2009 issue 2

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Volume 18, issue 2

Review

Semantic dementia - the role of interview and neuropsychological assessment in differential diagnosis

Emilia J. Sitek1,2, Dariusz Wieczorek3, Ewa Narożańska2
1. Zakład Pielęgniarstwa Neurologiczno-Psychiatrycznego Akademii Medycznej w Gdańsku
2. Oddział Neurologii Szpitala Specjalistycznego Św. Wojciecha w Gdańsku
3. Katedra i Klinika Rehabilitacji Akademii Medycznej w Gdańsku
Postępy Psychiatrii i Neurologii 2009; 18 (2): 183-187
Keywords: semantic dementia, primary progressive aphasia, Alzheimer's disease, frontotemporal dementia, frontotemporal lobar degeneration

Abstract

Objectives. The aim of the article is to describe cognitive dysfunction specificity in semantic dementia (SD ) in the context of other dementia types and to point to the importance of interview and neuropsychological assessment in differential diagnosis.
Views. Semantic dementia (SD) is a subtype of frontotemporal dementia (FTD). Progressive loss of semantic knowledge constitutes the core deficit. Episodic memory dysfunction is of late onset and milder character than semantic memory impairment, differentiating SD from Alzheimer 's disease. Language dysfunction at onset is limited mostly to naming and single-word comprehension, which allows differen-tiation between SD and various primary progressive aphasia types. Absence or mild intensity of behavioral disturbance in SD differentiate the condition from the behavioral variant FTD. Neuropsychological assessment allows to establish whether semantic memory deficit predominates in the clinical picture and to what extent the profile of other cognitive functions is characteristic of SD. Neuropsychological data combined with structural and functional neuroimaging findings that show atrophy and dysfunction of temporal poles provide grounds for a reliable diagnosis of SD.
Conclusions. Semantic dementia is a separate clinical entity, so far rarely diagnosed in Poland. Differential diagnosis of SD, enabled by the state-of-the-art knowledge about the condition characteristics, reąuires both neuropsychological assessment and neuroradiological examination.

Address for correspondence:
Dr Emilia Sitek
Szpital Specjalistyczny Św. Wojciecha w Gdańsku, Oddział Neurologii
Al. Jana Pawła II50, 80-432 Gdańsk
emiliasitek@amg.gda.pl