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Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Published online by Cambridge University Press:  17 July 2017

Sarah J Wakefield ,
Daniel J Blackburn Open the ORCID record for Daniel J Blackburn [Opens in a new window] ,
Kirsty Harkness ,
Aijaz Khan ,
Markus Reuber  and
Annalena Venneri
Sarah J Wakefield
Affiliation:
Department of Neuroscience, University of Sheffield, UK
Daniel J Blackburn
Affiliation:
Department of Neuroscience, University of Sheffield, UK Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
Kirsty Harkness
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
Aijaz Khan
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
Markus Reuber
Affiliation:
Department of Neuroscience, University of Sheffield, UK Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
Annalena Venneri*
Affiliation:
Department of Neuroscience, University of Sheffield, UK Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
*
Prof. Annalena Venneri, Department of Neuroscience, Medical School, Beech Hill Road, Sheffield S10 2RX, UK. Tel: +44 114 2713430; Fax: +44 114 2222290 E-mail: a.venneri@sheffield.ac.uk
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Abstract

Objectives

Patients with functional memory disorder (FMD) report significant memory failures in everyday life. Differentiating these patients from those with memory difficulties due to early stage neurodegenerative conditions is clinically challenging. The current study explored whether distinctive neuropsychological profiles could be established, suitable to differentiate patients with FMD from healthy individuals and those experiencing amnestic mild cognitive impairment (a-MCI).

Methods

Patients with a clinical diagnosis of FMD were compared with patients with a-MCI, and healthy matched controls on several tests assessing different cognitive functions. Patients with clinically established mood disorders were excluded. Patients with FMD and a-MCI were broadly comparable on the level of their subjective memory complaints as assessed by clinical interview.

Results

The neuropsychological profile of the FMD patients, although they expressed subjective memory and attention concerns during their clinical interview was distinct from patients with a-MCI on tests of memory [semantic fluency, age of acquisition (AoA) analysis of semantic fluency, verbal and non-verbal memory]. FMD patients did not differ significantly from healthy controls, but their scores on the letter fluency and digit cancellation tasks were not significantly different from those of the a-MCI patients indicating a possible sub-threshold deficit on these tasks.

Conclusion

Whilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by an early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.

Keywords

Alzheimer’s diseaseamnesticmemoryneuropsychological testing

Information

Type
Original Article
Information
Acta Neuropsychiatrica , Volume 30 , Issue 2 , April 2018 , pp. 90 - 96
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Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

