Effects of a 6-Month Cognitive Intervention Program on Brain Metabolism in Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease
Effects of a 6-Month Cognitive Intervention Program on Brain Metabolism in Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease
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DOI：
10.3233/jad-2011-100996
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发表时间：
2011-01-01
影响因子：
4
通讯作者：
Buerger, Katharina
中科院分区：
文献类型：
--
作者：
Foerster, Stefan;Buschert, Verena C.;Buerger, Katharina
认知干预对阿尔茨海默病（AD）脑代谢的影响在很大程度上尚未被探索。因此，我们旨在研究临床认知参数和FDG PET，以测试认知干预对健忘轻度认知障碍（aMCI）或轻度AD患者的影响。aMCI患者（n = 24）或轻度AD患者（n = 15）被随机分配到认知干预组（ig），接受每周一次的基于小组的多成分认知干预，或积极对照组（cg），接受铅笔纸练习进行自学。我们在基线和6个月后进行静息状态FDG-PET扫描和神经心理测试。使用基于体素的SPM5方法分析归一化FDG-PET图像，以确定纵向变化，组间时间相互作用以及与神经心理结局参数的相关性。主要的整体认知结果通过协方差分析确定，MMSE和ADAS-cog评分作为依赖测量。CGs的aMCI亚组和AD亚组均显示双侧皮质FDG摄取普遍下降，而iggs的AD亚组在aMCI亚组的情况下显示离散下降或没有下降。时间分析显示，ig的aMCI亚组代谢下降衰减最强，涉及左颞上回和前扣带回。然而，相关分析显示，FDG摄取增加与主要或次要结局参数的改善之间只有微弱的非显著关联。同时，ig患者aMCI亚组的整体认知状况也有显著改善。为期六个月的认知干预给aMCI患者带来了认知方面的益处，与此同时，受神经退行性阿尔茨海默病影响的皮质区域的糖代谢下降也有所减弱。
The effect of cognitive intervention on brain metabolism in Alzheimer's disease (AD) is largely unexplored. Therefore, we aimed to investigate clinical cognitive parameters and (18)FDG PET to test for effects of a cognitive intervention in patients with amnestic mild cognitive impairment (aMCI) or mild AD. Patients with aMCI (n = 24) or mild AD(n = 15) were randomly assigned either to cognitive intervention groups (IGs), receiving weekly sessions of group-based multicomponent cognitive intervention, or active control groups (CGs), receiving pencil-paper exercises for self-study. We obtained resting-state FDG-PET scans and neuropsychological testing at baseline and after six-months. Normalized FDG-PET images were analyzed using voxel-based SPM5 approaches to determine longitudinal changes, group-by-time interactions, and correlations with neuropsychological outcome parameters. Primary global cognitive outcome was determined by analyses of covariance with MMSE and ADAS-cog scores as dependent measures. Both, aMCI and AD subgroups of CGs showed widespread bilateral cortical declines in FDG uptake, while the AD subgroup of IGs showed discrete decline or rather no decline in case of the aMCI subgroup. Group by time analyses revealed strongest attenuation of metabolic decline in the aMCI subgroup of the IGs, involving left superior temporal-and anterior cingulate gyrus. However, correlation analyses revealed only weak non-significant associations betweenincreased FDG uptake and improvement in primary or secondary outcome parameters. Concurrently, there was significant improvement in global cognitive status in the aMCI subgroup of the IGs. A six-month cognitive intervention imparted cognitive benefits in patients with aMCI, which were concurrent with an attenuated decline of glucose metabolism in cortical regions affected by neurodegenerative AD.