A deficit of retrieval is characterized by a low free recall with a normalization of performance with cueing or recognition. This pattern is observed in many disorders, such as depression or executive dysfunction or even in normal aging. Impaired storage is characterized by a very low performance in free recall, which is only marginally improved with cueing. This pattern

is observed in patients with lesions of the hippocampus and related structures, such as AD. Therefore, Inhibitors,research,lifescience,medical before deciding that a patient has a true amnestic syndrome (ie, putative AD), it must be established that information has been registered and cannot be retrieved, even with the use of facilitation techniques (no effectiveness of cueing or recognition). Amnestic syndrome of the hippocampal

type This syndrome is defined by an impaired free recall associated with a limited effect of cueing on recall (reflecting Inhibitors,research,lifescience,medical storage impairment), together with many intrusions and false positives on recognition. This profile has been called amnestic syndrome of the hippocampal type,11 and is highly suggestive of AD (provided effective encoding of information had been checked previously). In contrast, it is not encountered in patients with depression, where encoding deficits are predominant, or in patients with frontotemporal degeneration, vascular dementia, or even normal aging, where Inhibitors,research,lifescience,medical impaired free recall is greatly improved or normalized with cueing or recognition.12,13 Interestingly, the hippocampal-type memory profile has also been observed in the early stages of AD, in patients without dementia (Mini-Mental State Examination score >25), and in Inhibitors,research,lifescience,medical a prospective study of elderly people who became

demented within 5 years.11,14 This most likely means that episodic memory is a constant, early, and reliable Idarubicin datasheet neuropsychological marker of the disease in relation to early involvement of mesial temporal structures.15 It appears to be possible to identify patients with prodromal AD, even today, using specific neu-ropsycliological tools that demonstrate an amnestic syndrome of the hippocampal type!” Once this hippocampal amnesia has been Inhibitors,research,lifescience,medical found, neuropsychological testing should seek normal performance in other cognitive domains, such as language, praxia, gnosia, and executive functions. Subtle deficits of executive functions such as working memory and verbal fluency impairment can be observed at this stage. We believe that the diagnosis of the predementia stage of AD will soon benefit from the combination of neuropsychology Digestive enzyme and structural and functional neuroimaging, focused on the hippocampal formations and related structures.1″-17 We propose clinical diagnostic criteria with high specificity for MCI of the Alzheimer type or prodromal AD. This may help clinicians to identify the largest subgroup of patients with MCI.
The most critical difficulty with the concept of MCI is that it is an arbitrary label on a continuum of cognitive changes that occur in people as they age.