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Quantitative and qualitative analyses of clock drawing in frontotemporal dementia and Alzheimer's disease

Published online by Cambridge University Press:  22 March 2006

MERVIN BLAIR ,
ANDREW KERTESZ ,
PAUL MCMONAGLE ,
WILDA DAVIDSON  and
NIKOLETTA BODI
MERVIN BLAIR
Affiliation:
Department of Cognitive Neurology, St. Joseph's Health Care, London, Ontario, Canada
ANDREW KERTESZ
Affiliation:
Department of Cognitive Neurology, St. Joseph's Health Care, London, Ontario, Canada
PAUL MCMONAGLE
Affiliation:
Department of Cognitive Neurology, St. Joseph's Health Care, London, Ontario, Canada
WILDA DAVIDSON
Affiliation:
Department of Cognitive Neurology, St. Joseph's Health Care, London, Ontario, Canada
NIKOLETTA BODI
Affiliation:
Department of Psychiatry, University of Szeged, Szeged, Hungary
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Abstract

The clock drawing test (CDT) is a widely used cognitive screening test. It is useful in identifying focal lesions and cognitive deficits in dementia groups. Lately, several studies attempted its use to differentiate between dementia subtypes. Although many studies have examined the CDT in dementia populations, research into the use of clock drawing in frontotemporal dementia (FTD) is limited. We examined quantitative (global) and qualitative (specific error type) differences on the CDT between FTD (n = 36) and Alzheimer's disease (AD; n = 25) patients and controls without dementia (n = 25). Results showed significantly lower overall scores in the dementia groups compared to the control group, whereas FTD patients scored significantly higher than the AD group. On qualitative analysis, the FTD group had fewer stimulus bound responses, conceptual deficits, and spatial or planning errors compared to the AD group. In conclusion, both global and error analysis of the CDT helped discriminate the FTD group from controls and AD patients. (JINS, 2006, 12, 159–165.)

Keywords

Pick's diseasePick complexAlzheimer's type dementiaPrimary progressive aphasiaSemantic dementiaClock drawing
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 2 , March 2006 , pp. 159 - 165
Copyright
© 2006 The International Neuropsychological Society

