Neurological changes and emotional functioning in adults with Down Syndrome

This study was designed to examine emotional changes in adults with Down Sy ndrome (DS) over time and whether changes in these psychological variables were associated with brain atrophy on MRI scan and the presence of patholog ical reflexes on the neurological examination. Participants were 26 adults with DS and their caregivers. Caregivers completed a measure of emotional f unctioning about individuals with DS at two different time points (1 year a part). Levels of cognitive functioning were measured and neurological and M RI examinations were performed on all subjects at initial testing. Signific ant group effect separated those with and without pathological findings on MRI and neurological exam across three different scales: depression, indiff erence, and pragmatic language functioning. Problems of poor pragmatic lang uage functioning appeared later in the course of suspected Alzheimer's dise ase (AD), as demonstrated by a significant group effect at time 2, but not at initial testing. In these subjects, the primary emotional change was a d ecline in social discourse (e.g. conversational style, literal understandin g, verbal expression in social contexts). These emotional levels were stabl e over time, regardless of degree of cognitive decline. Specific emotional changes occur during the course of AD which were associated with abnormal f indings from MRI and from neurological examination. These results, along wi th abnormalities in brain imaging and the presence of pathological reflexes , suggested that frontal lobe dysfunction is likely to be an early manifest ation of Alzheimer's Disease in Down Syndrome.