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<p><b>BACKGROUND</b>Previous studies have shown that brain functional activity in the resting state is impaired in Alzheimer's disease (AD) patients. However, alterations in intrinsic brain activity patterns in mild cognitive impairment (MCI) patients are poorly understood. This study aimed to explore the differences in regional intrinsic activities throughout the whole brain between aMCI patients and controls.</p><p><b>METHODS</b>In the present study, resting-state functional magnetic resonance imaging (fMRI) was performed on 18 amnestic MCI (aMCI) patients, 18 mild AD patients and 20 healthy elderly subjects. And amplitude of low-frequency fluctuation (ALFF) method was used.</p><p><b>RESULTS</b>Compared with healthy elderly subjects, aMCI patients showed decreased ALFF in the right hippocampus and parahippocampal cortex, left lateral temporal cortex, and right ventral medial prefrontal cortex (vMPFC) and increased ALFF in the left temporal-parietal junction (TPJ) and inferior parietal lobule (IPL). Mild AD patients showed decreased ALFF in the left TPJ, posterior IPL (pIPL), and dorsolateral prefrontal cortex compared with aMCI patients. Mild AD patients also had decreased ALFF in the right posterior cingulate cortex, right vMPFC and bilateral dorsal MPFC (dMPFC) compared with healthy elderly subjects.</p><p><b>CONCLUSIONS</b>Decreased intrinsic activities in brain regions closely related to episodic memory were found in aMCI and AD patients. Increased TPJ and IPL activity may indicate compensatory mechanisms for loss of memory function in aMCI patients. These findings suggest that the fMRI based on ALFF analysis may provide a useful tool in the study of aMCI patients.</p>
Subject(s)
Aged , Female , Humans , Male , Alzheimer Disease , Amnesia , Brain , Cognitive Dysfunction , Magnetic Resonance ImagingABSTRACT
<p><b>BACKGROUND</b>Previous studies have shown that the functional brain activity in the resting state is impaired in Alzheimer's disease (AD) patients. However, most studies focused on the relationship between different brain areas, rather than the amplitude or strength of the regional brain activity. The purpose of this study was to explore the functional brain changes in AD patients by measuring the amplitude of the blood oxygenation level dependent (BOLD) functional MRI (fMRI) signals.</p><p><b>METHODS</b>Twenty mild AD patients and twenty healthy elderly subjects participated in the fMRI scan. The amplitude of low frequency fluctuation (ALFF) was calculated using REST software.</p><p><b>RESULTS</b>Compared with the healthy elderly subjects, the mild AD patients showed decreased ALFF in the right posterior cingulate cortex, right ventral medial prefrontal cortex, and in the bilateral dorsal medial prefrontal cortex. No brain region with increased ALFF was found in the AD group compared with the control group.</p><p><b>CONCLUSIONS</b>The reduced activity in the posterior cingulate cortex and medial prefrontal cortex observed in the present study suggest that the functional abnormalities of those areas are at an early stage of AD. The ALFF analysis may provide a useful tool in fMRI study of AD.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease , Diagnosis , Case-Control Studies , Gyrus Cinguli , Magnetic Resonance Imaging , Methods , Prefrontal CortexABSTRACT
Objective To explore the effects of lamotrigine on the cognitive function and the quality of life in epilepsy patients.Methods This was a prospective study and 91 newly diagnosed epilepsy patients were enrolled.The neuropsychological tests score and the quality of life in epilepsy inventory(QOLIE-31) were obtained before and after the treatment with lamotrigine.A battery of neuropsychological tests comprised the auditory verbal learning test(AVLT), the logical memory test(LMT), the digital symbol test(DST), the stroop color word test(SCWT), the trail making test(TMT), the verbal fluency test(VFT), the WAIS block design test(WBDT), the WAIS digital span test(WDST)and the Boston naming test(BNT). Results The repeated assessments in the patients taking lamotrigine were associated with significant improvements in many domains.The greatest changes were observed in the immediate and delayed recall of AVLT, DST, the time consuming of SCWT card C and TMT test A and B, the immediate and delayed recall of LMT, VFT, WBDT and BNT.For the quality of life, significant improvements were recorded in the fields of the seizure worry(38.81?16.06 vs 45.68?15.18), the overall quality of life(59.12?13.50 vs 64.99?13.33), the social function(64.59?25.14 vs 69.41?22.70)and the self-health evaluation (71.18?13.73 vs 76.75?11.30).Conclusion Improvements of the cognitive function and the quality of life can be observed in the initial period of medication with lamotrigine in epilepsy patients.
