Cognitive syndrome

The cognitive syndrome of vascular dementia is characterized by memory deficit, dysexecutive syndrome, slowed information processing, and mood and personality changes. These features are found especially among patients with subcortical lesions. Patients with cortical lesions often have additional cortical neuropsychological syndromes.'36'

The memory deficit in vascular dementia is often less severe than in Alzheimer's disease. It is characterized by impaired recall, relatively intact recognition, and more benefit from cues.'49' The dysexecutive syndrome in vascular dementia includes impairment in goal formulation, initiation, planning, organizing, sequencing, executing, set-sifting and set-maintenance, as well as in abstracting.(! ,36,49) The dysexecutive syndrome in vascular dementia relates to lesions affecting the prefrontal subcortical circuit including prefrontal cortex, caudate, pallidum, thalamus, and the thalamocortical circuit (capsular genu, anterior capsule, anterior centrum semiovale, and anterior corona radiata). (59 Typically, personality and insight are relatively preserved in mild and moderate cases of vascular dementia.

Features that make the diagnosis of vascular dementia disease uncertain or unlikely include early and progressive worsening of memory, and other cognitive cortical deficits in the absence of corresponding focal lesions on brain imaging. (3°)

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