Brain imaging evidence of preclinical Alzheimer's disease in normal aging
Article first published online: 8 FEB 2006
Copyright © 2006 American Neurological Association
Annals of Neurology
Volume 59, Issue 4, pages 673–681, April 2006
How to Cite
Jagust, W., Gitcho, A., Sun, F., Kuczynski, B., Mungas, D. and Haan, M. (2006), Brain imaging evidence of preclinical Alzheimer's disease in normal aging. Ann Neurol., 59: 673–681. doi: 10.1002/ana.20799
- Issue published online: 24 MAR 2006
- Article first published online: 8 FEB 2006
- Manuscript Accepted: 13 DEC 2005
- Manuscript Revised: 1 DEC 2005
- Manuscript Received: 15 JUL 2005
- NIH (National Institute on Aging). Grant Numbers: AG12975, AG10220
- National Institute of Diabetes and Digestive and Kidney Diseases. Grant Number: DK60753
This study was designed to test the hypothesis that baseline glucose metabolism and medial temporal lobe brain volumes are predictive of cognitive decline in normal older people.
We performed positron emission tomography using [18F]fluorodeoxyglucose and structural magnetic resonance imaging at baseline in 60 cognitively normal community-dwelling older subjects who were part of a longitudinal cohort study. Subjects were followed for a mean of 3.8 years, with approximately annual evaluation of global cognition (the Modified Mini-Mental State Examination) and episodic memory (delayed recall). Baseline brain volumes and glucose metabolism were evaluated in relation to the rate of change in cognitive test scores.
Six subjects developed incident dementia or cognitive impairment (converters). Baseline positron emission tomography scans showed regions in left and right angular gyrus, left mid-temporal gyrus, and left middle frontal gyrus that predicted the rate of change on the Modified Mini-Mental State Examination (p < 0.001). The left hemisphere temporal and parietal regions remained significant when converters were excluded. Both hippocampal (p = 0.03) and entorhinal cortical volumes (p = 0.01) predicted decline on delayed recall over time, and entorhinal cortical volumes remained significant when converters were excluded (p = 0.02). These brain volumes did not predict Modified Mini-Mental State Examination decline.
These results indicate that temporal and parietal glucose metabolism predict decline in global cognitive function, and medial temporal brain volumes predict memory decline in normal older people. The anatomical location of these findings suggests detection of preclinical Alzheimer's disease pathology. Ann Neurol 2006