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References

1. Commissaris, CJ, Ponds, RW, Jolles, J. Subjective forgetfulness in a normal Dutch population: possibilities for health education and other interventions. Patient Educ Couns 1998;34:25–32.CrossRefGoogle Scholar
2. Ponds, RW, Commissaris, KJ, Jolles, J. Prevalence and covariates of subjective forgetfulness in a normal population in the Netherlands. Int J Aging Hum Dev 1997;45:207–221.Google Scholar
3. DoH. Prime Minister’s challenge on dementia: delivering major improvement in dementia care and research. England: DoH, 2015.Google Scholar
4. Menon, R, Larner, AJ. Use of cognitive screening instruments in primary care: the impact of national dementia directives (NICE/SCIE, National Dementia Strategy). Fam Pract 2011;28:272–276.Google Scholar
5. Larner, AJ. Impact of the National Dementia Strategy in a neurology-led memory clinic: 5-year data. Clin Med 2014;14:216.Google Scholar
6. Bell, S, Harkness, K, Dickson, JM, Blackburn, D. A diagnosis for £55: what is the cost of government initiatives in dementia case finding. Age Ageing 2015;44:344–345.Google Scholar
7. Blackburn, DJ, Wakefield, S, Shanks, MF, Harkness, K, Reuber, M, Venneri, A. Memory difficulties are not always a sign of incipient dementia: a review of the possible causes of loss of memory efficiency. Br Med Bull 2014;112:71–81.CrossRefGoogle Scholar
8. Schmidtke, K, Pohlmann, S, Metternich, B. The syndrome of functional memory disorder: definition, etiology, and natural course. Am J Geriatr Psychiatry 2008;16:981–988.CrossRefGoogle ScholarPubMed
9. Stone, J, Pal, S, Blackburn, D, Reuber, M, Thekkumpurath, P, Carson, A. Functional (psychogenic) cognitive disorders: a perspective from the neurology clinic. J Alzheimers Dis 2015;48(Suppl. 1):S5–S17.Google Scholar
10. Stone, J, Carson, A, Duncan, R et al. Symptoms ‘unexplained by organic disease’ in 1144 new neurology out-patients: how often does the diagnosis change at follow-up? Brain 2009;132(Pt 10):2878–2888.Google Scholar
11. Carson, AJ, Brown, R, David, AS et al. Functional (conversion) neurological symptoms: research since the millennium. J Neurol Neurosurg Psychiatry 2012;83:842–850.Google Scholar
12. Carson, AJ, Stone, J, Warlow, C, Sharpe, M. Patients whom neurologists find difficult to help. J Neurol Neurosurg Psychiatry 2004;75:1776–1778.Google Scholar
13. Stone, J, Warlow, C, Sharpe, M. The symptom of functional weakness: a controlled study of 107 patients. Brain 2010;133(Pt 5):1537–1551.Google Scholar
14. Amariglio, RE, Townsend, MK, Grodstein, F, Sperling, RA, Rentz, DM. Specific subjective memory complaints in older persons may indicate poor cognitive function. J Am Geriatr Soc 2011;59:1612–1617.CrossRefGoogle ScholarPubMed
15. Petersen, RC. Mild cognitive impairment: current research and clinical implications. Semin Neurol 2007;27:22–31.CrossRefGoogle ScholarPubMed
16. Petersen, RC. Mild cognitive impairment: useful or not? Alzheimers Dement 2005;1:5–10.Google Scholar
17. Wakefield, SJ, McGeown, WJ, Shanks, MF, Venneri, A. Differentiating normal from pathological brain ageing using standard neuropsychological tests. Curr Alzheimer Res 2014;11:765–772.Google Scholar
18. Ciaramelli, E, Lauro-Grotto, R, Treves, A. Dissociating episodic from semantic access mode by mutual information measures: evidence from aging and Alzheimer’s disease. J Physiol Paris 2006;100:142–153.Google Scholar
19. Venneri, A, Mitolo, M, De Marco, M. Paradigm shift: semantic memory decline as a biomarker of preclinical Alzheimer’s disease. Biomark Med 2016;10:5–8.Google Scholar
20. Forbes-McKay, KE, Venneri, A. Detecting subtle spontaneous language decline in early Alzheimer’s disease with a picture description task. Neurol Sci 2005;26:243–254.Google Scholar
21. Vita, MG, Marra, C, Spinelli, P et al. Typicality of words produced on a semantic fluency task in amnesic mild cognitive impairment: linguistic analysis and risk of conversion to dementia. J Alzheimers Dis 2014;42:1171–1178.Google Scholar
22. Biundo, R, Gardini, S, Caffarra, P et al. Influence of APOE status on lexical-semantic skills in mild cognitive impairment. J Int Neuropsychol Soc 2011;17:423–430.CrossRefGoogle ScholarPubMed
23. Hardy, J. Has the amyloid cascade hypothesis for Alzheimer’s disease been proved? Curr Alzheimer Res 2006;3:71–73.Google Scholar
24. Venneri, A, McGeown, WJ, Biundo, R, Mion, M, Nichelli, P, Shanks, MF. The neuroanatomical substrate of lexical-semantic decline in MCI APOE epsilon4 carriers and noncarriers. Alzheimer Dis Assoc Disord 2011;25:230–241.Google Scholar
25. Metternich, B, Schmidtke, K, Hull, M. How are memory complaints in functional memory disorder related to measures of affect, metamemory and cognition? J Psychosom Res 2009;66:435–444.Google Scholar
26. Kong, L, Wu, F, Tang, Y et al. Frontal-subcortical volumetric deficits in single episode, medication-naïve depressed patients and the effects of 8 weeks fluoxetine treatment: a VBM-DARTEL study. PLoS One 2014;9:e79055.Google Scholar
27. Tekin, S, Cummings, JL. Frontal-subcortical neuronal circuits and clinical neuropsychiatry: an update. J Psychosom Res 2002;53:647–654.Google Scholar
28. Tramoni, E, Aubert-Khalfa, S, Guye, M, Ranjeva, JP, Felician, O, Ceccaldi, M. Hypo-retrieval and hyper-suppression mechanisms in functional amnesia. Neuropsychologia 2009;47:611–624.Google Scholar
29. Høgh, P, Waldemar, G, Knudsen, GM et al. A multidisciplinary memory clinic in a neurological setting: diagnostic evaluation of 400 consecutive patients. Eur J Neurol 1999;6:279–288.Google Scholar
30. Mol, ME, van Boxtel, MP, Willems, D, Jolles, J. Do subjective memory complaints predict cognitive dysfunction over time? A six-year follow-up of the Maastricht aging study. Int J Geriatr Psychiatry 2006;21:432–441.Google Scholar
31. Royal College of Psychiatrists 2013; English National Memory Clinics audit report. Available at http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/nationalclinicalaudits/memoryclinicsaudit/memoryclinicsaudit2013.aspx.Google Scholar
32. Royal College of Psychiatrists 2015; Second English National Memory Clinics audit report. Available at http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/nationalclinicalaudits/memoryservicesaudit.aspx.Google Scholar
33. Samsi, K, Abley, C, Campbell, S et al. Negotiating a labyrinth: experiences of assessment and diagnostic journey in cognitive impairment and dementia. Int J Geriatr Psychiatry 2014;29:58–67.Google Scholar
34. Le Couteur, DG, Doust, J, Creasey, H, Brayne, C. Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis. BMJ 2013;347:f5125.Google Scholar
35. Hessler, J, Brönner, M, Etgen, T et al. Suitability of the 6CIT as a screening test for dementia in primary care patients. Aging Ment Health 2014;18:515–520.Google Scholar
36. Elsey, C, Drew, P, Jones, D et al. Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics. Patient Educ Couns 2015;98:1071–1077.Google Scholar
37. Jones, D, Drew, P, Elsey, C et al. Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders. Aging Ment Health 2016;20:500–509.Google Scholar
38. Metternich, B, Schmidtke, K, Dykierek, P, Hull, M. A pilot group therapy for functional memory disorder. Psychother Psychosom 2008;77:259–260.Google Scholar
39. Commissaris, CJ, Jolles, J, Verhey, FR, Ponds, RW, Damoiseaux, V, Kok, GJ. Forgetful or demented? Who worries and why? Tijdschr Gerontol Geriatr 1993;24:144–149.Google Scholar
40. Commissaris, K, Verhey, FR, Jolles, J. A controlled study into the effects of psychoeducation for patients with cognitive disturbances. J Neuropsychiatry Clin Neurosci 1996;8:429–435.Google Scholar
41. Mol, ME, Ruiter, RA, Verhey, FR, Dijkstra, J, Jolles, J. A study into the psychosocial determinants of perceived forgetfulness: implications for future interventions. Aging Ment Health 2008;12:167–176.Google Scholar
42. Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.Google Scholar