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Abstract
Objective: To assess how amyloid deposition, glucose hypometabolism, and cerebral atrophy affect neuropsychological performance in patients with Alzheimer disease (AD) dementia, patients with mild cognitive impairment (MCI), and controls over time.
Methods: A total of 41 patients with AD dementia, 28 patients with MCI, and 19 controls underwent [11C]–Pittsburgh compound B (11C-PiB) and [18F]-2-fluoro-2-deoxy-d-glucose (18F-FDG)–PET and MRI scans at baseline. We extracted global binding potential for 11C-PiB, the number of abnormal voxels for 18F-FDG, and gray matter volumes using SIENAX for MRI as measures of amyloid, hypometabolism, and atrophy. In addition, repeat neuropsychological testing was performed, including memory, attention, language, and executive tasks (mean follow-up 2.2 ± 0.7 years). Cross-sectional and longitudinal relationships between imaging markers and cognition were assessed using linear mixed models, including terms for the imaging markers, time, sex, age, diagnosis, and interactions for imaging marker × time and imaging marker × time × diagnosis.
Results: Linear mixed models showed that baseline hypometabolism and atrophy were associated with poorer baseline performance on attention and executive functions (p < 0.05), whereas amyloid was not related to baseline cognition. Hypometabolism and amyloid were strongly associated with longitudinal decline in essentially all cognitive domains (pinteraction < 0.05), whereas atrophy was related specifically to future decline in Mini-Mental State Examination and memory (pinteraction < 0.05).
Conclusion: Glucose hypometabolism and brain atrophy were associated with concurrent cognitive function, whereas brain amyloid was not. Amyloid deposition and glucose hypometabolism were predictors for decline of a wide variety of cognitive functions, while brain atrophy specifically predicted memory deterioration.
GLOSSARY
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- BPND=
- nondisplaceable binding potential;
- FDG=
- 2-fluoro-2-deoxy-d-glucose;
- MCI=
- mild cognitive impairment;
- MMSE=
- Mini-Mental State Examination;
- NGMV=
- normalized gray matter volume;
- PiB=
- Pittsburgh compound B;
- RAVLT=
- Rey Auditory Verbal Learning Test;
- TMT=
- Trail Making;
- VAT=
- Visual Association Test
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1756
See page 1760
Supplemental data at Neurology.org
- Received October 14, 2013.
- Accepted in final form January 22, 2014.
- © 2014 American Academy of Neurology
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