- Email: [email protected]
Measurement of the Precuneus and Hippocampal Volumes Using MR Volumetry in Alzheimer's Disease
Alzheimer’s Imaging Consortium IC-P: Imaging Posters measures (MMSE) in corresponding to underlying AD pathology. The use of a brief test such as the AD8 may improve strategies for detecting dementia in community settings and in developing countries where biomarkers may not be readily available and may also enrich clinical trial recruitment by increasing the likelihood that participants have underlying biomarker abnormalities that are increasingly becoming required for inclusion. IC-P-008
CORRELATING MINIMAL ATROPHY OF HIPPOCAMPUS (HPC) AND ENTORHINAL CORTEX (ERC) WITH MEMORY AND FUNCTIONAL ABILITY AMONG ELDERLY SUBJECTS
Daniel Varon1, Elizabeth Potter1, Miriam Rodriguez1, Warren Barker1, Balaibal Ashok Raj2, David Loewenstein1, Huntington Potter2, Ranjan Duara1, 1Mt. Sinai Medical Center, Miami Beach, FL, USA; 2 Byrd Alzheimer’s Research Institute, Tampa, FL, USA. Contact e-mail: [email protected] Background: In the earliest stages of Alzheimer’s disease, neurofibrillary tangles and atrophy generally occur initially in the transentorhinal cortex, and eventually progress to the entire limbic system and neocortex. Therefore, we studied the effect of very early atrophic changes in the ERC versus the HPC on memory, phonological verbal fluency and functional abilities. The objective was to compare the effects of very mild atrophy of the HPC and ERC, on memory and functional abilities among elderly individuals diagnosed with or without cognitive impairment. Methods: Using a validated visual rating system (VRS) on a single coronal MRI slice at the level of mammillary bodies, semiquantitative measurements of HPC and ERC atrophy were made among participants of the Florida ADRC. The sample included 781 subjects, with a mean age of 73 +/- 7 years of age (range 50 to 90 years); 459 subjects (59%) were female. Clinical assessments included the Mini-Mental State Examination (MMSE), Wechsler Memory Logical Memory-Delayed (WM LM-D) test, Fuld Object Memory Examination (FOME), verbal fluency test (FAS), and Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. Results: Compared to subjects with no HPC or ERC atrophy, subjects with minimal atrophy (having an atrophy score of 1, on a scale of 0 to 4) of the ERC with no HPC atrophy, and subjects with minimal ERC plus HPC atrophy had significantly more impaired scores on the MMSE, tests of episodic memory (FOME and LM-D), verbal fluency test (FAS) and CDR-SB. Subjects with minimal HPC but no ERC atrophy had intermediate neuropsychological scores that were not different from subjects with no atrophy. Subjects with mild to moderate atrophy (atrophy score of 2 or 3) of the ERC and HPC were not significantly worse than those with minimal atrophy. Conclusions: Minimal atrophy of the ERC, alone or in combination with early HPC atrophy, appears to be associated with impaired cognition and functional abilities. IC-P-009
MEASUREMENT OF THE PRECUNEUS AND HIPPOCAMPAL VOLUMES USING MR VOLUMETRY IN ALZHEIMER’S DISEASE
Seon-Young Ryu1, Min Jeong Kwon2, Ae Young Lee3, Sang-Bong Lee1, Dong Won Yang4, Tae-Woo Kim2, In-Uk Song5, Po-Sung Yang1, HyunJeong Kim1, 1The Catholic University of Korea, College of Medicine, Daejeon, Korea, Republic of; 2The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Korea, Republic of; 3Chungnam National University, College of Medicine, Daejeon, Korea, Republic of; 4The Catholic University of Korea, College of Medicine, Seoul, Korea, Republic of; 5The Catholic University of Korea, College of Medicine, Incheon, Korea, Republic of. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD) is associated with structural alterations in the medial temporal lobe and functional alterations in the posterior cortical region, especially in the early stage. However, the causes for these regional discrepancies are still unclear whether the posterior cortical hypometabolism reflects the disconnection from the medial temporal lobe pathology or results from its local pathology. The precuneus, one of the
