title: Medial temporal lobe function and structure in mild cognitive impairment.
abstract: Functional magnetic resonance imaging (fMRI) was used to study memory-associated activation of medial temporal lobe (MTL) regions in 32 nondemented elderly individuals with mild cognitive impairment (MCI). Subjects performed a visual encoding task during fMRI scanning and were tested for recognition of stimuli afterward. MTL regions of interest were identified from each individual's structural MRI, and activation was quantified within each region. Greater extent of activation within the hippocampal formation and parahippocampal gyrus (PHG) was correlated with better memory performance. There was, however, a paradoxical relationship between extent of activation and clinical status at both baseline and follow-up evaluations. Subjects with greater clinical impairment, based on the Clinical Dementia Rating Sum of Boxes, recruited a larger extent of the right PHG during encoding, even after accounting for atrophy. Moreover, those who subsequently declined over the 2.5 years of clinical follow-up (44% of the subjects) activated a significantly greater extent of the right PHG during encoding, despite equivalent memory performance. We hypothesize that increased activation in MTL regions reflects a compensatory response to accumulating AD pathology and may serve as a marker for impending clinical decline.
authors.affiliation: Department of Neurology, Gerontology Research Unit, Massachusetts General Hospital, MGH-East (149-2691), 149 13th Street, Charlestown, MA 02129, USA. bradd@nmr.mgh.harvard.edu
authors.forename: Bradford C
authors.initials: BC
authors.lastname: Dickerson
authors.forename: David H
authors.initials: DH
authors.lastname: Salat
authors.forename: Julianna F
authors.initials: JF
authors.lastname: Bates
authors.forename: Monika
authors.initials: M
authors.lastname: Atiya
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Killiany
authors.forename: Douglas N
authors.initials: DN
authors.lastname: Greve
authors.forename: Anders M
authors.initials: AM
authors.lastname: Dale
authors.forename: Chantal E
authors.initials: CE
authors.lastname: Stern
authors.forename: Deborah
authors.initials: D
authors.lastname: Blacker
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Albert
authors.forename: Reisa A
authors.initials: RA
authors.lastname: Sperling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual; D013702:Temporal Lobe / Q000473:pathology* / Q000502:physiology*