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Intelligence quotient–adjusted memory impairment is associated with abnormal single photon emission computed tomography perfusion

Published online by Cambridge University Press:  14 August 2007

DORENE M. RENTZ
Affiliation:
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
TERRI J. HUH
Affiliation:
Department of Psychiatry, University of California, San Francisco, California
LISA M. SARDINHA
Affiliation:
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
ERIN K. MORAN
Affiliation:
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
JOHN A. BECKER
Affiliation:
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
KIRK R. DAFFNER
Affiliation:
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
REISA A. SPERLING
Affiliation:
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
KEITH A. JOHNSON
Affiliation:
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Abstract

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. (JINS, 2007, 13, 821–831.)

Type
Research Article
Copyright
2007 The International Neuropsychological Society

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