Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Jan;58(1):81–84. doi: 10.1136/jnnp.58.1.81

Verbal fluency in dementia of frontal lobe type and dementia of Alzheimer type.

F Pasquier 1, F Lebert 1, L Grymonprez 1, H Petit 1
PMCID: PMC1073274  PMID: 7823074

Abstract

This study compares semantic (category) and letter-initial verbal fluency performance in dementia of frontal lobe type, dementia of Alzheimer type, and control subjects matched for age, sex, and level of education. As well as demographic characteristics, patients were matched for severity of dementia as estimated by the mini mental scale (23.2 (SD 4.9)). All patients with dementia of frontal lobe type had a frontal hypoperfusion on single photon emission computed tomography whereas patients with dementia of Alzheimer type showed mainly posterior deficits. Patients had significantly lower verbal fluency than controls but those with dementia of frontal lobe type did not differ from those with dementia of Alzheimer type in the number of words generated, intrusions, or preservations. Category fluency was more impaired than letter fluency in both dementias. No correlation between frontal index, frontal/parietal index, and fluency was found. Verbal fluency tests are sensitive tools for detecting dementia but do not seem useful in distinguishing between patients with dementia of Alzheimer type and those with dementia of frontal lobe type in early disease.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown R. G., Marsden C. D. 'Subcortical dementia': the neuropsychological evidence. Neuroscience. 1988 May;25(2):363–387. doi: 10.1016/0306-4522(88)90246-1. [DOI] [PubMed] [Google Scholar]
  2. Brown R. G., Marsden C. D. Cognitive function in Parkinson's disease: from description to theory. Trends Neurosci. 1990 Jan;13(1):21–29. doi: 10.1016/0166-2236(90)90058-i. [DOI] [PubMed] [Google Scholar]
  3. Burns A., Philpot M. P., Costa D. C., Ell P. J., Levy R. The investigation of Alzheimer's disease with single photon emission tomography. J Neurol Neurosurg Psychiatry. 1989 Feb;52(2):248–253. doi: 10.1136/jnnp.52.2.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Butters N., Granholm E., Salmon D. P., Grant I., Wolfe J. Episodic and semantic memory: a comparison of amnesic and demented patients. J Clin Exp Neuropsychol. 1987 Oct;9(5):479–497. doi: 10.1080/01688638708410764. [DOI] [PubMed] [Google Scholar]
  5. Crockett D., Bilsker D., Hurwitz T., Kozak J. Clinical utility of three measures of frontal lobe dysfunction in neuropsychiatric samples. Int J Neurosci. 1986 Nov;30(4):241–248. doi: 10.3109/00207458608985674. [DOI] [PubMed] [Google Scholar]
  6. Diesfeldt H. F. Categoriegebonden woordproduktie in een psychogeriatrische praktijk. Tijdschr Gerontol Geriatr. 1983 Apr;14(2):49–59. [PubMed] [Google Scholar]
  7. Diesfeldt H. F. Verbal fluency in senile dementia: an analysis of search and knowledge. Arch Gerontol Geriatr. 1985 Oct;4(3):231–239. doi: 10.1016/0167-4943(85)90005-6. [DOI] [PubMed] [Google Scholar]
  8. Duara R., Grady C., Haxby J., Sundaram M., Cutler N. R., Heston L., Moore A., Schlageter N., Larson S., Rapoport S. I. Positron emission tomography in Alzheimer's disease. Neurology. 1986 Jul;36(7):879–887. doi: 10.1212/wnl.36.7.879. [DOI] [PubMed] [Google Scholar]
  9. Fischer P., Gatterer G., Marterer A., Danielczyk W. Nonspecificity of semantic impairment in dementia of Alzheimer's type. Arch Neurol. 1988 Dec;45(12):1341–1343. doi: 10.1001/archneur.1988.00520360059012. [DOI] [PubMed] [Google Scholar]
  10. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  11. Girling D. M., Berrios G. E. Extrapyramidal signs, primitive reflexes and frontal lobe function in senile dementia of the Alzheimer type. Br J Psychiatry. 1990 Dec;157:888–893. doi: 10.1192/bjp.157.6.888. [DOI] [PubMed] [Google Scholar]
  12. Grober E., Buschke H., Crystal H., Bang S., Dresner R. Screening for dementia by memory testing. Neurology. 1988 Jun;38(6):900–903. doi: 10.1212/wnl.38.6.900. [DOI] [PubMed] [Google Scholar]
