The Neuropsychological Correlates of Brain Perfusion and Gray Matter Volume in Alzheimer’s Disease

Article type: Research Article

Authors: Tai, Hong^a | Hirano, Shigeki^{a; *} | Sakurai, Toru^a | Nakano, Yoshikazu^a | Ishikawa, Ai^a | Kojima, Kazuho^a | Li, Hongliang^a | Shimada, Hitoshi^{a; b} | Kashiwado, Koichi^{a; c} | Mukai, Hiroki^d | Horikoshi, Takuro^d | Sugiyama, Atsuhiko^a | Uno, Takashi^d | Kuwabara, Satoshi^a

Affiliations: [a] Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan | [b] Department of Functional Brain Imaging Research, Clinical Research Cluster, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan | [c] Kashiwado Hospital, Chiba, Japan | [d] Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University Chiba, Japan

Correspondence: [*] Correspondence to: Shigeki Hirano, MD, PhD, Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan. Tel.: +81 43 226 2126; Fax: +81 43 226 2160; E-mail: s_hirano@chiba-u.jp.

Abstract: Background:Neuropsychological tests, structural neuroimaging, and functional neuroimaging are employed as diagnostic and monitoring biomarkers of patients with Alzheimer’s disease (AD) Objective:We aimed to elucidate the similarities and differences in neuropsychological tests and neuroimaging with the use of the Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog), structural magnetic resonance image (MRI), and perfusion single photon emission computed tomography (SPECT), and parametric image analyses to understand its role in AD. Methods:Clinically-diagnosed AD patients (n = 155) were scanned with three-dimensional T1-weighted MRI and N-isopropyl-p-[123I] iodoamphetamine SPECT. Statistical parametric mapping 12 was used for preprocessing images, statistical analyses, and voxel-based morphometry for gray matter volume analyses. Group comparison (AD versus healthy controls), multiple regression analyses with MMSE, ADAS-cog total score, and ADAS-cog subscores as variables, were performed. Results:The AD group showed bilateral hippocampal volume reduction and hypoperfusion in the bilateral temporo-parietal lobe and posterior midline structures. Worse MMSE and ADAS-cog total score were associated with bilateral temporo-parietal volume loss and hypoperfusion. MMSE, but not ADAS-cog, was associated with the posterior midline structures. The ADAS-cog subscores were associated with the temporal volume, while perfusion analyses were linked to the left temporo-parietal region with the language function and right analogous region with the constructional praxis subscore. Conclusion:MMSE and ADAS-cog are associated with temporo-parietal regions, both in volume and perfusion. The MMSE score is associated with posterior midline structures and linked to an abnormal diagnostic AD pattern. Perfusion image analyses better represents the cognitive function in AD patients

Keywords: Alzheimer’s disease, alzheimer’s disease assessment scale, mini-mental state examination, regional cerebral blood flow, voxel-based morphometry

DOI: 10.3233/JAD-200676

Journal: Journal of Alzheimer's Disease, vol. 78, no. 4, pp. 1639-1652, 2020