Intelligence quotient-adjusted memory impairment is associated with abnormal single photon emission computed tomography perfusion.
Cognitive reserve among highly intelligent older individuals makes detection of early Alzheimer's disease (AD) difficult. We tested the hypothesis that mild memory impairment determined by IQ-adjusted norms is associated with single photon emission computed tomography (SPECT) perfusion abnormality at baseline and predictive of future decline. Twenty-three subjects with a Clinical Dementia Rating (CDR) score of 0, were reclassified after scores were adjusted for IQ into two groups, 10 as having mild memory impairments for ability (IQ-MI) and 13 as memory-normal (IQ-MN). Subjects underwent cognitive and functional assessments at baseline and annual follow-up for 3 years. Perfusion SPECT was acquired at baseline. At follow-up, the IQ-MI subjects demonstrated decline in memory, visuospatial processing, and phonemic fluency, and 6 of 10 had progressed to a CDR of 0.5, while the IQ-MN subjects did not show decline. The IQ-MI group had significantly lower perfusion than the IQ-MN group in parietal/precuneus, temporal, and opercular frontal regions. In contrast, higher perfusion was observed in IQ-MI compared with IQ-MN in the left medial frontal and rostral anterior cingulate regions. IQ-adjusted memory impairment in individuals with high cognitive reserve is associated with baseline SPECT abnormality in a pattern consistent with prodromal AD and predicts subsequent cognitive and functional decline.
Rentz
Dorene M
DM
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. drentz@partners.org
Huh
Terri J
TJ
Sardinha
Lisa M
LM
Moran
Erin K
EK
Becker
John A
JA
Daffner
Kirk R
KR
Sperling
Reisa A
RA
Johnson
Keith A
KA
D000368:Aged; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007360:Intelligence / Q000502:physiology*; D007361:Intelligence Tests; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010477:Perfusion / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon