P2-077

Poster P2:: Monday Posters homocysteine are associated not only with AD but also with PD. Vitamin B12 level is more sensitive measure to reflect cognitive dysfunction in the elderly patients than homocysteine. High level of vitamin B12 seems to have neuroprotective effect against degenerative process, irrespective of homocysteine level, rather than its deficiency producing neural damage, because measured vitamin B12 levels in the patients were still within normal range. P2-075

GLOBAL DETERIORATION IN INTELLECTUAL AND NEUROBIOLOGICAL STAGING SUPPORTS THE RETROGENESIS MODEL: THE OSAKITAJIRI PROJECT (2)

Mitsue Meguro1, Kyoko Akanuma1, Enjoo Lee2, Tomoko Ito2, Ryusaku Hashimoto2, Masashi Kasuya3, Hiroshi Ishii2,4, Satoshi Yamaguchi1, Kenichi Meguro5, 1Osaki-Tajiri SKIP Center, Osaki, Japan; 2Dept Behav Neurol Cogn Neurosci Tohoku Univ Grad Sch Med, Sendai, Japan; 3Dept Project Design Miyagi Univ, Sendai, Japan; 4Kawasaki Kokoro Hospital, Kawasaki, Japan; 5Dept Geriatr Behav Neurol Tohoku Univ Grad Sch Med, Sendai, Japan. Contact e-mail: [email protected] Background: In the progression of their disease, patients with Alzheimer’s disease (AD) have been observed to demonstrate various clinical features reminiscent of children. Based on behavioral, neurological, and neuropathological findings, Reisberg et al. noted the relationship between development and dementia and proposed the ‘retrogenesis’ model. Objective(s): We investigated the retrogenesis model using neuropsychological tests and neuroimaging methods. Methods: The functional assessment staging procedure (FAST) was used to assess functional ability, and the Tanaka-Binet intelligence scale (TB scale) was used to evaluate intellectual ability in 40 patients with probable AD (NINCDS-ADRDA) and 30 agematched healthy controls. The TB scale can assess the mental age (MA) and the basic age (BA) values. For the AD patients, regional cerebral atrophy was assessed by visual rating method (4-point) of MRI, and regional cerebral glucose metabolism (CMRglc) was evaluated with the FDG-PET and the autoradiographic method by Phelps et al. Informed consent was received from all the family members. Results: We found that the mean MA values of the AD patients and healthy controls were 98.5 and 149.5 months, respectively. There was a significant Spearman’s correlation between the FAST stage and the BA value (p⬍0.01). Degree of global atrophy and regional atrophy in the frontal and temporal lobes and parahippocampal gyrus were found to be correlated with the BA value (Spearman, p⬍0.01). Also, we noted that CMRglc of the entire grey matter and regional CMRglc in the frontal and temporal lobes and angular gyrus were associated with the BA value (Spearman, p⬍0.01). Conclusions: Global assessments of behavioral staging, cerebral atrophy, and glucose metabolism were important for assessment of patients with AD. Although further investigation would be needed, the findings support the general concordance of intellectual and functional decline in AD with the converse development acquisition of the same capacities, as hypothesized in the retrogenesis model. P2-076

LANGUAGE IMPAIRMENT IN MODERATE STAGES OF ALZHEIMER DISEASE

Paulo H. Bertolucci, Karin Z. Ortiz, Universidade Federal de Sa˜o Paulo, Sa˜o Paulo, Brazil. Background: Alzheimer Disease (AD) is usually associated with cognitive, language and behavioral impairments, which may become more severe as the disease progresses. Language impairments are mild in the early phases, and normally these language difficulties don’t interfere in communication, though, they can become severe during the disease progresses and modify the communication abilities. Objective(s): The aim of this study was to identify which are the most common language impairments that can be found in patients with moderate AD. Methods: We evaluated 19 patients with moderate AD, with 13 to 22 score at

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MMSE; 8 were female, 16 had 4 years or less of education and 3 had more than 4 years of education. All patients were evaluated by the Boston test (Goodglass & Kaplan, 1983; 2001), and performed tasks involving oral and writing language abilities. Data acquired on this language evaluation were compared with the average of normal population data, with the same age and years of education. Results: We observed important differences when we considered the cognitive impairments. Patients that scored more than 16 in the MEEM presented difficulties in oral comprehension of words that should have been matched with visual stimulus, complex ideational material, alphabet letters writing, written confrontation naming and reading comprehension of paragraphs and sentences. Patients that scored less then 16, otherwise, presented deterioration in all linguistic tasks. Besides all difficulties described, they had difficulties in all written tasks and in words and sentences repetition, that revealed deficit in simple linguistic aspects. Conclusions: We conclude that language impairment can vary in patients with moderate AD but seems to follow cognitive deterioration. P2-077

MUTANT PRESENILIN-1 M233L PRESENTING SEVERE PARKINSONISM AND COMMON PATTERNING OF TEMPORAL PROCESSES IN NEUROLOGICAL SYMPTOMS

Masaki Ikeda1, Kimie Yonemura2, Yasuo Harigaya3, Koichi Okamoto1, 1 Department of Neurology, Gunma University Graduate School of Medicine, Maebashi, Japan; 2Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, Maebashi, Japan; 3Department of Neurology, Maebashi Red Cross Hospital, Maebashi, Japan. Contact e-mail: [email protected] Background: Presenilin-1 (PS1) is the most frequent causative gene in familial Alzheimer’s disease (FAD). We screened possible causative genes of a FAD Japanese family that has four individuals from three generations. Objective(s): Elucidate temporal processes of neurological features and radiological findings in FAD patients with PS1 M233L. Methods: We analyzed gene sequences of PS1, tau and ␣-synuclein as causative genes of dementia in two siblings of this family. We also analyzed the relationship with temporal processes of neurological symptoms and radiological findings of MRI/CT and SPECT. Results: Two siblings had common clinical phenotype characterized by dementia, cortical symptoms of apraxia, agnosia and apathy, with severe parkinsonism since onset of the disease. The temporal processes of regional brain atrophy of these siblings of MRI showed that temporo-parietal lobe and hippocampus at initial stage, and then atrophies of frontal lobe and basal ganglia followed. Conclusions: PS1 M233L showed common clinical phenotype corresponded to temporal processes of regional brain atrophy in two siblings. This implicated that PS1 M233L mutation might possess some pathological function to neurodegeneration in certain areas of FAD brains as well as A␤ accumulation and NFT appearance. P2-078

PSYCHOMETRIC TESTS DISTINGUISH FRONTOTEMPORAL DEMENTIA FROM AD: A CLINICOPATHOLOGIC STUDY

Rajka M. Liscic1,2, Storandt Martha, Cairns J. Nigel, Morris C. John, 1 Institute for Medical Research and Occupational Health, Zagreb, Croatia; 2Departments of Neurology, Pathology and Immunology, Psychology and the ADRC, School of Medicine, Washington University, St. Louis, MO, USA. Contact e-mail: [email protected] Background: Frontotemporal lobar degeneration (FTLD) is a heterogeneous group of disorders that may be mistaken clinically for Alzheimer’s disease (AD). A proportion of patients who meet the NINCDSADRDA criteria for AD have FTLD confirmed at autopsy with or without neuropathological AD-type changes. Cerebral deposition of A␤ peptide is the initiating event in AD, associated with APOE ⑀4 allele. Thus, more sensitive clinical diagnostic tools are required to distinguish