Clinical Neurology, Dept of Neuroscience (DINOGMI), University of Genoa, Italy.
Nuclear Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
J Alzheimers Dis. 2014;39(1):103-13. doi: 10.3233/JAD-121684.
We evaluated the brain metabolic correlates of main indexes of a widely used word list learning test, the Rey Auditory Verbal Memory Test (RAVLT), in a group of elderly subjects with memory complaints. Fifty-four subjects (age: 72.02 ± 7.45; Mini-Mental State Examination (MMSE) score: 28.9 ± 1.24) presenting at a memory clinic complaining of memory deficit, but not demented, and thirty controls (age: 71.87 ± 7.08; MMSE score: 29.1 ± 1.1) were included. Subjects with memory complaints included both patients with (amnestic mild cognitive impairment, aMCI) and without (subjective memory complaints, SMC) impairment on memory tests. All subjects underwent 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), analyzed with statistical parametric. Patients with aMCI but not those with SMC showed the expected posterior cingulate-precuneus and parietal hypometabolism as compared to controls. Correlation was determined for between four indexes of the RAVLT and brain metabolism. The results show a significant correlation between the delayed recall score and metabolism in posterior cingulate gyrus of both hemispheres and in left precuneus, as well as between a score of long-term percent retention and metabolism in left posterior cingulate gyrus, precuneus, and orbitofrontal areas. These correlations survived correction for age, education, and MMSE score. No correlation was found between immediate or total recall scores and glucose metabolism. These data show the relevant role of posterior cingulate-precuneus and orbitofrontal cortices in retention and retrieval of de-contextualized verbal memory material in a group of elderly subjects with memory complaints and shed light on the topography of synaptic dysfunction in these subjects, overlapping that found in the earliest stages of Alzheimer-type neurodegeneration.
我们评估了广泛使用的单词列表学习测试( Rey 听觉言语记忆测试(RAVLT))的主要指标的大脑代谢相关性,该测试在一组有记忆主诉的老年患者中进行。54 名患者(年龄:72.02 ± 7.45;简易精神状态检查(MMSE)评分:28.9 ± 1.24)因记忆缺陷而就诊于记忆诊所,但未痴呆,以及 30 名对照者(年龄:71.87 ± 7.08;MMSE 评分:29.1 ± 1.1)。有记忆主诉的患者包括记忆测试有(遗忘型轻度认知障碍,aMCI)和无(主观记忆主诉,SMC)障碍的患者。所有患者均接受 18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)检查,并进行统计参数分析。与对照组相比,aMCI 患者而非 SMC 患者表现出预期的后扣带回-楔前叶和顶叶代谢低下。RAVLT 的四个指标与大脑代谢之间的相关性进行了确定。结果显示,延迟回忆评分与双侧后扣带回和左侧楔前叶以及长期保留率评分与左侧后扣带回、楔前叶和眶额区的代谢之间存在显著相关性。这些相关性在纠正年龄、教育和 MMSE 评分后仍然存在。即时回忆或总回忆评分与葡萄糖代谢之间无相关性。这些数据表明,后扣带回-楔前叶和眶额皮质在有记忆主诉的老年患者中对去语境化言语记忆材料的保留和检索具有重要作用,并阐明了这些患者突触功能障碍的拓扑结构,与阿尔茨海默型神经退行性变的早期阶段发现的重叠。