title: Different brain networks mediate task performance in normal aging and AD: defining compensation.
abstract: OBJECTIVE
  To determine whether the pathologic mechanisms of AD alter the brain networks subserving performance of a verbal recognition task.
  
  
  BACKGROUND
  Functional imaging studies comparing task-related activation in AD patients and controls generally have not used network analysis and have not controlled for task difficulty.
  
  
  METHODS
  H2 15O PET was used to measure regional cerebral blood flow in 14 patients and 11 healthy elders during the performance of a serial verbal recognition task under two conditions: low demand, with study list size (SLS) equal to one; and titrated demand, with SLS adjusted so that each subject recognized words at 75% accuracy. The Scaled Subprofile Model was used to identify networks of regionally covarying activity across these task conditions.
  
  
  RESULTS
  In the elders, higher SLS was associated with the recruitment of a network of brain areas involving left anterior cingulate and anterior insula (R2 = 0.94; p < 0.0001). Three patients also expressed this network. In the remaining patients, higher SLS was associated with the recruitment of an alternate network consisting of left posterior temporal cortex, calcarine cortex, posterior cingulate, and the vermis (R2 = 0.81, p < 0.001). Expression of this network was unrelated to SLS in the elders and more intact AD patients.
  
  
  CONCLUSIONS
  The patients' use of the alternate network may indicate compensation for processing deficits. The transition from the normal to the alternate network may indicate a point where brain disease has irreversibly altered brain function and thus may have important implications for therapeutic intervention.
authors.affiliation: Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY, USA. ys11@columbia.edu
authors.forename: Y
authors.initials: Y
authors.lastname: Stern
authors.forename: J R
authors.initials: JR
authors.lastname: Moeller
authors.forename: K E
authors.initials: KE
authors.lastname: Anderson
authors.forename: B
authors.initials: B
authors.lastname: Luber
authors.forename: N R
authors.initials: NR
authors.lastname: Zubin
authors.forename: A A
authors.initials: AA
authors.lastname: DiMauro
authors.forename: A
authors.initials: A
authors.lastname: Park
authors.forename: C E
authors.initials: CE
authors.lastname: Campbell
authors.forename: K
authors.initials: K
authors.lastname: Marder
authors.forename: K
authors.initials: K
authors.lastname: Bell
authors.forename: R
authors.initials: R
authors.lastname: Van Heertum
authors.forename: H A
authors.initials: HA
authors.lastname: Sackeim
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000544:Alzheimer Disease / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D009483:Neuropsychological Tests; D013647:Task Performance and Analysis; D014055:Tomography, Emission-Computed