O6jRcqEbKClOWBS9vBTGcL5BmNdpkwDntISxJEcEIrxtOSEaf_4OehSX6_LxMcUxIznMj3N9SJuZfi9DfhamwuilU5ULVttAMP_sz_h36q8EMvNgCSZ_C7_v-o7oGcGSrSA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2760222634</pqid></control><display><type>article</type><title>Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype</title><source>SAGE:Jisc Collections:SAGE Journals Read and Publish 2023-2024:2025 extension (reading list)</source><creator>Abbate, Carlo ; Trimarchi, Pietro D. ; Fumagalli, Giorgio G. ; Gallucci, Alessia ; Tomasini, Emanuele ; Fracchia, Stefania ; Rebecchi, Isabella ; Morello, Elisabetta ; Fontanella, Anna ; Parisi, Paola M.R. ; Tartarone, Federica ; Giunco, Fabrizio ; Ciccone, Simona ; Nicolini, Paola ; Lucchi, Tiziano ; Arosio, Beatrice ; Inglese, Silvia ; Rossi, Paolo D.</creator><creatorcontrib>Abbate, Carlo ; Trimarchi, Pietro D. ; Fumagalli, Giorgio G. ; Gallucci, Alessia ; Tomasini, Emanuele ; Fracchia, Stefania ; Rebecchi, Isabella ; Morello, Elisabetta ; Fontanella, Anna ; Parisi, Paola M.R. ; Tartarone, Federica ; Giunco, Fabrizio ; Ciccone, Simona ; Nicolini, Paola ; Lucchi, Tiziano ; Arosio, Beatrice ; Inglese, Silvia ; Rossi, Paolo D.</creatorcontrib><description>Background:
Alzheimer’s disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants.
Objective:
We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype.
Methods:
We performed a retrospective longitudinal case-series study of 17 AD outpatients with the possible CM-phenotype (CM-ADs). Then, in a cross-sectional study, we compared the CM-ADs to a sample of 30 AD patients with the CA-phenotype (CA-ADs). The primary outcome was the frequency of cognitive and behavioral features. Data were analyzed as differences in percentage by non-parametric Chi Square and mean differences by parametric T-test.
Results:
Anterograde amnesia (100%) with early confabulation (88.2%), disorientation (88.2%) and non-infrequently retrograde amnesia (64.7%) associated with reduced insight (88.2%), moderate prefrontal executive impairment (94.1%) and attention deficits (82.3%) dominated the CM-phenotype. Neuropsychiatric features with striking misidentification (52.9%), other less-structured delusions (70.6%), and brief hallucinations (64.7%) were present. Marked behavioral disturbances were present early in some patients and very common at later stages. At the baseline, the CM-ADs showed more confabulation (p < 0.001), temporal disorientation (p < 0.02), misidentification (p = 0.013), other delusions (p = 0.002), and logorrhea (p = 0.004) than the CA-ADs. In addition, more social disinhibition (p = 0.018), reduction of insight (p = 0.029), and hallucination (p = 0.03) persisted at 12 months from baseline. Both the CA- and CM-ADs showed anterior and medial temporal atrophy. Compared to HCs, the CM-ADs showed more right fronto-insular atrophy, while the CA-ADs showed more dorsal parietal, precuneus, and right parietal atrophy.
