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Review
. 2016 Apr;22(2 Dementia):385-403.
doi: 10.1212/CON.0000000000000298.

The Mental Status Examination in Patients With Suspected Dementia

Murray Grossman, David J Irwin
Review

The Mental Status Examination in Patients With Suspected Dementia

Murray Grossman et al. Continuum (Minneap Minn). 2016 Apr.

Abstract

Purpose of review: This article describes a comprehensive approach to the mental status examination and diagnostic workup of patients suspected of having an emerging neurodegenerative dementia. Key strategies for obtaining a history and bedside examination techniques are highlighted.

Recent findings: Classic descriptions of behavioral neurology syndromes were largely based on clinicopathologic correlations of strategic lesions in stroke patients. While still very important, advances in neuroimaging have expanded our armamentarium of cognitive evaluations to include assessments of findings in nonstroke anatomic distributions of disease. These efforts support comprehensive assessments of large-scale cerebral networks in cognitive neurology.

Summary: A thorough and focused mental status examination is essential for the evaluation of patients with cognitive symptoms. Selective use of laboratory testing and neuroimaging can aid in the diagnosis of dementia by excluding non-neurodegenerative etiologies. Neurodegenerative disease-specific tests are in development and will enhance diagnosis and efforts for disease-modifying therapy development.

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Figures

Figure 1-1
Figure 1-1
Modified Rey-Osterrieth figure. Construction of a modified Rey-Osterrieth figure by the patient in Case 1-1 reveals some poor organization with minor spatial displacement (arrow) and omissions (asterisks).
Figure 1-2
Figure 1-2
Knife-edge cortical atrophy in the behavioral variant of frontotemporal dementia. Parasagittal T1 MRI of the right hemisphere of the patient in Case 1-3 displaying significant dorsolateral, orbitofrontal, and perisylvian atrophy in the frontal lobes and severe anterior and medial temporal atrophy in the right hemisphere greater than the left hemisphere (arrows). There is relative preservation of posterior cortices, resulting in a dramatic knife-edge appearance of the border between precentral gyri and postcentral gyri.
See this image and copyright information in PMC

References

    1. Avants BB, Libon DJ, Rascovsky K, et al. Sparse canonical correlation analysis relates network-level atrophy to multivariate cognitive measures in a neurodegenerative population. Neuroimage 2014; 84: 698– 711. doi:10.1016/j.neuroimage.2013.09.048. - PMC - PubMed
    1. Bonner MF, Peelle JE, Cook PA, Grossman M. Heteromodal conceptual processing in the angular gyrus. Neuroimage 2013; 71: 175– 186. doi:10.1016/j.neuroimage.2013.01.006. - PMC - PubMed
    1. Grossman M, Peelle JE, Smith EE, et al. Category-specific semantic memory: converging evidence from bold fMRI and Alzheimer’s disease. Neuroimage 2013; 68: 263– 274. doi:10.1016/j.neuroimage.2012.11.057. - PMC - PubMed
    1. Cooke A, Grossman M, DeVita C, et al. Large-scale neural network for sentence processing. Brain Lang 2006; 96(1): 14– 36. doi:10.1016/j.bandl.2005.07.072. - PubMed
    1. Grossman M, McMillan C, Moore P, et al. What’s in a name: voxel-based morphometric analyses of MRI and naming difficulty in Alzheimer’s disease, frontotemporal dementia and corticobasal degeneration. Brain 2004; 127(pt 3): 628– 649. doi:10.1093/brain/awh075. - PubMed