- Email: [email protected]
P1-171: Evaluation of entorhinal and transentorhinal region in Alzheimer's disease and mild cognitive impairment by 3T MRI
T258 P1-170
Poster Presentations P1 NON-VERBAL MEMORY PERFORMANCE IS ASSOCIATED WITH CONVERSION TO DEMENTIA WITHIN ONE YEAR: A PROSPECTIVE STUDY OF MILD COGNITIVE IMPAIRMENT USING COMPUTERIZED COGNITIVE ASSESSMENT
Ely S. Simon1, Tzvi Dwolatzky2, Felicia Goldstein3, Glen M. Doniger1, Allan I. Levey3, James Lah3, Michael Friger2, 1NeuroTrax Corporation, Newark, NJ, USA; 2Ben-Gurion University, Beersheva, Israel; 3Emory University, Atlanta, GA, USA. Contact e-mail: [email protected] Background: Approximately 10-15% of individuals diagnosed with MCI convert to dementia annually, and it is challenging for the clinician to assess risk. The present study evaluates which memory measures are most informative in the prospective identification of elderly at high risk for dementia in a multiethnic cohort. Objective: To evaluate the utility of baseline memory tests in identifying MCI individuals likely to convert to dementia over one year. Methods: Sixty-eight individuals with MCI (Petersen’s criteria; age: 75.3⫾5.9; education: 13.6⫾4.1) completed computerized cognitive assessment (Mindstreams, NeuroTrax, Corp. NJ) at baseline and at 1-year follow-up. Independent groups t-tests were used to compare baseline data for MCIs with controls (N⫽56; age: 76.2⫾6.0; education: 13.5⫾3.7) and dementia patients (DSM-IV criteria; N⫽28; age: 80.0⫾6.0; education: 12.1⫾3.3) as well as between MCIs converting and not converting to dementia. Logistic regression was used to assess probability of conversion to dementia among the MCIs. Results: MCIs at baseline performed more poorly than controls on the Verbal Memory test (VMT; p⬍0.001) and the Non-Verbal Memory test (NVMT; p⬍0.001), with larger effect sizes for VMT (raw: Cohen’s d⫽1.39; normalized: d⫽1.47) versus NVMT (raw: d⫽0.82; normalized: d⫽0.88). MCIs performed better than dementia patients (p⬍0.02), again, with larger effect sizes for VMT (raw: d⫽1.04; normalized: d⫽0.60) versus NVMT (raw: d⫽0.79; normalized: d⫽0.53). MCIs converting to dementia performed more poorly than those not converting on raw VMT (p⫽0.04) and NVMT (p⬍0.001) measures, with a larger effect size for NVMT (d⫽1.07) as compared with VMT (d⫽0.68), but only the NVMT difference persisted (p⫽0.004; d⫽0.89 versus p⫽0.28; d⫽0.30 for VMT) after normalization for age and education. Similarly, univariate regression models indicated that NVMT (p⫽0.044) but not VMT (p⫽0.38) was significantly associated with probability of conversion to dementia. Conclusions: Non-verbal memory performance may be particularly important in identifying MCI patients at high risk for dementia who would benefit most from early treatment. P1-171
EVALUATION OF ENTORHINAL AND TRANSENTORHINAL REGION IN ALZHEIMER’S DISEASE AND MILD COGNITIVE IMPAIRMENT BY 3T MRI
Junko Takahashi, Satoshi Takahashi, Tasuo Terayama, Iwate Medical University, Morioka, Japan. Contact e-mail: [email protected] Background: In Alzheimer’s disease (AD), entorhinal and transentorhinal regions are damaged preceding to other structures. Evaluation and comparison of entorhinal and transentorhinal region enable to detect early change of Alzheimer disease. We evaluated entorhinal region and transentorhinal resion by 3T MRI. The patients with AD and Mild cognitive impairment (MCI) underwent the sequences of white matter suppression image and estimated tissue cell density. Methods: Subjects were 10 patients with MCI (74 ⫾ 7 years old, MMSE 26⫾1), 43 patients with AD (73⫾9 years old, FAST IV 27 cases, V 9 cases, VI 7 cases), and 12 controls (73 ⫾ 14 years old) without neurological deficits whose MRI were normal. All subjects underwent MiniMental State Examination (MMSE), Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wechsler Memory Scale-Revised (WMS-R), Modified Wisconsin card Sorting Test and neurological examination. All scans were performed using a Signa VH/I 3.0 Tesla MR imaging system and a standard head coil. We employed IR sequence (TR 4000ms, TE 20ms, TI 250 ms, matrix 256⫻256, FOV 220⫻220 mm, 3 mm thickness and 1 mm gap) to suppress white matter signals, words for emphasizing gray matter signals.
