We aimed to elucidate the functional neuroanatomical correlates of Frontal Assessment Battery (FAB) performances by applying [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) to a large population of patients with Alzheimer disease (AD).
Methods:
The FAB was administered to 177 patients with AD, and regional cerebral glucose metabolism (rCMglc) was measured by FDG-PET scan. Correlations between FAB scores and rCMglc were explored using both region-of-interest-based (ROI-based) and voxel-based approaches.
Results:
The ROI-based analysis showed that FAB scores correlated with the rCMglc of the dorsolateral prefrontal cortices. Voxel-based approach revealed significant positive correlations between FAB scores and rCMglc which were in various cortical regions including the temporal and parietal cortices as well as frontal regions, independent of age, gender, and education. After controlling the effect of global disease severity with Mini-Mental State Examination score, significant positive correlation was found only in the bilateral prefrontal regions.
Conclusions:
Although FAB scores are influenced by temporoparietal dysfunction due to the overall progression of AD, it likely reflects prefrontal dysfunction specifically regardless of global cognitive state or disease severity in patients with AD.
ReadyREOttBRGraceJCahn-WeinerDA. Apathy and executive dysfunction in mild cognitive impairment and Alzheimer disease. Am J Geriatr Psychiatry. 2003;11
(2):222–228.
2.
GoldbergEBougakovD. Neuropsychologic assessment of frontal lobe dysfunction. Psychiatr Clin North Am. 2005;28
(3):567–580.
3.
DuboisBSlachevskyALitvanIPillonB. The FAB: a frontal assessment battery at bedside. Neurology. 2000;55
(11):1621–1626.
4.
SlachevskyAVillalpandoJMSarazinMHahn-BarmaVPillonBDuboisB. Frontal assessment battery and differential diagnosis of frontotemporal dementia and Alzheimer disease. Arch Neurol. 2004;61
(7):1104–1107.
5.
KugoATeradaSAtaTJapanese version of the Frontal Assessment Battery for dementia. Psychiatry Res. 2007;153
(1):69–75.
6.
OshimaETeradaSSatoSFrontal assessment battery and brain perfusion imaging in Alzheimer’s disease. Int Psychogeriatr. 2012;24
(6):994–1001.
7.
SilvermanDH. Brain 18F-FDG PET in the diagnosis of neurodegenerative dementias: comparison with perfusion SPECT and with clinical evaluations lacking nuclear imaging. J Nucl Med. 2004;45
(4):594–607.
8.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Washington, D. C: American Psychiatric Association; 2000.
9.
McKhannGDrachmanDFolsteinMKatzmanRPriceDStadlanEM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology. 1984;34
(7):939–944.
10.
LeeJHLeeKULeeDYDevelopment of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci. 2002;57
(1):P47–P53.
11.
MorrisJCHeymanAMohsRCThe Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology. 1989;39
(9):1159–1165.
12.
HughesCPBergLDanzigerWLCobenLAMartinRL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566–572.
13.
KimTHHuhYChoeJYKorean version of frontal assessment battery: psychometric properties and normative data. Dement Geriatr Cogn Disord. 2010;29
(4):363–370.
14.
GoldenCJFreshwaterSM. The Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. Chicago: Stoelting; 2002.
15.
SeoEHLeeDYChooIHNormative study of the Stroop Color and Word Test in an educationally diverse elderly population. Int J Geriatr Psychiatry. 2008;23
(10):1020–1027.
16.
FristonKJAshburnerJFrithCDSpatial registration and normalization of images. Hum Brain Mapp. 1995;3(3):165–189.
17.
MinoshimaSFreyKAFosterNLKuhlDE. Preserved pontine glucose metabolism in Alzheimer disease: a reference region for functional brain image (PET) analysis. J Comput Assist Tomogr. 1995;19
(4):541–547.
18.
Tzourio-MazoyerNLandeauBPapathanassiouDAutomated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage. 2002;15
(1):273–289.
19.
ChumbleyJWorsleyKFlandinGFristonK. Topological FDR for neuroimaging. Neuroimage. 2010;49
(4):3057–3064.
20.
PatakyTC. Assessing the significance of pedobarographic signals using random field theory. J Biomech. 2008;41
(11):2465–2473.
KumeKHanyuHMurakamiMFrontal assessment battery and brain perfusion images in amnestic mild cognitive impairment. Geriatr Gerontol Int. 2011;11
(1):77–82.
23.
GuedjEAllaliGGoetzCFrontal assessment battery is a marker of dorsolateral and medial frontal functions: A SPECT study in frontotemporal dementia. J Neurol Sci. 2008;273
(1-2):84–87.
24.
YoshidaHTeradaSSatoSFrontal assessment battery and brain perfusion imaging in early dementia. Dement Geriatr Cogn Disord. 2009;27
(2):133–138.
25.
KemperSMcDowdJM. Dimensions of cognitive aging: executive function and verbal fluency. In: HoferSMAlwinDF, ed. Handbook of Cognitive Aging: Interdisciplinary Perspectives. Thousand Oaks, Calif: Sage; 2008:181–192.
26.
TranelDAndersonSWBentonA. Development of the Concept of “Executive Function” and Its Relationship to the Frontal Lobes. In: BollerFGrafmanJ, ed. Handbook of Neuropsychology. Amsterdam: Elsevier; 1994:125–148.
27.
ForsterSTeipelSZachCFDG-PET mapping the brain substrates of visuo-constructive processing in Alzheimer’s disease. J Psychiatr Res. 2010;44
(7):462–469.
28.
DesgrangesBBaronJCde la SayetteVThe neural substrates of memory systems impairment in Alzheimer’s disease. A PET study of resting brain glucose utilization. Brain. 1998;121
(pt 4):611–631.
29.
SchonknechtODHuntAToroPBihemispheric cerebral FDG PET correlates of cognitive dysfunction as assessed by the CERAD in Alzheimer’s disease. Clin EEG Neurosci. 2011;42
(2):71–76.
30.
BraakHBraakE. Evolution of the neuropathology of Alzheimer’s disease. Acta Neurol Scand Suppl. 1996;165:3–12.
31.
BraakHBraakE. Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol. 1991;82
(4):239–259.
32.
BallMJNeuronal loss, neurofibrillary tangles and granulovacuolar degeneration in the hippocampus with ageing and dementia. A quantitative study. Acta Neuropathol. 1977;37
(2):111–118.
33.
GouldRLArroyoBBrownRGOwenAMBullmoreETHowardRJ. Brain mechanisms of successful compensation during learning in Alzheimer disease. Neurology. 2006;67
(6):1011–1017.
34.
ParienteJColeSHensonRAlzheimer’s patients engage an alternative network during a memory task. Ann Neurol. 2005;58
(6):870–879.
35.
ChooIHLeeDYYounJCTopographic patterns of brain functional impairment progression according to clinical severity staging in 116 Alzheimer disease patients: FDG-PET study. Alzheimer Dis Assoc Disord. 2007;21
(2):77–84.
