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Comparative Study
. 2003 Aug 26;61(4):500-6.
doi: 10.1212/01.wnl.0000079052.01016.78.

Comparison of memory fMRI response among normal, MCI, and Alzheimer's patients

M M Machulda  1 , H A Ward, B Borowski, J L Gunter, R H Cha, P C O'Brien, R C Petersen, B F Boeve, D Knopman, D F Tang-Wai, R J Ivnik, G E Smith, E G Tangalos, C R Jack Jr
Affiliations
Comparative Study

Comparison of memory fMRI response among normal, MCI, and Alzheimer's patients

M M Machulda et al. Neurology. .

Erratum in

  • Neurology. 2003 Oct 28;61(8):1164

Abstract

Objective: To determine whether an fMRI memory encoding task distinguishes among cognitively normal elderly individuals, patients with mild cognitive impairment (MCI), and patients with early Alzheimer's disease (AD).

Methods: Twenty-nine subjects (11 normal, 9 MCI, 9 AD) were studied with an fMRI memory encoding task. A passive sensory task was also performed to assess potential intergroup differences in fMRI responsiveness. Activation in the medial temporal lobe for the memory task and in the anatomic rolandic area for the sensory task was studied. Intergroup comparisons were performed using receiver operating characteristic (ROC) analyses. The ROC method provides rigorous control of artifactual false-positive "activation." Subjects were tested for recall and recognition of the encoding task stimuli following the fMRI study.

Results: Medial temporal lobe activation was greater in normal subjects than MCI and AD patients (p = 0.03 and p = 0.04). There was no difference between AD and MCI patients in fMRI memory performance [corrected]. There was an association between fMRI memory activation (area under the ROC curve) and post-fMRI performance on recognition and free recall. There was no difference among the three groups on the sensory task.

Conclusions: MCI and AD patients had less medial temporal lobe activation on the memory task than the normal subjects but similar activation as normal subjects on the sensory task. These findings suggest decreased medial temporal activation may be a specific marker of limbic dysfunction due to the neurodegenerative changes of AD. In addition, fMRI is sufficiently sensitive to detect changes in the prodromal, MCI, phase of the disease.

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Figures

Figure 1
Figure 1
Memory activation map. Coronal image of a memory activation map of an AD patient (thresholded at r = .41). True positive activation in medial temporal lobe bilaterally, right greater than left.
Figure 2
Figure 2
ROI for the memory task. Coronal image shows an example of the bilateral medial temporal lobe ROIs encompassing the hippocampus, fusiform, and parahippocampal gyri.
Figure 3
Figure 3
ROI for the sensory task. Axial image shows the ROI drawn over the left sensory-motor strip.
Figure 4
Figure 4
Memory ROC curves. Median and Interquartile ranges are plotted for the three groups: Normals are indicated by squares, MCIs by triangles, and ADs by circles.
See this image and copyright information in PMC

References

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