Using gray matter emphasized image. Prior to IR sequence, all cases underwent conventional spin echo T2 weighted sequence (TR 3800ms, TE 80 ms, matrix 512⫻256, FOV 220⫻220 mm, 5 mm thickness and 1.5 mm gap). ROIs were positioned on entorhinal region and transentorhinal region in gray matter emphasized images. To compare each structure, their intensities were divided by CA1 values. Results: The decline of intensities in entorhinal region and transentorhinal region preceded CA1 decline (p⬍0.05). From MCI period, transentorhinal intensity preceded entorhinal intensity (p⬍0.05). Conclusions: By using 3T MRI, we can visualize detailed morphological changes of entorhinal region and trnasentorhinal region, and furthermore observe longitudinal changes of those structures from MCI to AD patients. This method is a powerful tool to elucidate AD etiology and to evaluate the efficacy of anti-AD drugs including acetylcholinesterase inhibitor. P1-172
NEURONAL NETWORKS UNDERLYING INTERHEMISPHERIC CONNECTIVITY IN HEALTHY AGING AND AMNESTIC MILD COGNITIVE IMPAIRMENT
Stefan J. Teipel1, Oliver Pogarell2, Thomas Meindl3, Harald Hampel4, 1 Department of Psychiatry, University Rostock, Rostock, Germany; 2 Department of Psychiatry, University Munich, Munich, Germany; 3 Department of Radiology, University Munich, Munich, Germany; 4 Trinity College, Dublin, Dublin, Ireland. Contact e-mail: [email protected] Background: Interhemispheric coherence derived from EEG recordings is a measure of functional interhemispheric connectivity. Fractional anisotropy and mean diffusivity derived from diffusion tensor imaging (DTI) allow determining the integrity of subcortical fibre tracts in the living human brain. Methods: We studied the pattern of subcortical fibre tracts underlying inter-hemispheric coherence and its alteration in mild cognitive impairment (MCI), an at risk syndrome for Alzheimer’s disease, in 16 subjects with amnestic MCI and 20 cognitively healthy elderly control subjects using resting state EEG and high resolution DTI at 3 Tesla. We applied a multivariate network approach based on principal component analysis to fractional anisotropy and mean diffusivity maps and used multivariate analysis of variance to determine effects of coherence on the regional pattern of diffusivity. We used high-dimensional image warping to control for partial volume effects in the diffusivity maps. Results: Temporo-parietal coherence in the alpha band was significantly correlated with a regional pattern of diffusivity compromising predominantly posterior white matter tracts including posterior corpus callosum, parietal, temporal and occipital lobe white matter, thalamus, midbrain, pons and cerebellum, both in MCI subjects and controls (p ⬍ 0.05). In MCI subjects, frontal coherence in the alpha band was significantly correlated with a predominately frontal pattern of diffusivity including fiber tracts of the anterior corpus callosum, frontal lobe white matter, thalamus, pons and cerebellum (p ⬍ 0.05). Frontal coherences in the control subjects and beta coherences in both groups were not related to regional pattern of diffusivity. Conclusions: Our data indicate a specific network of subcortical fiber tracts including the corpus callosum, thalamus, midbrain and cerebellum subserving the maintenance of interhemispheric resting state coherence in the human brain. The combination of DTI and functional imaging appears to be a powerful approach to detect the morphological basis of normal brain function and its alterations in neurodegenerative disease. P1-173
SUBJECTIVE MEMORY COMPLAINTS AND NURSING HOME ADMISSION: A FOUR-YEAR FOLLOW-UP
Gunhild Waldemar1, Volkert Siersma2, Frans B. Waldorff2,1, 1Memory Disorders Research Group, Dept. of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; 2Research Unit and Dept. of General Practice, Institute of Public Health, Copenhagen University, Copenhagen, Denmark. Contact e-mail: [email protected]