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posteromedial cortex, has recently received much attention by functional neuroimaging studies and is considered as the critical early area of involvement in AD. Objective: To assess the relationships between the precuneus and hippocampus in patients with AD, we investigated the precuneus volume with a MR volumetric method, along with the degree of hippocampal volume. As an additional analysis, we attempted to evaluate a possible association between the precuneus volume and specific neuropsychological domains in patients with AD. Methods: Nineteen subjects with AD and 13 healthy age-matched control subjects were studied. With three-dimensional fast-field echo MRI, we measured the volumes of the precuneus and hippocampus. These measurements were normalized by the total intracranial volume. Results: The AD patients showed a significant volume reduction in the total precuneus which was more prominent in the right side, compared with controls (p ¼ 0.024). The AD group had also significant volume reductions in the bilateral hippocampus as compared with controls. No significant correlation was found between the total precuneus and hippocampal volumes in the AD group. Among the neuropsychological domains, the total precuneus volume was significantly correlated with the visuospatial function and category fluency test in the AD patients. Conclusions: These results suggest that, in addition to the volumetric measurement of the hippocamapus, the measurement of the precuneus volume might be useful radiological index for the diagnosis of AD. Furthermore, the findings with both the precuneus and hippocampal atrophy showing no correlation between the two structures in the AD patients support that the presence of precuneus atrophy in AD would be due to its local pathology per se rather than the secondary consequence of the medial temporal lobe pathology. IC-P-010
CULTURALLY FAIR EPISODIC MEMORY MEASURES IN DIFFERENT ETHNIC GROUPS
Maria T. Greig-Custo1, David Loewenstein1, Elizabeth Potter1, Warren Barker1, John Schinka2, Balaibal Ashok Raj2, Yougui Wu3, Daniel Varon1, Huntington Potter2, Ranjan Duara1, 1Mt. Sinai Medical Center, Miami Beach, FL, USA; 2Byrd Alzheimer’s Research Institute, Tampa, FL, USA; 3Univ of South Florida, Tampa, FL, USA. Contact e-mail: [email protected] Background: The diagnoses of dementia and amnestic MCI (aMCI) are predominantly based on measures of episodic memory (EM) and functional assessments. Medial temporal atrophy (MTA) scores can serve as an unbiased quantitative biomarker of neurodegenerative disease and be used to calibrate clinical dementia rating (CDR) and EM scores among subjects of different ethnic, cultural and educational backgrounds. We compared the correlations of EM and CDR-Sum of Boxes (CDR-SB) to MTA scores among African Americans (AA), White Hispanics (WH) and White NonHispanic (WNH) subjects. Methods: Subjects (57 AA, 164 WH and 396 WNH) had complete neurological and neuropsychological evaluations, including the CDR-SB and three commonly used memory measures, i.e., Fuld Object Memory Evaluation (FOME), Wechsler Memory Logical Memory-Delayed (WM LM-D), and Hopkins Verbal Learning Test -Delayed (HVLT-D). Subjects were diagnosed as having no cognitive impairment (NCI, 60.9%), amnestic MCI (16.1%), or non-amnestic MCI (9.5%), or dementia (13.5%). The MTA score was calculated as the mean score of three bilateral regions, i.e., hippocampus, entorhinal and perirhinal cortex measured on a 1.5 mm thick coronal MRI slice at the mammillary body level. Results: CDR-SB (r ¼ .52 to .59; p <.001) and FOME scores (r ¼ -.44 to -.54; p < .001) were strongly correlated with MTA scores in all three ethnic groups. HVLT was also correlated with MTA scores in WH (r ¼ -.50; p < .001) and WNH ethnic groups (r ¼ -.44; p < .001), but less strongly (r ¼ -.37; p < .01) among AA subjects. WM LM-D and MTA scores were not significantly correlated (r ¼ -.22) among AA subjects, although WM LM-D were significantly correlated among WH (r ¼ -.39; p < .001) and WNH (r ¼ -.39; p < .001) subjects. Conclusions: Using MTA scores as a biomarker of neurodegenerative pathology, the FOME and HVLT-D were shown to be culturally/ethnically fair memory measures among WNH, WH and AA subjects, whereas the WM LM-D did not appear to be an adequate episodic memory measure among AA subjects.