Conclusion:
We described an AD phenotype resembling diencephalic rather than hippocampal amnesia and overlapping the past-century description of presbyophrenia.</description><identifier>ISSN: 1387-2877</identifier><identifier>ISSN: 1875-8908</identifier><identifier>EISSN: 1875-8908</identifier><identifier>DOI: 10.3233/JAD-220919</identifier><identifier>PMID: 36442200</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Alzheimer Disease - complications ; Alzheimer Disease - psychology ; Alzheimer's disease ; Amnesia ; Amnesia - psychology ; Atrophy ; Cognitive ability ; Confusion ; Cortex (parietal) ; Cross-Sectional Studies ; Disorientation ; Genotype & phenotype ; Hallucinations ; Hippocampus ; Humans ; Memory ; Memory Disorders ; Neurodegenerative diseases ; Neuropsychological Tests ; Phenotypes ; Retrograde amnesia ; Retrospective Studies</subject><ispartof>Journal of Alzheimer's disease, 2023-01, Vol.91 (1), p.363-388</ispartof><rights>2023 – The authors. Published by IOS Press</rights><rights>Copyright IOS Press BV 2023</rights><rights>2023 – The authors. Published by IOS Press 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-4c08d6b6a8e70a0a3defa458f8981f43705ec74f65e27ede8ebb3c9e672cbc263</citedby><cites>FETCH-LOGICAL-c438t-4c08d6b6a8e70a0a3defa458f8981f43705ec74f65e27ede8ebb3c9e672cbc263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36442200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abbate, Carlo</creatorcontrib><creatorcontrib>Trimarchi, Pietro D.</creatorcontrib><creatorcontrib>Fumagalli, Giorgio G.</creatorcontrib><creatorcontrib>Gallucci, Alessia</creatorcontrib><creatorcontrib>Tomasini, Emanuele</creatorcontrib><creatorcontrib>Fracchia, Stefania</creatorcontrib><creatorcontrib>Rebecchi, Isabella</creatorcontrib><creatorcontrib>Morello, Elisabetta</creatorcontrib><creatorcontrib>Fontanella, Anna</creatorcontrib><creatorcontrib>Parisi, Paola M.R.</creatorcontrib><creatorcontrib>Tartarone, Federica</creatorcontrib><creatorcontrib>Giunco, Fabrizio</creatorcontrib><creatorcontrib>Ciccone, Simona</creatorcontrib><creatorcontrib>Nicolini, Paola</creatorcontrib><creatorcontrib>Lucchi, Tiziano</creatorcontrib><creatorcontrib>Arosio, Beatrice</creatorcontrib><creatorcontrib>Inglese, Silvia</creatorcontrib><creatorcontrib>Rossi, Paolo D.</creatorcontrib><title>Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype</title><title>Journal of Alzheimer's disease</title><addtitle>J Alzheimers Dis</addtitle><description>Background:
Alzheimer’s disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants.
Objective:
We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype.
Methods:
We performed a retrospective longitudinal case-series study of 17 AD outpatients with the possible CM-phenotype (CM-ADs). Then, in a cross-sectional study, we compared the CM-ADs to a sample of 30 AD patients with the CA-phenotype (CA-ADs). The primary outcome was the frequency of cognitive and behavioral features. Data were analyzed as differences in percentage by non-parametric Chi Square and mean differences by parametric T-test.
Results:
Anterograde amnesia (100%) with early confabulation (88.2%), disorientation (88.2%) and non-infrequently retrograde amnesia (64.7%) associated with reduced insight (88.2%), moderate prefrontal executive impairment (94.1%) and attention deficits (82.3%) dominated the CM-phenotype. Neuropsychiatric features with striking misidentification (52.9%), other less-structured delusions (70.6%), and brief hallucinations (64.7%) were present. Marked behavioral disturbances were present early in some patients and very common at later stages. At the baseline, the CM-ADs showed more confabulation (p < 0.001), temporal disorientation (p < 0.02), misidentification (p = 0.013), other delusions (p = 0.002), and logorrhea (p = 0.004) than the CA-ADs. In addition, more social disinhibition (p = 0.018), reduction of insight (p = 0.029), and hallucination (p = 0.03) persisted at 12 months from baseline. Both the CA- and CM-ADs showed anterior and medial temporal atrophy. Compared to HCs, the CM-ADs showed more right fronto-insular atrophy, while the CA-ADs showed more dorsal parietal, precuneus, and right parietal atrophy.