Poster Presentations P1 NON-VERBAL MEMORY PERFORMANCE IS ASSOCIATED WITH CONVERSION TO DEMENTIA WITHIN ONE YEAR: A PROSPECTIVE STUDY OF MILD COGNITIVE IMPAIRMENT USING COMPUTERIZED COGNITIVE ASSESSMENT
Ely S. Simon1, Tzvi Dwolatzky2, Felicia Goldstein3, Glen M. Doniger1, Allan I. Levey3, James Lah3, Michael Friger2, 1NeuroTrax Corporation, Newark, NJ, USA; 2Ben-Gurion University, Beersheva, Israel; 3Emory University, Atlanta, GA, USA. Contact e-mail: [email protected] Background: Approximately 10-15% of individuals diagnosed with MCI convert to dementia annually, and it is challenging for the clinician to assess risk. The present study evaluates which memory measures are most informative in the prospective identification of elderly at high risk for dementia in a multiethnic cohort. Objective: To evaluate the utility of baseline memory tests in identifying MCI individuals likely to convert to dementia over one year. Methods: Sixty-eight individuals with MCI (Petersen’s criteria; age: 75.3⫾5.9; education: 13.6⫾4.1) completed computerized cognitive assessment (Mindstreams, NeuroTrax, Corp. NJ) at baseline and at 1-year follow-up. Independent groups t-tests were used to compare baseline data for MCIs with controls (N⫽56; age: 76.2⫾6.0; education: 13.5⫾3.7) and dementia patients (DSM-IV criteria; N⫽28; age: 80.0⫾6.0; education: 12.1⫾3.3) as well as between MCIs converting and not converting to dementia. Logistic regression was used to assess probability of conversion to dementia among the MCIs. Results: MCIs at baseline performed more poorly than controls on the Verbal Memory test (VMT; p⬍0.001) and the Non-Verbal Memory test (NVMT; p⬍0.001), with larger effect sizes for VMT (raw: Cohen’s d⫽1.39; normalized: d⫽1.47) versus NVMT (raw: d⫽0.82; normalized: d⫽0.88). MCIs performed better than dementia patients (p⬍0.02), again, with larger effect sizes for VMT (raw: d⫽1.04; normalized: d⫽0.60) versus NVMT (raw: d⫽0.79; normalized: d⫽0.53). MCIs converting to dementia performed more poorly than those not converting on raw VMT (p⫽0.04) and NVMT (p⬍0.001) measures, with a larger effect size for NVMT (d⫽1.07) as compared with VMT (d⫽0.68), but only the NVMT difference persisted (p⫽0.004; d⫽0.89 versus p⫽0.28; d⫽0.30 for VMT) after normalization for age and education. Similarly, univariate regression models indicated that NVMT (p⫽0.044) but not VMT (p⫽0.38) was significantly associated with probability of conversion to dementia. Conclusions: Non-verbal memory performance may be particularly important in identifying MCI patients at high risk for dementia who would benefit most from early treatment. P1-171
EVALUATION OF ENTORHINAL AND TRANSENTORHINAL REGION IN ALZHEIMER’S DISEASE AND MILD COGNITIVE IMPAIRMENT BY 3T MRI
Junko Takahashi, Satoshi Takahashi, Tasuo Terayama, Iwate Medical University, Morioka, Japan. Contact e-mail: [email protected] Background: In Alzheimer’s disease (AD), entorhinal and transentorhinal regions are damaged preceding to other structures. Evaluation and comparison of entorhinal and transentorhinal region enable to detect early change of Alzheimer disease. We evaluated entorhinal region and transentorhinal resion by 3T MRI. The patients with AD and Mild cognitive impairment (MCI) underwent the sequences of white matter suppression image and estimated tissue cell density. Methods: Subjects were 10 patients with MCI (74 ⫾ 7 years old, MMSE 26⫾1), 43 patients with AD (73⫾9 years old, FAST IV 27 cases, V 9 cases, VI 7 cases), and 12 controls (73 ⫾ 14 years old) without neurological deficits whose MRI were normal. All subjects underwent MiniMental State Examination (MMSE), Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wechsler Memory Scale-Revised (WMS-R), Modified Wisconsin card Sorting Test and neurological examination. All scans were performed using a Signa VH/I 3.0 Tesla MR imaging system and a standard head coil. We employed IR sequence (TR 4000ms, TE 20ms, TI 250 ms, matrix 256⫻256, FOV 220⫻220 mm, 3 mm thickness and 1 mm gap) to suppress white matter signals, words for emphasizing gray matter signals.
