title: Clinical Dementia Rating Scale Detects White Matter Changes in Older Adults at Risk for Alzheimer's Disease.
abstract: This study investigated the putative changes in regional gray matter and cingulum bundle segments in mild cognitive impairment (MCI) by using two diagnostic criteria. Participants comprised 50 older adults with MCI and 22 healthy older controls (HC). The older adults with MCI were further divided into two groups defined by a global Clinical Dementia Rating (CDR) score of 0.5 and with (the CDR/NPT MCI group) or without (the CDR MCI group) objective cognitive impairments determined using neuropsychological tests (NPTs). Comparable regional gray matter integrity was observed among the three groups. However, the integrity of the right inferior segment of the cingulum bundle in the two MCI groups was more reduced than that in the HC group, and the CDR/NPT MCI group exhibited additional disruption in the left inferior cingulum bundle. The results also demonstrated that neuropsychological measures have greater predictive value for changes in white matter beyond the contribution of an informant-based instrument alone. Overall, the findings confirm the utility of informant-based assessment in detecting microstructural brain changes in high-risk older adults, even before objective cognitive impairment is evident. The findings also suggest that combining the neuropsychological measures with the informant-based assessment provided the greatest predictive value in assessing white matter disruption. The essential role of the white matter measurement as a biomarker for detecting individuals at a high risk of developing dementia was highlighted.
authors.affiliation: Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.|Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Chang
authors.affiliation: Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Shiuan
authors.initials: YS
authors.lastname: Yen
authors.affiliation: Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Ta-Fu
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Section of Neurology, Renai Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Sui-Hing
authors.initials: SH
authors.lastname: Yan
authors.affiliation: Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.|Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan.|Graduate Institute of Brain and Mind Sciences College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Wen-Yih Isaac
authors.initials: WY
authors.lastname: Tseng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D066127:White Matter / Q000473:pathology*
keywords: Alzheimer’s disease; cognition; diffusion magnetic resonance imaging; early diagnosis; mild cognitive impairment; neuropsychology