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Functional Interactions of the Entorhinal Cortex: An ¹⁸F-FDG PET Study on Normal Aging and Alzheimer’s Disease

¹ Department of Clinical Pathophysiology, Nuclear Medicine Unit, University of Florence, Italy
² Department of Neurological and Psychiatric Sciences, University of Florence, Italy
³ Neurological Clinic and Max-Planck-Institute for Neurological Research, University of Cologne, Germany

View larger version (93K): [in a new window]   FIGURE 1. Brain areas characterized by reduced rCMRgl in AD patients compared with healthy control subjects. Results (black blobs) are displayed as SPM projections in the 3 orthogonal right sagittal, posterior coronal, and superior axial views. Results are displayed at P < 0.001 (A) and P < 0.005 (B), uncorrected for multiple comparisons. Local maxima of these brain regions can be found in Table 2. (C) White spheres corresponding to the left EC (x = -20, y = -14, z = -20) and right EC (x = 18, y = -13, z = -16) are displayed on the coronal and axial slices of a spatially standardized MR image (left) and an 18F-FDG PET image (right). Axial slices are shown at z = -18 mm relative to the AC–PC line and coronal slices are shown at y = -13 mm relative to the origin. Corresponding local maxima are reported in Table 2.

View larger version (129K): [in a new window]   FIGURE 2. Functional interactions between the EC and the rest of the brain in healthy control subjects. (Top) Results (black blobs) are displayed as SPM projections in the 3 orthogonal right sagittal, posterior coronal, and superior axial views (P < 0.001, uncorrected for multiple comparisons). Local maxima of these regions can be found in Tables 3 and 4. (Bottom) Areas showing significant correlations are displayed on the axial slices of a standard MR image beginning at -26 mm relative to the AC–PC line (upper left of image) and extending up to 44 mm above the AC–PC line (lower right of image). Images are displayed in neurologic convention (left is left and right is right). t-Value color-coded scale is shown at the bottom right.

View larger version (148K): [in a new window]   FIGURE 3. (A) Functional interactions between the EC and the rest of the brain in AD patients. (Top) Results (black blobs) are displayed as SPM projections in the 3 orthogonal right sagittal, posterior coronal, and superior axial views (P < 0.001, uncorrected for multiple comparisons). Local maxima of regions of correlated activity can be found in Tables 5 and 6. (Bottom) Areas showing significant correlations are displayed on the axial slices of a standard MR image beginning at -26 mm relative to the AC–PC line (upper left of image) and extending up to 44 mm above the AC–PC line (lower right of image). Images are displayed in neurologic convention (left is left and right is right). t-Value color-coded scale is shown at the bottom right. (B) 18F-FDG PET images of a 77-y-old woman with AD. Eight coronal slices orthogonal to the long temporal axis (top row) and axial slices parallel to the frontooccipital plane (bottom row) are shown. In this case, a coupled metabolic reduction in the temporoparietal cortex and in the ipsilateral medial temporal cortex (arrows) is evident.

View larger version (23K): [in a new window]   FIGURE 4. Scatter plots show the most significant EC correlations in NC and AD patients. (A) Correlations between percentage nrCMRgl values extracted from the left and right EC and the left and right inferior parietal lobule (IPL) in NC (diamonds). Note that the left and right EC both show bilateral significant correlations with the IPL. (B) Correlations between percentage nrCMRgl values extracted from the left and right EC and the left and right inferior temporal cortex (ITC) in AD patients (triangles). Note that in AD patients the left EC is related to the left ITC (R = 0.35) but not to the right ITC (R = 0.002; not significant) and vice versa, with the right EC correlated with the right ITC (R = 0.41) but not with the left ITC (R = 0.06; not significant), despite being, on the whole, the most related areas in AD. Regression models and correlation coefficients (R) are reported at the top of each graph.