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P3‐052: Neuropsychiatric syndromes in Alzheimer's disease: Relationship to cognitive and functional progression. The Cache County dementia progression study
Author(s) -
Treiber Katherine,
Shao Huibo,
Zandi Peter,
Steinberg Martin,
Corcoran Chris,
Cook Larry,
Norton Maria,
Green Robert C.,
Piercy Kathy,
Rabins Peter,
Breitner John C.S.,
Welsh-Bohmer Kathleen A.,
Lyketsos Constantine G.,
Tschanz JoAnn T.
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1616
Subject(s) - dementia , clinical dementia rating , cognition , population , alzheimer's disease , psychology , cognitive decline , effects of sleep deprivation on cognitive performance , psychiatry , disease , clinical psychology , medicine , environmental health
and peripheral insulin in early AD. Medial temporal lobe (MTL) anatomy is intimately associated with both memory processes and AD pathology. Defective insulin signaling may be a component of AD neuropathology .We hypothesized that higher peripheral insulin levels during a 3-hour IV glucose tolerance test (IVGTT) would be associated with greater regional hippocampal volume in early AD. Methods: Fifty-five control and 59 early AD non-diabetic subjects over the age of 60 participated in this study. Insulin area under the curve (AUC) was calculated during IVGTT. All image analysis was performed with SPM5. T1-weighted MRI scans were processed to generate spatially normalized and modulated gray matter volume (GMV) maps. Voxel-wise multiple regression was carried out within groups specifying insulin AUC, age and gender as independent variables, and the gray matter maps as the dependent variable. ANCOVA was performed on the whole group specifying interaction between insulin AUC and dementia status. Both age and gender were included in the model. Results: Regression analysis of the AD group showed a relationship between insulin AUC and GMV at widespread locations, including both hippocampi. Additional relationships were present at both cingulate gyri, the insulae and parietal lobes. Similar analyses in the control group revealed no regional relationships in MTL anatomy. The ANCOVA analysis revealed a differential relationship across AD and controls groups for insulin AUC and GMV in the right hippocampus and both fusiform gyri, with higher insulin AUC levels associated with greater GMV in the AD group. Conclusions: Higher peripheral insulin levels appear to be related to preserved GMV in specific anatomy related to memory function in AD. This suggests attenuated insulin-related trophic influences in AD, and raises the possibility of chronic brain insulin resistance as a factor in AD pathophysiology.