What is the Difference Between Cortical and Subcortical Dementia

The key difference between cortical and subcortical dementia is that cortical dementia is a type of dementia affecting the cerebral cortex of the brain, while subcortical dementia is a type of dementia affecting the subcortex area of the brain, which comprises white matter and includes several regions such as the striatum, globus pallidus, and substantia nigra.

Dementia is a condition that results in the impaired ability to remember, think, or make decisions. It can affect different parts of the brain. Based on that, dementia can be categorized into two types: cortical and subcortical dementia. Cortical dementia affects the cerebral cortex region of the brain, which is above the subcortex, while subcortical dementia affects the subcortex region of the brain.

CONTENTS

1. Overview and Key Difference
2. What is Cortical Dementia
3. What is Subcortical Dementia
4. Similarities – Cortical and Subcortical Dementia
5. Cortical vs. Subcortical Dementia in Tabular Form
6. Summary – Cortical vs. Subcortical Dementia

What is Cortical Dementia?

Cortical dementia usually describes dementia affecting the cerebral cortex of the brain. The cerebral cortex is the brain’s outermost layer and has gray matter. It performs various important functions. There are different types of cortical dementias, such as Alzheimer’s disease, frontotemporal lobe dementia, Lewy body dementia, Creutzfeldt-Jakob disease, and posterior cortical atrophy. The symptoms of cortical dementia may include memory loss, disorientation, confusion, changes in personality, mood, and behavior, changes in judgment, inability to recognize familiar faces or known objects, difficulty in walking, difficulty in speaking, problems in swallowing, language, and emotional issues. Moreover, cortical dementia can be caused by the build-up of proteins called Beta-amyloid in the brain, abnormal amounts of tau protein, and another kind of protein called TDP-43 in the brain due to gene mutations.

Cortical dementia can be diagnosed through physical exams, blood tests, family history, cerebrospinal fluid (CSF) samples, and genetic testing. Furthermore, treatment of cortical dementia can be carried out by giving medications like aducanumab (Aduhelm), antianxiety agents, physical therapy, speech therapy, and occupational therapy.

What is Subcortical Dementia?

Subcortical dementia is due to damage to the subcortex region of the brain. There are different types of subcortical dementias, such as Huntington’s disease, Parkinson’s disease, and AIDS dementia complex. The symptoms of subcortical dementia may include difficulty performing certain tasks, difficulty in following instructions, forgetting current and past events, language difficulties, misplacing items, getting lost regularly, changes to the sleep pattern, losing interest in people, hallucinations, delusions, poor judgment, changes in the mood and inability to perceive dangers. Moreover, subcortical dementia is caused by small vessel disease that reduces blood flow to the brain and damages the axons or white matter.

Subcortical dementia can be diagnosed through medical history, physical examination, blood tests, mental ability tests, and imaging tests like CT scans and MRIs. Furthermore, subcortical dementia can be treated through medications to treat high blood pressure, high cholesterol, anticoagulants or low dose of aspirin (reduce the risk of blood clots), acetylcholinesterase inhibitors, such as donepezil, memantine, cholinesterase inhibitors, and therapies such as cognitive stimulation therapy, cognitive rehabilitation, talking therapies, cognitive behavioral therapy, occupational therapy, and music and creative arts therapy.

What are the Similarities Between Cortical and Subcortical Dementia?

• Cortical and subcortical dementia are two types of dementia based on the affected region of the brain.
• Both dementias are mainly characterized by memory loss or forgetfulness.
• Both dementias can be diagnosed through physical examination, blood tests, and mental ability tests.
• They are mainly treated through specific medications and therapies.

What is the Difference Between Cortical and Subcortical Dementia?

Cortical dementia is a type of dementia that affects the cerebral cortex of the brain, while subcortical dementia is a type of dementia that affects the subcortex area of the brain, which comprises white matter, and includes several regions such as the striatum, globus pallidus, and substantia nigra. Thus, this is the key difference between cortical and subcortical dementia. Furthermore, cortical dementia damages the neural cell bodies, axon terminals, and dendrites called gray matter. On the other hand, subcortical dementia damages the axons or white matter.

The infographic below presents the differences between cortical and subcortical dementia in tabular form for side-by-side comparison.

Summary – Cortical vs. Subcortical Dementia

Dementia causes memory loss, problems in language, defects in problem-solving, and other problems in thinking abilities that are severe enough to interfere with the daily life of people. Cortical and subcortical dementia are two types of dementia based on the affected region of the brain. Cortical dementia affects the brain’s cerebral cortex, which consists mainly of gray matter. On the other hand, subcortical dementia affects the subcortex area of the brain, which consists primarily of white matter. So, this summarizes the difference between cortical and subcortical dementia.

Reference:

1. “What Is Cortical Dementia? Symptoms, Treatment, and Outlook.” Medical News Today.
2. “Subcortical Dementia: Types, Symptoms, and Treatment.” Medical News Today.

Image Courtesy:

1. “Alzheimers Disease” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Blausen 0704 ParkinsonsDisease” By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work (CC BY 3.0) via Commons Wikimedia