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P4‐375: Alzheimer's disease and mild cognitive impairment weaken connections within the default‐mode network: A multimodal study with resting‐state fMRI, diffusion MRI and FDG‐PET
Author(s) -
Zhu David,
Majumdar Shantanu,
Korolev Igor,
Berger Kevin,
Bozoki Andrea
Publication year - 2012
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.2013.08.275
Subject(s) - default mode network , resting state fmri , posterior cingulate , psychology , diffusion mri , neuroscience , voxel , alzheimer's disease , cognition , audiology , medicine , cardiology , magnetic resonance imaging , disease , radiology
Alzheimer’s disease (AD) is important from the therapeutic point of view. Despite many neuropsychological studies to differentiate VaD from AD, only a few studies focused on subcortical VaD (SVaD), among the heterogeneous VaD. Furthermore, these studies on SVaD did not eliminate confounding effects of mixed Alzheimer and vascular pathology. We aimed to investigate neuropsychological differences between patients with Pittsburgh compound-B (PIB) negative SVaD and those with PIB-positive AD. Methods: We recruited patients who were clinically diagnosed with SVaD or AD, and underwent a 11 C-PIB PET scan and MRI at Samsung Medical Center or Asan Medical Center, Seoul Korea, between September 2008 and May 2011. All patients met SVaD (N1⁄469) or AD (N1⁄467) criteria as described in the study from our group. The final patient sample consisted of 44/69 (63.8%) SVaD patients who tested negative for PIB retention [PIB (-) SVaD] and 59/67 (88.1%) AD patients who tested positive for PIB retention [PIB (+) AD]. Results: Neuropsychological profile differences among the groups were analyzed by applying an analysis of covariance (ANCOVA) with Bonferroni post hoc analysis. Age and education were entered as covariates. As shown in Table 1, post hoc comparisons showed that both PIB (+) AD and PIB (-) SVaD patients were significantly more impaired than NC on every neuropsychological test. Patients with PIB (-) SVaD performed better than PIB (+) AD patients on both verbal and visual memory tests including delayed recalls of the verbal learning test and Rey Complex Figure test. In contrast, PIB (-) SVaD patients were worse than PIB (+) AD patients on frontal executive tests including the semantic/phonemic fluency of the Controlled Oral Word Association Test (COWAT) and Stroop word/color tests. The two patient groups performed comparably in attention, language, calculation, praxis, and visuospatial domains. Domain score using SNSB-D showed the same trend. Conclusions: Our study is unique in selecting each patient group based on amyloid imaging, which minimized the possibility of contaminating mixed vascular and AD pathologies.