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References

REFERENCES

Brun, A. (1987). Frontal lobe degeneration of non-Alzheimer type. I. Neuropathology. Archives of Gerontology and Geriatrics, 6, 193–208.Google Scholar
Bowler, J.V., Munoz, D.G., Merskey, H., & Hachinski, V. (1998). Fallacies in the pathological confirmation of the diagnosis of Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 64, 18–24.Google Scholar
Cahn-Weiner, D.A., Williams, K., Grace, J., Tremont, G., Westervelt, H., & Stern, R.A. (2003). Discrimination of dementia with lewy bodies from Alzheimer disease and Parkinson disease using the clock drawing test. Cognitive and Behavioral Neurology, 16, 85–92.Google Scholar
Cosentino, S., Jefferson, A., Chute, D.L., Kaplan, E., & Libon, D.L. (2004). Clock drawing errors in dementia: Neuropsychological and neuroanatomical considerations. Cognitive and Behavioral Neurology, 17, 74–84.Google Scholar
Crum, R.M., Anthony, J.C., Bassett, S.S., & Folstein, M.F. (1993). Population-based norms for the mini-mental state examination by age and educational level. Journal of the American Medical Association, 269, 2386–2391.Google Scholar
Dastoor, D., Schwartz, G., & Kurtzman, D. (1991). Clock drawing: An assessment technique in dementia. Journal of Clinical and Experimental Gerontology, 13, 69–85.Google Scholar
Elfgren, C., Brun, A., Gustafson, L., Johanson, A., Minthon, L., Passant, U., & Risberg, J. (1994). Neuropsychological tests as discriminators between dementia of Alzheimer's type and frontotemporal dementia. International Journal of Geriatric Psychiatry, 9, 635–642.Google Scholar
Esteban-Santillan, C., Praditsuwan, R., Ueda, H., & Geldmacher, D.S. (1998). Clock drawing test in very mild Alzheimer's disease. Journal of the American Geriatrics Society, 46, 1266–1269.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Freedman, M., Leach, L., Kaplan, E., Shulman, K.I., & Delis, D.C. (1994). Clock drawing: A neuropsychological analysis. New York: Oxford University Press.
Heinik, J., Lahav, D., Drummer, D., Vainer-Benajah, Z., & Lin, R. (2000). Comparison of a clock drawing test in elderly schizophrenia and Alzheimer's disease patients: A preliminary study. International Journal of Geriatric Psychiatry, 15, 638–643.Google Scholar
Hodges, J.R. & Patterson, K. (1995). Is semantic memory consistently impaired early in the course of Alzheimer's disease? Neuroanatomical and diagnostic implications. Neuropsychologia 33, 441–459.Google Scholar
Hodges, J.R., Patterson, K., Oxbury, S., & Funnell, E. (1992). Semantic dementia: Progressive fluent aphasia with temporal lobe atrophy. Brain, 115, 1783–1806.Google Scholar
Huntzinger, J.A., Rosse, R.B., Schwartz, B.L., Ross, L.A., & Deutsch, S.I. (1992). Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting: A preliminary report. General Hospital Psychiatry, 14, 142–144.Google Scholar
Jurica, P.J., Leitten, C.L., & Mattis, S. (2001). Dementia rating scale-2. Lutz, FL.: Psychological Assessment Resources.
Kertesz, A., Davidson, W., McCabe, P., Takagi, K., & Munoz, D. (2003). Primary progressive aphasia: Diagnosis, varieties, evolution. Journal of the International Neuropsychological Society, 9, 710–719.Google Scholar
Kertesz, A., McMonagle, P., Blair, M., Davidson, W., & Munoz, D.G. (2005). The evolution and pathology of frontotemporal dementia. Brain, 128, 1996–2005.Google Scholar
Kertesz, A. & Munoz, D.G. (1998). Pick's disease and Pick complex. New York: Wiley-Liss.
Kirk, A. & Kertesz, A. (1991). On drawing impairment in Alzheimer's disease. Archives of Neurology, 48, 73–77.Google Scholar
Kitabayashi, Y., Ueda, H., Narumoto, J., Nakamura, K., Kita, H., & Fukui, K. (2001). Qualitative analyses of clock drawings in Alzheimer's disease and vascular dementia. Psychiatry and Clinical Neurosciences, 55, 485–491.Google Scholar
Knopman, D.S., Boeve, B.F., Parisi, J.E., Dickson, D.W., Smith, G.E., Ivnik, R.J., Josephs, K.A., & Petersen, R.C. (2005). Antemortem diagnosis of frontotemporal lobar degeneration. Annals of Neurology, 57, 480–488.Google Scholar
Kremer, R. (2002). Clock drawing test in dementia: A critical review. Revista Neurológica Argentina, 27, 223–227.Google Scholar
Libon, D.J., Malamut, B.L., Swenson, R., Sands, L.P., & Cloud, B.S. (1996). Further analysis of clock drawing among demented and nondemented older subjects. Archives of Clinical Neuropsychology, 11, 193–205.Google Scholar
Libon, D.J., Swenson, R.A., Barnoski, E.J., & Sands, L.P. (1993). Clock drawing as an assessment tool for dementia. Archives of Clinical Neuropsychology, 8, 405–415.Google Scholar
McKhann, G.M., Albert, M.S., Grossman, M., Miller, B., Dickson, D., & Trojanowski, J.Q. (2001). Clinical and pathological diagnosis of frontotemporal dementia. Archives of Neurology, 58, 1803–1809.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of NINCDS-ADRDA Work Group under auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.Google Scholar
Mendez, M.F., Ala, T., & Underwood, K.L. (1992). Development of scoring criteria for the clock drawing task in Alzheimer's disease. Journal of the American Geriatrics Society, 40, 1095–1099.Google Scholar
Mesulam, M.M. (1987). Primary progressive aphasia—Differentiation from Alzheimer's disease. Annals of Neurology, 22, 533–534.Google Scholar
Moretti, R., Torre, P., Rodolfo, M.A., Giuseppe, C., & Bava, A. (2002). Ten-point clock test: A correlation analysis with other neuropsychological tests in dementia. International Journal of Geriatric Psychiatry, 17, 347–353.CrossRefGoogle Scholar
Neary, D., Snowden, J.S., Gustafson, L., Passant, U., Stuss, D., Black, S., Freedman, M., Kertesz, A., Robert, P.H., Albert, M., Boone, K., Miller, B.L., Cummings, J., & Benson, D.F. (1998). Frontotemporal lobar degeneration—A consensus on clinical diagnostic criteria. Neurology, 51, 1546–1554.Google Scholar
Pachana, N.A., Boone, K.B, Miller, B.L., Cummings, J.L., & Berman, N. (1996). Comparison of neuropsychological functioning in Alzheimer's disease and frontotemporal dementia. Journal of the International Neuropsychological Society, 2, 505–510.Google Scholar
Perry, R.J. & Hodges, J.R. (1999). Attention and executive deficits in Alzheimer's disease. Brain, 122, 383–404.Google Scholar
Rascovsky, K., Salmon, D.P., Ho, G.J., Galasko, D., Peavy, G.M., Hansen, L.A., & Thal, L.J. (2002). Cognitive profiles differ in autopsy-confirmed frontotemporal dementia and AD. Neurology, 58, 1801–1808.Google Scholar
Rouleau, I., Salmon, D.P., & Butters, N. (1996). Longitudinal analysis of clock drawing in Alzheimer's disease patients. Brain and Cognition, 31, 17–34.Google Scholar
Rouleau, I., Salmon, D.P., Butters, N., Kennedy, C., & McGuire, K. (1992). Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease. Brain and Cognition, 18, 70–87.Google Scholar
Royall, D.R., Cordes, J.A., & Polk, M. (1998). CLOX: An executive clock drawing task. Journal of Neurology, Neurosurgery and Psychiatry, 64, 588–594.Google Scholar
Shulman, K.I. (2000). Clock-drawing: Is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561.Google Scholar
Shulman, K.I., Gold, D., Cohen, C., & Zucchero, C. (1993). Clock-drawing and dementia in the community: A longitudinal study. International Journal of Geriatric Psychiatry, 8, 487–496.Google Scholar
Snowden, J.S., Goulding, P.J., & Neary, D. (1989). Semantic dementia: A form of circumscribed cerebral atrophy. Behavioural Neurology, 2, 167–182.Google Scholar
Sunderland, T., Hill, J.L., Mellow, A.M., Lawlor, B.A., Gundersheimer, J., Newhouse, P.A., & Grafman, J.H. (1989). Clock drawing in Alzheimer's disease: A novel measure of dementia severity. Journal of the American Geriatrics Society, 37, 725–729.Google Scholar
Tuokko, H., Hadjistavropoulos, T., Miller, J.A., & Beattie, B.L. (1992). The clock test: A sensitive measure to differentiate normal elderly from those with Alzheimer disease. Journal of the American Geriatrics Society, 40, 579–584.Google Scholar
Wolf-Klein, G.P., Silverstone, F.A., Levy, A.P., & Brod, M.S. (1989). Screening for Alzheimer's disease by clock drawing. Journal of the American Geriatrics Society, 37, 730–773.Google Scholar