Using gray matter emphasized image. Prior to IR sequence, all cases underwent conventional spin echo T2 weighted sequence (TR 3800ms, TE 80 ms, matrix 512⫻256, FOV 220⫻220 mm, 5 mm thickness and 1.5 mm gap). ROIs were positioned on entorhinal region and transentorhinal region in gray matter emphasized images. To compare each structure, their intensities were divided by CA1 values. Results: The decline of intensities in entorhinal region and transentorhinal region preceded CA1 decline (p⬍0.05). From MCI period, transentorhinal intensity preceded entorhinal intensity (p⬍0.05). Conclusions: By using 3T MRI, we can visualize detailed morphological changes of entorhinal region and trnasentorhinal region, and furthermore observe longitudinal changes of those structures from MCI to AD patients. This method is a powerful tool to elucidate AD etiology and to evaluate the efficacy of anti-AD drugs including acetylcholinesterase inhibitor. P1-172
NEURONAL NETWORKS UNDERLYING INTERHEMISPHERIC CONNECTIVITY IN HEALTHY AGING AND AMNESTIC MILD COGNITIVE IMPAIRMENT
Stefan J. Teipel1, Oliver Pogarell2, Thomas Meindl3, Harald Hampel4, 1 Department of Psychiatry, University Rostock, Rostock, Germany; 2 Department of Psychiatry, University Munich, Munich, Germany; 3 Department of Radiology, University Munich, Munich, Germany; 4 Trinity College, Dublin, Dublin, Ireland. Contact e-mail: [email protected] Background: Interhemispheric coherence derived from EEG recordings is a measure of functional interhemispheric connectivity. Fractional anisotropy and mean diffusivity derived from diffusion tensor imaging (DTI) allow determining the integrity of subcortical fibre tracts in the living human brain. Methods: We studied the pattern of subcortical fibre tracts underlying inter-hemispheric coherence and its alteration in mild cognitive impairment (MCI), an at risk syndrome for Alzheimer’s disease, in 16 subjects with amnestic MCI and 20 cognitively healthy elderly control subjects using resting state EEG and high resolution DTI at 3 Tesla. We applied a multivariate network approach based on principal component analysis to fractional anisotropy and mean diffusivity maps and used multivariate analysis of variance to determine effects of coherence on the regional pattern of diffusivity. We used high-dimensional image warping to control for partial volume effects in the diffusivity maps. Results: Temporo-parietal coherence in the alpha band was significantly correlated with a regional pattern of diffusivity compromising predominantly posterior white matter tracts including posterior corpus callosum, parietal, temporal and occipital lobe white matter, thalamus, midbrain, pons and cerebellum, both in MCI subjects and controls (p ⬍ 0.05). In MCI subjects, frontal coherence in the alpha band was significantly correlated with a predominately frontal pattern of diffusivity including fiber tracts of the anterior corpus callosum, frontal lobe white matter, thalamus, pons and cerebellum (p ⬍ 0.05). Frontal coherences in the control subjects and beta coherences in both groups were not related to regional pattern of diffusivity. Conclusions: Our data indicate a specific network of subcortical fiber tracts including the corpus callosum, thalamus, midbrain and cerebellum subserving the maintenance of interhemispheric resting state coherence in the human brain. The combination of DTI and functional imaging appears to be a powerful approach to detect the morphological basis of normal brain function and its alterations in neurodegenerative disease. P1-173
SUBJECTIVE MEMORY COMPLAINTS AND NURSING HOME ADMISSION: A FOUR-YEAR FOLLOW-UP
Gunhild Waldemar1, Volkert Siersma2, Frans B. Waldorff2,1, 1Memory Disorders Research Group, Dept. of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; 2Research Unit and Dept. of General Practice, Institute of Public Health, Copenhagen University, Copenhagen, Denmark. Contact e-mail: [email protected]