Neuropsychological alterations in patients with computed tomography-detected basal ganglia calcification

To investigate the cognitive and mental status of patients with basal ganglia calcification on a computed tomographic scan.

Eighteen ambulatory patients with basal ganglia calcification and without other radiological findings who were identified from the computed tomography records of a general hospital in a 2-year period and 16 control subjects who were matched for age, education, sex, and premorbid IQ estimation consented to participate. All subjects underwent a neurological evaluation, a comprehensive neuropsychological battery, and tests with psychiatric rating scales.

Significant differences for the control group were found in tests that evaluated motor speed and executive, visuospatial, and some memory functions. Four patients (22%) met criteria for organic mood disorder (minor depression, three patients; bipolar depression, one patient) according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, whereas six other patients (33%) met diagnostic criteria for obsessive-compulsive disorder.

These results indicate that patients with basal ganglia calcifications frequently have a subcortical pattern of neuropsychological dysfunction and behavioral changes that are known to be associated with alterations of the frontal-limbic-basal ganglia circuits. The pattern of neuropsychological impairment is consistent with basal ganglia damage. However, poor performance in other neuropsychological tests suggest additional involvement of other connected networks.