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

Abstract

We report the case of a chess player with superior premorbid cognitive function who presented to the Cognitive Disorders clinic at the National Hospital for Neurology and Neurosurgery with a 2-year history of symptoms of possible memory loss. Initially the MRI scan appearance was within normal limits and his cognitive scores inside the normal range; subsequently his cognitive function deteriorated and he fulfilled criteria for Mild Cognitive Impairment (MCI) two years later. Unexpectedly he died of an unrelated illness seven months later and post mortem examination of the brain was carried out, revealing advanced Alzheimer’s disease (CERAD definite and NIA-Regan Institute high likelihood).

This case highlights the difficulties encountered in assessing patients with superior premorbid function in the early stages of Alzheimer’s disease, and reveals the value of serial MRI and neuropsychological assessment in detecting and monitoring early neurodegenerative disease.

We would like to thank Dr John Stevens and the Department of Neuropsychology, The National Hospital for Neurology and Neurosurgery, London, for their help in the preparation of this paper. JMS is an Alzheimer Society (UK) Research Fellow; NCF is a Medical Research Council Clinician Scientist, NMR is in receipt of a Medical Research Council Program Grant.

Notes

We would like to thank Dr John Stevens and the Department of Neuropsychology, The National Hospital for Neurology and Neurosurgery, London, for their help in the preparation of this paper. JMS is an Alzheimer Society (UK) Research Fellow; NCF is a Medical Research Council Clinician Scientist, NMR is in receipt of a Medical Research Council Program Grant.