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P4‐102: Anosognosia in Amnestic Mci and AD: Decreased Functional Connectivity of Cortical Midline Structures
Author(s) -
Ries Michele L.,
McLaren Donald,
Kastman Erik,
Kosmatka Kristopher,
Gallagher Catherine,
Bendlin Barbara,
Johnson Sterling,
Tudorascu Dana
Publication year - 2010
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.2010.08.160
Subject(s) - anosognosia , posterior cingulate , psychology , functional connectivity , neuroscience , boston naming test , correlation , temporal lobe , mnemonic , audiology , cortex (anatomy) , medicine , neuropsychology , cognition , cognitive psychology , geometry , mathematics , epilepsy
Background: Computerized testing has become increasingly common as a cognitive evaluation method in clinical trials and other settings for both healthy controls and clinical populations. Despite this prevalence, the literature on diagnostic utility is not extensive and the discriminative abilities of computerized batteries examining different dementias are not currently known. The CogState computerized battery is an example of a measure that has been used in multiple clinical trials and is administered to patients as an early identification of mild cognitive impairment (MCI). We report here the results of a study comparing CogState performance across groups of healthy controls, MCI, Alzheimer’s disease (AD), Lewy Body dementia (DLB), and Fronto-temporal dementia (FTD). Methods: Participants were 106 individuals (23 healthy controls; 19 MCI; 45 AD; 9 DLB; 10 FTD) seen through the University of Michigan Alzheimer’s Disease Research Center, with diagnoses established by clinician consensus. Participants were administered the CogState Clinic battery consisting of subtests measuring speed and accuracy of responses on measures of simple reaction time (Detection), choice reaction time (Identification), working memory (One-Back), incidental learning (One-Card Learning), divided attention (Monitoring), and associative learning (Associate Learning). Results: ANOVAs indicated that all variables comprising the CogState battery discriminated dementia groups (AD, DLB, FTD) from MCI and controls, such that the dementia groups performed worse than the MCI and control groups. MCI participants performed significantly worse than controls on only the working memory speed and accuracy tasks (One-Back). Whereas no differences were noted between AD and other dementias, the DLB group performed worse than the other dementia groups on response speed to the working memory task (One-Back) and simple reaction time (Detection). Conclusions: This CogState Clinic battery appears to be effective in discriminating normal and sub-threshold clinical groups from dementia groups, but not as effective in differentiating healthy controls and MCI or between dementia groups. The results with One-Back suggest particular sensitivity to variable cognitive performance, and it may be especially useful in clinical trials. For enhanced discrimination among dementias clinically, other CogState measures emphasizing executive ability, such as Mazes, may be more sensitive to differences among patient subgroups and should be considered in future clinical trials.