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Abstract
Objective: To identify biological evidence for Alzheimer disease (AD) in individuals with subjective memory impairment (SMI) and unimpaired cognitive performance and to investigate the longitudinal cognitive course in these subjects.
Method: [18F]fluoro-2-deoxyglucose PET (FDG-PET) and structural MRI were acquired in 31 subjects with SMI and 56 controls. Cognitive follow-up testing was performed (average follow-up time: 35 months). Differences in baseline brain imaging data and in memory decline were assessed between both groups. Associations of memory decline with brain imaging data were tested.
Results: The SMI group showed hypometabolism in the right precuneus and hypermetabolism in the right medial temporal lobe. Gray matter volume was reduced in the right hippocampus in the SMI group. At follow-up, subjects with SMI showed a poorer performance than controls on measures of episodic memory. Longitudinal memory decline in the SMI group was associated with reduced glucose metabolism in the right precuneus at baseline.
Conclusion: The cross-sectional difference in 2 independent neuroimaging modalities indicates early AD pathology in SMI. The poorer memory performance at follow-up and the association of reduced longitudinal memory performance with hypometabolism in the precuneus at baseline support the concept of SMI as the earliest manifestation of AD.
GLOSSARY
- AD=
- Alzheimer disease;
- AUC=
- area under the curve;
- BDI=
- Beck Depression Inventory;
- CERAD=
- Consortium to Establish a Registry for Alzheimer's Disease;
- CI=
- confidence interval;
- FDG-PET=
- [18F]fluoro-2-deoxyglucose PET;
- FWE=
- family-wise error;
- GM=
- gray matter;
- MCI=
- mild cognitive impairment;
- rCGM=
- regional cerebral glucose metabolism;
- ROC=
- receiver operating characteristic;
- ROI=
- region of interest;
- SCID=
- Structured Clinical Interview for DSM-IV;
- SMI=
- subjective memory impairment;
- SVC=
- small volume correction;
- TMT=
- Trail-Making Test;
- VLMT=
- Verbal Learning and Memory Test;
- WM=
- white matter
Footnotes
Study funding: Supported by the Alzheimer Forschungsinitiative (AFI) and the German Competence Network on Dementia funded by the German Federal Ministry for Education and Research (grant O1GI 0102).
Editorial, page 1308
- Received November 7, 2011.
- Accepted March 28, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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