Conclusion:
We described an AD phenotype resembling diencephalic rather than hippocampal amnesia and overlapping the past-century description of presbyophrenia.</description><subject>Alzheimer Disease - complications</subject><subject>Alzheimer Disease - psychology</subject><subject>Alzheimer's disease</subject><subject>Amnesia</subject><subject>Amnesia - psychology</subject><subject>Atrophy</subject><subject>Cognitive ability</subject><subject>Confusion</subject><subject>Cortex (parietal)</subject><subject>Cross-Sectional Studies</subject><subject>Disorientation</subject><subject>Genotype & phenotype</subject><subject>Hallucinations</subject><subject>Hippocampus</subject><subject>Humans</subject><subject>Memory</subject><subject>Memory Disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neuropsychological Tests</subject><subject>Phenotypes</subject><subject>Retrograde amnesia</subject><subject>Retrospective Studies</subject><issn>1387-2877</issn><issn>1875-8908</issn><issn>1875-8908</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNptkc1uFSEYhidGY2t14wUYEheaJqMMMMC4MDk5x1pNjV3UNWGYbzo0DExhprGuvA1vr1dS6qn1J64g8PDwwlsUTyv8ihJKX39cbUpCcFM194rdSoq6lA2W9_OcSlESKcRO8SilM4wxxY14WOxQzlg-gXeLrxsL3sA0aGcNuoCYloQO7TQFo8dJO7QaPSSrkfVo5b4NYEeIV99_JLSxCXSCN-hkAHQcUrKtA7QOvtft4vRsgy8_2WQ78LPtrfm5go4H8GG-nOBx8aDXLsGT23Gv-HLw7mR9WB59fv9hvToqDaNyLpnBsuMt1xIE1ljTDnrNatnLRlY9owLXYATreQ1EQAcS2paaBrggpjWE073i7dY7Le0InclponZqinbU8VIFbdXfO94O6jRcqEbKClOWBS9vBTGcL5BmNdpkwDntISxJEcEIrxtOSEaf_4OehSX6_LxMcUxIznMj3N9SJuZfi9DfhamwuilU5ULVttAMP_sz_h36q8EMvNgCSZ_C7_v-o7oGcGSrSA</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Abbate, Carlo</creator><creator>Trimarchi, Pietro D.</creator><creator>Fumagalli, Giorgio G.</creator><creator>Gallucci, Alessia</creator><creator>Tomasini, Emanuele</creator><creator>Fracchia, Stefania</creator><creator>Rebecchi, Isabella</creator><creator>Morello, Elisabetta</creator><creator>Fontanella, Anna</creator><creator>Parisi, Paola M.R.</creator><creator>Tartarone, Federica</creator><creator>Giunco, Fabrizio</creator><creator>Ciccone, Simona</creator><creator>Nicolini, Paola</creator><creator>Lucchi, Tiziano</creator><creator>Arosio, Beatrice</creator><creator>Inglese, Silvia</creator><creator>Rossi, Paolo D.</creator><general>SAGE Publications</general><general>IOS Press BV</general><general>IOS Press</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230101</creationdate><title>Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype</title><author>Abbate, Carlo ; Trimarchi, Pietro D. ; Fumagalli, Giorgio G. ; Gallucci, Alessia ; Tomasini, Emanuele ; Fracchia, Stefania ; Rebecchi, Isabella ; Morello, Elisabetta ; Fontanella, Anna ; Parisi, Paola M.R. ; Tartarone, Federica ; Giunco, Fabrizio ; Ciccone, Simona ; Nicolini, Paola ; Lucchi, Tiziano ; Arosio, Beatrice ; Inglese, Silvia ; Rossi, Paolo D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-4c08d6b6a8e70a0a3defa458f8981f43705ec74f65e27ede8ebb3c9e672cbc263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Alzheimer Disease - complications</topic><topic>Alzheimer Disease - psychology</topic><topic>Alzheimer's disease</topic><topic>Amnesia</topic><topic>Amnesia - psychology</topic><topic>Atrophy</topic><topic>Cognitive ability</topic><topic>Confusion</topic><topic>Cortex (parietal)</topic><topic>Cross-Sectional Studies</topic><topic>Disorientation</topic><topic>Genotype & phenotype</topic><topic>Hallucinations</topic><topic>Hippocampus</topic><topic>Humans</topic><topic>Memory</topic><topic>Memory Disorders</topic><topic>Neurodegenerative diseases</topic><topic>Neuropsychological Tests</topic><topic>Phenotypes</topic><topic>Retrograde amnesia</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abbate, Carlo</creatorcontrib><creatorcontrib>Trimarchi, Pietro D.</creatorcontrib><creatorcontrib>Fumagalli, Giorgio G.</creatorcontrib><creatorcontrib>Gallucci, Alessia</creatorcontrib><creatorcontrib>Tomasini, Emanuele</creatorcontrib><creatorcontrib>Fracchia, Stefania</creatorcontrib><creatorcontrib>Rebecchi, Isabella</creatorcontrib><creatorcontrib>Morello, Elisabetta</creatorcontrib><creatorcontrib>Fontanella, Anna</creatorcontrib><creatorcontrib>Parisi, Paola M.R.