Cognitive and Neuroimaging Profiles in Mild Cognitive Impairment and Alzheimer's Disease: Data from the Spanish Multicenter Normative Studies (NEURONORMA Project)

Article type: Research Article

Authors: Sánchez-Benavides, Gonzalo^a | Peña-Casanova, Jordi^{a; b; *} | Casals-Coll, Marta^a | Gramunt, Nina^c | Molinuevo, José L.^d | Gómez-Ansón, Beatriz^e | Aguilar, Miguel^f | Robles, Alfredo^g | Antúnez, Carmen^h | Martínez-Parra, Carlosⁱ | Frank-García, Anna^j | Fernández-Martínez, Manuel^k | Blesa, Rafael^l | for the NEURONORMA Study Team

Affiliations: [a] Hospital del Mar Research Institute, Barcelona, Spain | [b] Section of Behavioral Neurology and Dementias, Hospital del Mar, Parc Salut Mar, Barcelona, Spain | [c] BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain | [d] Department of Neurology, Hospital Clínic i Provincial, Barcelona, Spain | [e] Department of Neuroradiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain | [f] Department of Neurology, Hospital Mútua de Terrassa, Terrassa, Spain | [g] Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain | [h] Department of Neurology, Hospital Virgen Arrixaca, Murcia, Spain | [i] Department of Neurology, Hospital Virgen Macarena, Sevilla, Spain | [j] Department of Neurology, Hospital Universitario La Paz, Madrid, Spain | [k] Department of Neurology, Hospital de Cruces, Barakaldo, Spain | [l] Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Correspondence: [*] Correspondence to: Jordi Peña-Casanova, Behavioral Neurology and Dementia Section, Neurology Department, Hospital del Mar, Passeig Maritim, 25-29, 08003 Barcelona, Spain. Tel.: +34 93 3160778; Fax: +34 93 3160723; E-mail: JPcasanova@parcdesalutmar.cat.

Abstract: The aim of this study was to characterize the neuropsychological and neuroimaging profiles of mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients, and to study the magnitude of the differences by comparing both outcomes with healthy subjects in a cross-sectional manner. Five hundred and thirty-five subjects (356 cognitively normal adults (CONT), 79 MCI, and 100 AD) were assessed with the NEURONORMA neuropsychological battery. Thirty CONT, 23 MCI, and 23 AD subjects from this sample were included in the neuroimaging substudy. Patients' raw cognitive scores were converted to age and education-adjusted scaled ones (range 2–18) using co-normed reference values. Medians were plotted to examine the cognitive profile. MRIs were processed by means of FreeSurfer. Effect size indices (Cohen's d) were calculated in order to compare the standardized differences between patients and healthy subjects. Graphically, the observed cognitive profiles for MCI and AD groups produced near to parallel lines. Verbal and visual memories were the most impaired domains in both groups, followed by executive functions and linguistic/semantic ones. The largest effect size between AD and cognitively normal subjects was found for the FCSRT (d = 4.05, AD versus CONT), which doubled the value obtained by the best MRI measure, the right hippocampus (d = 1.65, AD versus CONT). Our results support the notion of a continuum in cognitive profile between MCI and AD. Neuropsychological outcomes, in particular the FCSRT, are better than neuroimaging ones at detecting differences among subjects.

Keywords: Alzheimer's disease, magnetic resonance imaging, mild cognitive impairment, neuropsychological tests, neuropsychology

DOI: 10.3233/JAD-132186

Journal: Journal of Alzheimer's Disease, vol. 41, no. 3, pp. 887-901, 2014