Knight's move thinking? Mild cognitive impairment in a chess player

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The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
06:23

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

Published on: October 13, 2016

H A Archer1, J M Schott, J Barnes

  • 1The Dementia Research Centre, The National Hospital for Neurology and Neurosurgery, London, UK.

Neurocase
|April 5, 2005
PubMed

Insights

Early Alzheimer's disease (AD) is challenging to diagnose in individuals with high cognitive function. Serial MRI and neuropsychological tests are crucial for detecting neurodegeneration in these complex cases.

Area of Science:

  • Neuroscience
  • Neurology
  • Geriatrics

Background:

  • Assessing early neurodegenerative diseases like Alzheimer's disease (AD) can be difficult in individuals with superior premorbid cognitive function.
  • Standard diagnostic tools may not immediately detect cognitive decline in highly intelligent individuals.

Observation:

  • A chess player with high cognitive function presented with memory loss symptoms.
  • Initial MRI scans and cognitive tests were normal, but cognitive function later declined, meeting criteria for Mild Cognitive Impairment (MCI).

Findings:

  • Post-mortem examination revealed advanced Alzheimer's disease (CERAD definite, NIA-Regan high likelihood).
  • This case underscores the diagnostic challenges in early AD for high-functioning individuals.

Implications:

  • Serial Magnetic Resonance Imaging (MRI) and neuropsychological assessments are valuable for early detection and monitoring of neurodegenerative diseases.
  • Recognizing the impact of superior premorbid function is essential for accurate diagnosis and management of Alzheimer's disease.

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