CORRELATING MINIMAL ATROPHY OF HIPPOCAMPUS (HPC) AND ENTORHINAL CORTEX (ERC) WITH MEMORY AND FUNCTIONAL ABILITY AMONG ELDERLY SUBJECTS
Daniel Varon1, Elizabeth Potter1, Miriam Rodriguez1, Warren Barker1, Balaibal Ashok Raj2, David Loewenstein1, Huntington Potter2, Ranjan Duara1, 1Mt. Sinai Medical Center, Miami Beach, FL, USA; 2 Byrd Alzheimer’s Research Institute, Tampa, FL, USA. Contact e-mail: [email protected] Background: In the earliest stages of Alzheimer’s disease, neurofibrillary tangles and atrophy generally occur initially in the transentorhinal cortex, and eventually progress to the entire limbic system and neocortex. Therefore, we studied the effect of very early atrophic changes in the ERC versus the HPC on memory, phonological verbal fluency and functional abilities. The objective was to compare the effects of very mild atrophy of the HPC and ERC, on memory and functional abilities among elderly individuals diagnosed with or without cognitive impairment. Methods: Using a validated visual rating system (VRS) on a single coronal MRI slice at the level of mammillary bodies, semiquantitative measurements of HPC and ERC atrophy were made among participants of the Florida ADRC. The sample included 781 subjects, with a mean age of 73 +/- 7 years of age (range 50 to 90 years); 459 subjects (59%) were female. Clinical assessments included the Mini-Mental State Examination (MMSE), Wechsler Memory Logical Memory-Delayed (WM LM-D) test, Fuld Object Memory Examination (FOME), verbal fluency test (FAS), and Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. Results: Compared to subjects with no HPC or ERC atrophy, subjects with minimal atrophy (having an atrophy score of 1, on a scale of 0 to 4) of the ERC with no HPC atrophy, and subjects with minimal ERC plus HPC atrophy had significantly more impaired scores on the MMSE, tests of episodic memory (FOME and LM-D), verbal fluency test (FAS) and CDR-SB. Subjects with minimal HPC but no ERC atrophy had intermediate neuropsychological scores that were not different from subjects with no atrophy. Subjects with mild to moderate atrophy (atrophy score of 2 or 3) of the ERC and HPC were not significantly worse than those with minimal atrophy. Conclusions: Minimal atrophy of the ERC, alone or in combination with early HPC atrophy, appears to be associated with impaired cognition and functional abilities. IC-P-009
MEASUREMENT OF THE PRECUNEUS AND HIPPOCAMPAL VOLUMES USING MR VOLUMETRY IN ALZHEIMER’S DISEASE
Seon-Young Ryu1, Min Jeong Kwon2, Ae Young Lee3, Sang-Bong Lee1, Dong Won Yang4, Tae-Woo Kim2, In-Uk Song5, Po-Sung Yang1, HyunJeong Kim1, 1The Catholic University of Korea, College of Medicine, Daejeon, Korea, Republic of; 2The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Korea, Republic of; 3Chungnam National University, College of Medicine, Daejeon, Korea, Republic of; 4The Catholic University of Korea, College of Medicine, Seoul, Korea, Republic of; 5The Catholic University of Korea, College of Medicine, Incheon, Korea, Republic of. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD) is associated with structural alterations in the medial temporal lobe and functional alterations in the posterior cortical region, especially in the early stage. However, the causes for these regional discrepancies are still unclear whether the posterior cortical hypometabolism reflects the disconnection from the medial temporal lobe pathology or results from its local pathology. The precuneus, one of the
S9