  13. Gustafson L. Frontal lobe degeneration of non-Alzheimer type. II. Clinical picture and differential diagnosis. Arch Gerontol Geriatr. 1987 Sep;6(3):209–223. doi: 10.1016/0167-4943(87)90022-7. [DOI] [PubMed] [Google Scholar]
  14. Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
  15. Hart S., Smith C. M., Swash M. Word fluency in patients with early dementia of Alzheimer type. Br J Clin Psychol. 1988 May;27(Pt 2):115–124. doi: 10.1111/j.2044-8260.1988.tb00759.x. [DOI] [PubMed] [Google Scholar]
  16. Hécaen H., Ruel J. Sièges lésionnels intrafrontaux et déficit au test de "fluence verbale". Rev Neurol (Paris) 1981;137(4):277–284. [PubMed] [Google Scholar]
  17. Jagust W. J., Reed B. R., Seab J. P., Kramer J. H., Budinger T. F. Clinical-physiologic correlates of Alzheimer's disease and frontal lobe dementia. Am J Physiol Imaging. 1989;4(3):89–96. [PubMed] [Google Scholar]
  18. Martin A., Fedio P. Word production and comprehension in Alzheimer's disease: the breakdown of semantic knowledge. Brain Lang. 1983 May;19(1):124–141. doi: 10.1016/0093-934x(83)90059-7. [DOI] [PubMed] [Google Scholar]
  19. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  20. Miller B. L., Cummings J. L., Villanueva-Meyer J., Boone K., Mehringer C. M., Lesser I. M., Mena I. Frontal lobe degeneration: clinical, neuropsychological, and SPECT characteristics. Neurology. 1991 Sep;41(9):1374–1382. doi: 10.1212/wnl.41.9.1374. [DOI] [PubMed] [Google Scholar]
  21. Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull. 1971 Sep;27(3):272–277. doi: 10.1093/oxfordjournals.bmb.a070866. [DOI] [PubMed] [Google Scholar]
  22. Monsch A. U., Bondi M. W., Butters N., Salmon D. P., Katzman R., Thal L. J. Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer type. Arch Neurol. 1992 Dec;49(12):1253–1258. doi: 10.1001/archneur.1992.00530360051017. [DOI] [PubMed] [Google Scholar]
  23. Montaldi D., Brooks D. N., McColl J. H., Wyper D., Patterson J., Barron E., McCulloch J. Measurements of regional cerebral blood flow and cognitive performance in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):33–38. doi: 10.1136/jnnp.53.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Neary D., Snowden J. S., Northen B., Goulding P. Dementia of frontal lobe type. J Neurol Neurosurg Psychiatry. 1988 Mar;51(3):353–361. doi: 10.1136/jnnp.51.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Neary D., Snowden J. S., Shields R. A., Burjan A. W., Northen B., MacDermott N., Prescott M. C., Testa H. J. Single photon emission tomography using 99mTc-HM-PAO in the investigation of dementia. J Neurol Neurosurg Psychiatry. 1987 Sep;50(9):1101–1109. doi: 10.1136/jnnp.50.9.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Pendleton M. G., Heaton R. K., Lehman R. A., Hulihan D. Diagnostic utility of the Thurstone Word Fluency Test in neuropsychological evaluations. J Clin Neuropsychol. 1982 Dec;4(4):307–317. doi: 10.1080/01688638208401139. [DOI] [PubMed] [Google Scholar]
  27. Pillon B., Dubois B., Ploska A., Agid Y. Severity and specificity of cognitive impairment in Alzheimer's, Huntington's, and Parkinson's diseases and progressive supranuclear palsy. Neurology. 1991 May;41(5):634–643. doi: 10.1212/wnl.41.5.634. [DOI] [PubMed] [Google Scholar]
  28. Risberg J. Frontal lobe degeneration of non-Alzheimer type. III. Regional cerebral blood flow. Arch Gerontol Geriatr. 1987 Sep;6(3):225–233. doi: 10.1016/0167-4943(87)90023-9. [DOI] [PubMed] [Google Scholar]
  29. Tröster A. I., Salmon D. P., McCullough D., Butters N. A comparison of the category fluency deficits associated with Alzheimer's and Huntington's disease. Brain Lang. 1989 Oct;37(3):500–513. doi: 10.1016/0093-934x(89)90032-1. [DOI] [PubMed] [Google Scholar]
  30. Warrington E. K. The selective impairment of semantic memory. Q J Exp Psychol. 1975 Nov;27(4):635–657. doi: 10.1080/14640747508400525. [DOI] [PubMed] [Google Scholar]
  31. Weingartner H., Kaye W., Smallberg S. A., Ebert M. H., Gillin J. C., Sitaram N. Memory failures in progressive idiopathic dementia. J Abnorm Psychol. 1981 Jun;90(3):187–196. doi: 10.1037//0021-843x.90.3.187. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES