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P4‐151: The Diagnostic Accuracy of an Incidental Memory Test in Differentiating Between Normal Aging and Mild Alzheimer's Disease
Author(s) -
Karrasch Mira,
Myllyniemi Anna,
Latvasalo Linda,
Söderholm Carina,
Ellfolk Ulla,
Laine Matti
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.2010.08.210
Subject(s) - memorization , audiology , recall , episodic memory , psychology , free recall , memory test , test (biology) , ageing , medicine , disease , developmental psychology , cognition , cognitive psychology , psychiatry , paleontology , biology
changes in brain blood flow at rest reflect a specific response to cholinesterase inhibitor (ChEI) treatment or are simply a systemic response to cholinergic enhancement.Methods: Twenty four patients with probable AD were recruited for the study. All had psychiatric, neurological and neuropsychological assessments and structuralMRI scanning. A perfusionMRI scan was acquired before and after 20 weeks of ChEI treatment. Post treatment scans were compared to pre treatment scans. Patients was also classified into responders and non responders based on clinical and neuropsychological criteria. Post treatment scans of each sub-group were then compared to pre treatment scans. Results: Assessing treatment response in the entire group of patients with AD revealed increases in perfusion in the bilateral temporal regions and the posterior cingulate. Decreases in perfusion were detected in left frontal and temporal regions. At retest, in the sub-group of patients who responded to treatment, increased perfusion was recorded in the right caudate (tail and body), but there were decreases in bilateral frontal regions, the right caudate head and the left cuneus. Non responders had increases in perfusion in bilateral temporal regions, but decreases in the right caudate body. Conclusions: Increases in brain blood flow in cortical regions after treatment most likely reflect a systemic response to cholinergic enhancement rather than a specific response to treatment. Perfusion changes in the left caudate nucleus were the only ones which paralleled clinical and cognitive response. This finding suggests that increases in cortical brain blood flow or metabolism do not accurately reflect a specific clinically relevant effect of treatment.