posteromedial cortex, has recently received much attention by functional neuroimaging studies and is considered as the critical early area of involvement in AD. Objective: To assess the relationships between the precuneus and hippocampus in patients with AD, we investigated the precuneus volume with a MR volumetric method, along with the degree of hippocampal volume. As an additional analysis, we attempted to evaluate a possible association between the precuneus volume and specific neuropsychological domains in patients with AD. Methods: Nineteen subjects with AD and 13 healthy age-matched control subjects were studied. With three-dimensional fast-field echo MRI, we measured the volumes of the precuneus and hippocampus. These measurements were normalized by the total intracranial volume. Results: The AD patients showed a significant volume reduction in the total precuneus which was more prominent in the right side, compared with controls (p ¼ 0.024). The AD group had also significant volume reductions in the bilateral hippocampus as compared with controls. No significant correlation was found between the total precuneus and hippocampal volumes in the AD group. Among the neuropsychological domains, the total precuneus volume was significantly correlated with the visuospatial function and category fluency test in the AD patients. Conclusions: These results suggest that, in addition to the volumetric measurement of the hippocamapus, the measurement of the precuneus volume might be useful radiological index for the diagnosis of AD. Furthermore, the findings with both the precuneus and hippocampal atrophy showing no correlation between the two structures in the AD patients support that the presence of precuneus atrophy in AD would be due to its local pathology per se rather than the secondary consequence of the medial temporal lobe pathology. IC-P-010
CULTURALLY FAIR EPISODIC MEMORY MEASURES IN DIFFERENT ETHNIC GROUPS
Maria T. Greig-Custo1, David Loewenstein1, Elizabeth Potter1, Warren Barker1, John Schinka2, Balaibal Ashok Raj2, Yougui Wu3, Daniel Varon1, Huntington Potter2, Ranjan Duara1, 1Mt. Sinai Medical Center, Miami Beach, FL, USA; 2Byrd Alzheimer’s Research Institute, Tampa, FL, USA; 3Univ of South Florida, Tampa, FL, USA. Contact e-mail: [email protected] Background: The diagnoses of dementia and amnestic MCI (aMCI) are predominantly based on measures of episodic memory (EM) and functional assessments. Medial temporal atrophy (MTA) scores can serve as an unbiased quantitative biomarker of neurodegenerative disease and be used to calibrate clinical dementia rating (CDR) and EM scores among subjects of different ethnic, cultural and educational backgrounds. We compared the correlations of EM and CDR-Sum of Boxes (CDR-SB) to MTA scores among African Americans (AA), White Hispanics (WH) and White NonHispanic (WNH) subjects. Methods: Subjects (57 AA, 164 WH and 396 WNH) had complete neurological and neuropsychological evaluations, including the CDR-SB and three commonly used memory measures, i.e., Fuld Object Memory Evaluation (FOME), Wechsler Memory Logical Memory-Delayed (WM LM-D), and Hopkins Verbal Learning Test -Delayed (HVLT-D). Subjects were diagnosed as having no cognitive impairment (NCI, 60.9%), amnestic MCI (16.1%), or non-amnestic MCI (9.5%), or dementia (13.5%). The MTA score was calculated as the mean score of three bilateral regions, i.e., hippocampus, entorhinal and perirhinal cortex measured on a 1.5 mm thick coronal MRI slice at the mammillary body level. Results: CDR-SB (r ¼ .52 to .59; p <.001) and FOME scores (r ¼ -.44 to -.54; p < .001) were strongly correlated with MTA scores in all three ethnic groups. HVLT was also correlated with MTA scores in WH (r ¼ -.50; p < .001) and WNH ethnic groups (r ¼ -.44; p < .001), but less strongly (r ¼ -.37; p < .01) among AA subjects. WM LM-D and MTA scores were not significantly correlated (r ¼ -.22) among AA subjects, although WM LM-D were significantly correlated among WH (r ¼ -.39; p < .001) and WNH (r ¼ -.39; p < .001) subjects. Conclusions: Using MTA scores as a biomarker of neurodegenerative pathology, the FOME and HVLT-D were shown to be culturally/ethnically fair memory measures among WNH, WH and AA subjects, whereas the WM LM-D did not appear to be an adequate episodic memory measure among AA subjects.