Cognitive impairment in Alzheimer's disease correlates with ventricular width and atrophy-corrected cortical glucose metabolism

We compared the correlation of PET and MRI with neuropsychological tests in 26 patients with probable Alzheimer's disease (AD). The width of the temporal horns and the third ventricle, regional metabolic rates of glucose (rCMRGlu) and the proportion of cerebrospinal fluid space in mesial temporal and temporoparietal cortical regions were measured with three-dimensionally coregistered PET and MRI in two planes perpendicular to the Sylvian fissure. Highly significant correlations between rCMRGlu and neuropsychological tests were found mainly in the temporoparietal cortex, with and without correction for atrophy. Correlations of similar magnitude were seen also between most tests and the width of the temporal horns and third ventricle. Changes in the third ventricle and mesial temporal lobe were best seen with MRI, whereas PET most clearly depicted alterations in neocortical association areas. These two aspects of the disease correlated with the severity of dementia to a similar degree.

[1]  C. Bohm,et al.  Performance Study of the PC‐384 Positron Camera System for Emission Tomography of the Brain , 1984, Journal of computer assisted tomography.

[2]  C. Grady,et al.  Heterogeneous anterior‐posterior metabolic patterns in dementia of the Alzheimer type , 1988, Neurology.

[3]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[4]  J. Haxby,et al.  Quantitative computed tomography in dementia of the Alzheimer type , 1986, Neurology.

[5]  O Nalcioglu,et al.  Quantification of magnetic resonance scans for hippocampal and parahippocampal atrophy in Alzheimer's disease , 1991, Neurology.

[6]  S. Rapoport,et al.  Positron emission tomography in Alzheimer's disease in relation to disease pathogenesis: a critical review. , 1991, Cerebrovascular and brain metabolism reviews.

[7]  M. Černý,et al.  Synthesis of 2-deoxy-2-fluoro-D-glucose , 1969 .

[8]  R A Zimmerman,et al.  The effect of focal cerebral atrophy in positron emission tomographic studies of aging and dementia. , 1990, International journal of radiation applications and instrumentation. Part B, Nuclear medicine and biology.

[9]  K Wienhard,et al.  Estimation of Local Cerebral Glucose Utilization by Positron Emission Tomography of [18F]2-Fluoro-2-Deoxy-D-Glucose: A Critical Appraisal of Optimization Procedures , 1985, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[10]  J V Haxby,et al.  High-resolution PET studies in Alzheimer's disease. , 1991, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[11]  Peter Herscovitch,et al.  Correction of Positron Emission Tomography Data for Cerebral Atrophy , 1986, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[12]  K Herholz,et al.  Three-dimensional alignment of functional and morphological tomograms. , 1990, Journal of computer assisted tomography.

[13]  R. Gur,et al.  Gender differences in age effect on brain atrophy measured by magnetic resonance imaging. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[14]  J. Haxby,et al.  Longitudinal study of cerebral metabolic asymmetries and associated neuropsychological patterns in early dementia of the Alzheimer type. , 1990, Archives of neurology.

[15]  A. Alavi,et al.  Positron emission tomography in aging and dementia: effect of cerebral atrophy. , 1987, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[16]  H. Fukuyama,et al.  Coronal reconstruction images of glucose metabolism in Alzheimer's disease , 1991, Journal of the Neurological Sciences.

[17]  A. Hirano,et al.  AN ATLAS OF THE HUMAN BRAIN FOR COMPUTERIZED TOMOGRAPHY. , 1978 .

[18]  L. Sokoloff,et al.  Local cerebral glucose utilization in the normal conscious macaque monkey , 1978, Annals of neurology.

[19]  H. Braak,et al.  Neuropathological stageing of Alzheimer-related changes , 2004, Acta Neuropathologica.

[20]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[21]  Rapoport Si,et al.  Positron emission tomography in Alzheimer's disease in relation to disease pathogenesis: a critical review. , 1991 .

[22]  J E Holden,et al.  Modeling the Dependence of Hexose Distribution Volumes in Brain on Plasma Glucose Concentration: Implications for Estimation of the Local 2-Deoxyglucose Lumped Constant , 1991, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[23]  A. Alavi,et al.  Analysis of brain and cerebrospinal fluid volumes with MR imaging. Part I. Methods, reliability, and validation. , 1991, Radiology.

[24]  HERMAN BUSCHKE,et al.  Evaluating storage, retention, and retrieval in disordered memory and learning , 1974, Neurology.

[25]  D. Jewett,et al.  Simple synthesis of F-18-labeled 2-fluoro-2-deoxy-D-glucose: concise communication. , 1984, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[26]  K. Herholz,et al.  Regional Kinetic Constants and Cerebral Metabolic Rate for Glucose in Normal Human Volunteers Determined by Dynamic Positron Emission Tomography of [18F]-2-Fluoro-2-Deoxy-D-Glucose , 1984, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[27]  M. Albert,et al.  Ventricular size in patients with presenile dementia of the Alzheimer's type. , 1984, Archives of neurology.

[28]  C. Jack,et al.  MR‐based hippocampal volumetry in the diagnosis of Alzheimer's disease , 1992, Neurology.

[29]  W. Jagust,et al.  Quantitative NMR measurements of hippocampal atrophy in Alzheimer's disease , 1988, Magnetic resonance in medicine.

[30]  P. Scheltens,et al.  Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[31]  M. LeMay,et al.  Temporal lobe atrophy in patients with Alzheimer disease: a CT study. , 1989, AJNR. American journal of neuroradiology.

[32]  K Wienhard,et al.  Computer Assisted Mapping in Quantitative Analysis of Cerebral Positron Emission Tomograms , 1985, Journal of computer assisted tomography.

[33]  M J de Leon,et al.  Ventricular volume and cognitive deficit: a computed tomographic study. , 1983, Radiology.

[34]  Jerry L Prince,et al.  Measurement of Radiotracer Concentration in Brain Gray Matter Using Positron Emission Tomography: MRI-Based Correction for Partial Volume Effects , 1992, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[35]  E. S. Gollin,et al.  Developmental Studies of Visual Recognition of Incomplete Objects , 1960 .