</creatorcontrib><creatorcontrib>Tartarone, Federica</creatorcontrib><creatorcontrib>Giunco, Fabrizio</creatorcontrib><creatorcontrib>Ciccone, Simona</creatorcontrib><creatorcontrib>Nicolini, Paola</creatorcontrib><creatorcontrib>Lucchi, Tiziano</creatorcontrib><creatorcontrib>Arosio, Beatrice</creatorcontrib><creatorcontrib>Inglese, Silvia</creatorcontrib><creatorcontrib>Rossi, Paolo D.</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of Alzheimer's disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abbate, Carlo</au><au>Trimarchi, Pietro D.</au><au>Fumagalli, Giorgio G.</au><au>Gallucci, Alessia</au><au>Tomasini, Emanuele</au><au>Fracchia, Stefania</au><au>Rebecchi, Isabella</au><au>Morello, Elisabetta</au><au>Fontanella, Anna</au><au>Parisi, Paola M.R.</au><au>Tartarone, Federica</au><au>Giunco, Fabrizio</au><au>Ciccone, Simona</au><au>Nicolini, Paola</au><au>Lucchi, Tiziano</au><au>Arosio, Beatrice</au><au>Inglese, Silvia</au><au>Rossi, Paolo D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype</atitle><jtitle>Journal of Alzheimer's disease</jtitle><addtitle>J Alzheimers Dis</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>91</volume><issue>1</issue><spage>363</spage><epage>388</epage><pages>363-388</pages><issn>1387-2877</issn><issn>1875-8908</issn><eissn>1875-8908</eissn><abstract>Background:
Alzheimer’s disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants.
Objective:
We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype.
Methods:
We performed a retrospective longitudinal case-series study of 17 AD outpatients with the possible CM-phenotype (CM-ADs). Then, in a cross-sectional study, we compared the CM-ADs to a sample of 30 AD patients with the CA-phenotype (CA-ADs). The primary outcome was the frequency of cognitive and behavioral features. Data were analyzed as differences in percentage by non-parametric Chi Square and mean differences by parametric T-test.
Results:
Anterograde amnesia (100%) with early confabulation (88.2%), disorientation (88.2%) and non-infrequently retrograde amnesia (64.7%) associated with reduced insight (88.2%), moderate prefrontal executive impairment (94.1%) and attention deficits (82.3%) dominated the CM-phenotype. Neuropsychiatric features with striking misidentification (52.9%), other less-structured delusions (70.6%), and brief hallucinations (64.7%) were present. Marked behavioral disturbances were present early in some patients and very common at later stages. At the baseline, the CM-ADs showed more confabulation (p < 0.001), temporal disorientation (p < 0.02), misidentification (p = 0.013), other delusions (p = 0.002), and logorrhea (p = 0.004) than the CA-ADs. In addition, more social disinhibition (p = 0.018), reduction of insight (p = 0.029), and hallucination (p = 0.03) persisted at 12 months from baseline. Both the CA- and CM-ADs showed anterior and medial temporal atrophy. Compared to HCs, the CM-ADs showed more right fronto-insular atrophy, while the CA-ADs showed more dorsal parietal, precuneus, and right parietal atrophy.
Conclusion:
We described an AD phenotype resembling diencephalic rather than hippocampal amnesia and overlapping the past-century description of presbyophrenia.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>36442200</pmid><doi>10.3233/JAD-220919</doi><tpages>26</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1387-2877 |
| ispartof | Journal of Alzheimer's disease, 2023-01, Vol.91 (1), p.363-388 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9881034 |
| source | SAGE:Jisc Collections:SAGE Journals Read and Publish 2023-2024:2025 extension (reading list) |
| subjects | Alzheimer Disease - complications Alzheimer Disease - psychology Alzheimer's disease Amnesia Amnesia - psychology Atrophy Cognitive ability Confusion Cortex (parietal) Cross-Sectional Studies Disorientation Genotype & phenotype Hallucinations Hippocampus Humans Memory Memory Disorders Neurodegenerative diseases Neuropsychological Tests Phenotypes Retrograde amnesia Retrospective Studies |
| title | Diencephalic versus Hippocampal Amnesia in Alzheimer’s Disease: The Possible Confabulation-Misidentification Phenotype |
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