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Objective To establish the bedside screening scale for cognition examination in systemic lupus erythematosus patients.Methods The modified mini-mental status examination(MMMSE)(revised by the Neurology Department of Hua Shan Hospital)was applied to examine the recognition function of SLE pa- tients.The results were compared with those of the traditional mini-mental status examination(MMSE).Results MMSE examination results showed that NPSLE score was lower than that of normal control group(P＜0.01),no significant difference was found between NPSLE patients and SLE control group(P＞0,05),and the completion time was longer than SLE control group and normal control group(P＜0.01);but no significant difference was found between SLE control group and normal control group.The result of MMMSE examination showed that the score of NPSLE group was lower than that of SLE control group and normal control group(P＜0.01),and the completion time was longer than SLE control group and normal control group(P＜0.01);but the score of SLE control group was lower than the normal control group,and its completion time was longer than normal control group,the difference was statistically significant(P＜0.01).Conclusion MMSE is the most widely used dementia scale,but it is not sensitive in demonstrating the impairment of recognition function.The several items we added to the MMMSE can detect recognition impairment more sensitively,and ean be very easily applied,costs less time(within 10 minutes).Therefore,it can be used for SLE bedside screening.
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Objective To analyze the characteristics of auditory verbal memory impairment in mild Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI).Methods Auditory verbal memory test was performed in 72 patients with MCI,45 patients with mild AD,and 62 normal controls.Results Significant intergroup differences were found in total former five free recall and learning scores,The MCI subjects( 16.4?5.5,2.6?1.7)performed significantly more poorly than the normal control subjects(NC) (30.2?5.6,3.4?1.9),and mild AD categories (9.8?4.1,2.0?1.2) showed lower results than the MCI subjects(t=2.26,P
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Objective: To investigate the cognitive impairment features in patients with amnestic mild cognitive impairment(aMCI) and vascular cognitive impairment-no dementia(VCI-ND).Methods:Sixteen normal elders,10 patients with aMCI and 12 patients with VCI-ND were recruited.The normal elders were selected from communities in Shanghai,while the aMCI and VCI-ND patients were selected from outpatient clinic.All participants ranged in age of 50～80 years,with education level of junior middle school or above,and they completed cranial CT or MRI and a series of neuropsychological tests.Results:In the three memory tests,aMCI group performed worst.The scores of both aMCI and VCI-ND groups were lower than that of the normal elders.For example,the delayed recall scores of the Rey-Osterrich complex figure test in the three groups were(18.8?9.5)(normal),(5.6?5.6)(aMCI) and(9.6?7.0)(VCI-ND)(P
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Objective: To investigate applicability for Boston naming test (30 items) (BNT) in Chinese elderly and identify effect for mild cognitive impairment (MCI) and Alzheimer's dementia(AD) using BNT. Methods:100 normal elderly, 38 amnesic MCI, 34 mild AD and 38 moderate AD were evaluated by neuropsychological tests (include BNT, mini mental state examination and auditory verbal memory test, etc). MMSE total score of 4 groups were 28.4?1.5, 26.1?2.6, 20.7?1.7, and 15.6?3.3, respectively. Results: Age, sex, level of education were found to be significant factors affecting overall scores of spontaneous naming in normal elderly group. Spontaneous naming score for participants of elementary, high school and college groups were 22.2?3.3, 25.5?2.5 and 26.3?1.8, respectively. Scoring of male participants higher than that of females. Spontaneous naming score of 4 groups were 24.9?3.0, 20.9?3.6, 18.7?4.0 and 15.7?4.2, respectively. As cut-off ≤22 score of spontaneous naming of BNT, the sensitivities for MCI, mild AD and moderate AD were 61%, 79% and 95% respectively; the specificities were all around 81%. Selective impairment of unfamiliar items occurred MCI and mild AD and hold of familiar item across diagnostic groups. Semantic cue naming and recognition ability by BNT showed there was progressive damage in AD patients, but less than that of spontaneous naming of BNT. Conclusion: The ability of naming is influenced by age, gender and educational level. Patients with MCI or mild AD have impairment in naming.