title: Memory encoding in Alzheimer's disease: an fMRI study of explicit and implicit memory.
abstract: Alzheimer's disease is the most common cause of dementia in older adults. Although the cognitive deficits and pathologic hallmarks of Alzheimer's disease have been well characterized, few functional imaging studies have examined the functional competency of specific brain regions and their relationship to specific behavioural memory deficits in Alzheimer's disease. We used functional MRI (fMRI) to examine seven early stage Alzheimer's disease patients and seven healthy age-matched neurologically normal control subjects during intentional encoding of scenes. Subjects viewed blocks of novel scenes, repeated scenes or baseline. Data were analysed using whole-brain statistical parametric mapping and region of interest approaches. The Alzheimer's disease group demonstrated impaired explicit recognition memory, but intact implicit memory (repetition priming), for the scenes. Alzheimer's disease patients demonstrated a graded deficit in activation for novel versus repeated scenes along the ventral visual stream, with most impaired activation changes in the mesial temporal lobe (MTL) and fusiform regions, most preserved activations in primary visual cortex and variably affected activations in secondary visual areas. Group-level correlations with behavioural measures of explicit memory were found in MTL, lingual and fusiform areas, whereas correlations with priming were found in lateral occipital, parietal and frontal areas. Together, these fMRI findings indicate a dissociation in Alzheimer's disease between impaired explicit memory encoding in MTL and fusiform regions and intact implicit encoding in earlier-stage occipital cortex.
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, Massachusetts 02115, USA. agolby@bwh.harvard.edu
authors.forename: Alexandra
authors.initials: A
authors.lastname: Golby
authors.forename: Gerald
authors.initials: G
authors.lastname: Silverberg
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Race
authors.forename: Susan
authors.initials: S
authors.lastname: Gabrieli
authors.forename: James
authors.initials: J
authors.lastname: O'Shea
authors.forename: Kyle
authors.initials: K
authors.lastname: Knierim
authors.forename: Glenn
authors.initials: G
authors.lastname: Stebbins
authors.forename: John
authors.initials: J
authors.lastname: Gabrieli
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D008569:Memory Disorders / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D010775:Photic Stimulation / Q000379:methods; D010781:Photography; D021641:Recognition, Psychology; D012044:Regression Analysis; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology