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Research ArticleClinical Investigations

Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project

Silvia Morbelli, Robert Perneczky, Alexander Drzezga, Giovanni B. Frisoni, Anna Caroli, Bart N.M. van Berckel, Rik Ossenkoppele, Eric Guedj, Mira Didic, Andrea Brugnolo, Mehrdad Naseri, Gianmario Sambuceti, Marco Pagani and Flavio Nobili
Journal of Nuclear Medicine June 2013, 54 (6) 894-902; DOI: https://doi.org/10.2967/jnumed.112.113928
Silvia Morbelli
1Nuclear Medicine, Department of Internal Medicine, IRCCS AOU San Martino–IST, University of Genoa, Genoa, Italy
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Robert Perneczky
2Department of Psychiatry and Psychotherapy, Technische Universität, Munich, Germany
3Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, Imperial College of Science, Technology, and Medicine, London, United Kingdom
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Alexander Drzezga
4Department of Nuclear Medicine, Technische Universität, Munich, Germany
5Department of Nuclear Medicine, University of Cologne, Cologne, Germany
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Giovanni B. Frisoni
6LENITEM Laboratory of Epidemiology and Neuroimaging-IRCCS S. Giovanni di Dio-FBF, Brescia, Italy
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Anna Caroli
6LENITEM Laboratory of Epidemiology and Neuroimaging-IRCCS S. Giovanni di Dio-FBF, Brescia, Italy
7Medical Imaging Unit, Biomedical Engineering Department, Mario Negri Institute, Bergamo, Italy
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Bart N.M. van Berckel
8Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
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Rik Ossenkoppele
8Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
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Eric Guedj
9Aix-Marseille University, CERIMED and CNRS, Marseille, France
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Mira Didic
10APHM, CHU Timone, Service de Neurologie et Neuropsychologie, Aix-Marseille University, INSERM U 1106, Marseille, France
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Andrea Brugnolo
11Clinical Neurophysiology, Department of Neuroscience, Ophthalmology, and Genetics, IRCCS AOU San Martino–IST, University of Genoa, Genoa, Italy
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Mehrdad Naseri
1Nuclear Medicine, Department of Internal Medicine, IRCCS AOU San Martino–IST, University of Genoa, Genoa, Italy
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Gianmario Sambuceti
1Nuclear Medicine, Department of Internal Medicine, IRCCS AOU San Martino–IST, University of Genoa, Genoa, Italy
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Marco Pagani
12Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy and
13Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
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Flavio Nobili
11Clinical Neurophysiology, Department of Neuroscience, Ophthalmology, and Genetics, IRCCS AOU San Martino–IST, University of Genoa, Genoa, Italy
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  • FIGURE 1.
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    FIGURE 1.

    Comparison between LE (A) and HE (B) prodromal AD patients and education-matched controls. Height significance threshold: P < 0.05, corrected for multiple comparisons (false discovery rate), at both peak and cluster levels. Figure displays regions of significant difference, color-graded in terms of z values. Talairach coordinates and further details are provided in Supplemental Table 2.

  • FIGURE 2.
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    FIGURE 2.

    Comparison between LE and HE prodromal AD patients. Height thresholds: uncorrected P < 0.001 at peak level; P < 0.05 FDR-corrected at cluster level. These 2 clusters were finally saved and used as ROIs, one with ROI depression (A, LE > HE) and another with ROI compensation (B, HE > LE). Talairach coordinates and further details are provided in Supplemental Table 2 and in Table 3.

  • FIGURE 3.
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    FIGURE 3.

    Voxelwise interregional correlation analysis of ROI depression in LE (A) and HE (B) prodromal AD patients. Talairach coordinates and further details are provided in Table 4.

  • FIGURE 4.
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    FIGURE 4.

    Interregional correlation analysis of ROI compensation in LE (A) and HE (B) prodromal AD patients. Talairach coordinates and further details are provided in Table 5.

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    FIGURE 5.

    Interregional correlation analysis of ROI compensation in LE (A) and HE (B) controls. Other figure details are provided in legend to Figure 2. Talairach coordinates and further details are provided in Supplemental Table 3.

  • FIGURE 6.
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    FIGURE 6.

    Point-by-point comparison of distribution of results of voxelwise interregional correlation analysis of ROI compensation in HE prodromal AD patient and HE control. Brain regions that significantly correlated with ROI compensation are superimposed on MR scan (yellow in HE prodromal AD patient and blue in HE control).

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    TABLE 1

    Patient and Control Characteristics

    CharacteristicHE control (n = 48)LE control (n = 42)HE prodromal AD (n = 28)LE prodromal AD (n = 36)
    Age (y)68.6 ± 6.565.4 ± 5.971.0 ± 8.373.5 ± 8.0
    Sex
     Men25141813
     Women23281023
    Education (y)14.4 ± 2.27.8 ± 1.915.1 ± 2.47.0 ± 1.0
    Follow-up (mo)16.1 ± 18.219.9 ± 17.124.3 ± 18.020.1 ± 14.0
    Baseline MMSE29.4 ± 1.029.1 ± 1.427.2 ± 1.326.9 ± 1.7
    Follow-up MMSE29.1 ± 1.229.0 ± 1.624.1 ± 2.223.9 ± 1.9
    • Data are mean ± SD.

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    TABLE 2

    Baseline Neuropsychologic z Scores of Patient Groups

    GroupHE prodromal AD (n = 28)LE prodromal AD (n = 36)P
    Immediate recall−1.83 ± 1.00−1.25 ± 0.99NS
    Delayed recall−2.06 ± 1.07−1.89 ± 0.74NS
    Visuoconstruction−0.53 ± 1.94−0.48 ± 1.76NS
    Verbal fluency−0.16 ± 1.060.47 ± 1.38NS
    Attention−0.51 ± 2.55−0.61 ± 2.01NS
    Executive function−1.35 ± 2.08−1.42 ± 1.10NS
    • NS = not significant.

    • Data are mean ± SD.

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    TABLE 3

    Results of 18F-FDG Brain PET Comparison Between HE and LE Prodromal AD Patients, with ROI Compensation

    Peak level
    Cluster levelTalairach coordinates
    AnalysisCluster extentCorrected PCortical regionMaximum z scorexyzCortical regionBA
    LE > HE1,4120.007L occipital4.4−42−74−10Fusiform gyrus19
    L temporal3.69−63−60−2Inferior temporal gyrus37
    L temporal3.25−50−7311Middle temporal gyrus39
    L occipital3.21−46−8110Middle occipital gyrus19
    L occipital3.06−26−841Middle occipital gyrus18
    HE > LE6930.046R frontal3.344835−3Inferior frontal gyrus47
    R frontal3.1550292Inferior frontal gyrus45
    R frontal3.01443820Middle frontal gyrus46
    R frontal2.850328Inferior frontal gyrus46
    R frontal2.77405316Superior frontal gyrus10
    R frontal2.683413−12Inferior frontal gyrus13
    R frontal2.63424916Middle frontal gyrus46
    R frontal2.5309−17Inferior frontal gyrus47
    • P values of <0.001 (uncorrected at voxel level) and <0.05 (FDR-corrected for multiple comparisons at cluster level) were accepted as statistically significant. In cluster level section, reported for each statistically significant cluster are number of voxels, corrected P value, and cortical region where cluster was found. In peak level section, reported for each significant cluster are z score, peak coordinates, corresponding cortical region, and BA.

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    TABLE 4

    Results of Interregional Correlation Analysis of ROI Depression in LE and HE Prodromal AD Patients

    Peak level
    Cluster levelTalairach coordinates
    AnalysisCluster extentCorrected PCortical regionMaximum z scorexyzCortical regionBA
    LE7310.045L occipital3.72−48−779Middle occipital gyrus19
    L temporal3.68−57−645Middle temporal gyrus37
    L temporal3.61−42−51−11Fusiform gyrus37
    R occipital3.504−8634Cuneus19
    R occipital3.446−9623Cuneus18
    R occipital3.2220−7433Cuneus7
    HE6780.03L temporal4.32−61−62−5Inferior temporal gyrus37
    L temporal3.88−50−76−3Inferior temporal gyrus19
    L temporal3.64−48−7317Middle temporal gyrus39
    L occipital3.30−44−7626Superior occipital gyrus19
    • P values of <0.001 (uncorrected at voxel level) and <0.05 (FDR-corrected for multiple comparisons at cluster level) were accepted as statistically significant. In cluster level section, reported for each statistically significant cluster are number of voxels, corrected P value, and cortical region where cluster was found. In peak level section, reported for each significant cluster are z score, peak coordinates, corresponding cortical region, and BA.

    • View popup
    TABLE 5

    Results of Interregional Correlation Analysis of ROI Compensation in LE and HE Prodromal AD Patients

    Peak level
    Cluster levelTalairach coordinates
    AnalysisCluster extentCorrected PCortical regionMaximum z scorexyzCortical regionBA
    LE1,2860.026R frontal4.312228−18Middle frontal gyrus11
    R frontal4.233030−15Inferior frontal gyrus47
    R frontal4.121817−11Subcallosal gyrus47
    R frontal4.152286Inferior frontal gyrus45
    R frontal3.97424916Middle frontal gyrus46
    R frontal3.954829−2Inferior frontal gyrus45
    R frontal3.946414Inferior frontal gyrus46
    R frontal3.873831−12Inferior frontal gyrus47
    R limbic3.81834−12Anterior cingulate32
    HE11,3030.0001L frontal17.2−50313Precentral gyrus44
    L occipital16−16−682Lingual gyrus18
    R frontal15.930−1347Middle frontal gyrus6
    R frontal15.636−837Precentral gyrus6
    R frontal14.3221649Superior frontal gyrus8
    L limbic8.84−18−47−4Parahippocampal gyrus19
    L temporal8.22−408−31Superior temporal gyrus38
    L temporal5.61−61−37−8Middle temporal gyrus21
    L temporal5.39−63−24−21Inferior temporal gyrus20
    L parietal5.12−20−4652Precuneus7
    L parietal4.96−18−4736Precuneus31
    R temporal4.9055−21−23Fusiform gyrus20
    R temporal4.8059−11−18Inferior temporal gyrus21
    R frontal4.78105421Superior frontal gyrus9
    R frontal4.4223337Middle frontal gyrus8
    L sublobar3.96−3010−2Claustrum
    R temporal3.784817−13Superior temporal gyrus38
    2,0000.003L cerebellum14.6−36−54−36Cerebellar tonsil
    • P values of <0.001 (uncorrected at voxel level) and <0.05 (FDR-corrected for multiple comparisons at cluster level) were accepted as statistically significant. In cluster level section, reported for each statistically significant cluster are number of voxels, corrected P value, and cortical region where cluster was found. In peak level section, reported for each significant cluster are z score, peak coordinates, corresponding cortical region, and BA.

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Journal of Nuclear Medicine: 54 (6)
Journal of Nuclear Medicine
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Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project
Silvia Morbelli, Robert Perneczky, Alexander Drzezga, Giovanni B. Frisoni, Anna Caroli, Bart N.M. van Berckel, Rik Ossenkoppele, Eric Guedj, Mira Didic, Andrea Brugnolo, Mehrdad Naseri, Gianmario Sambuceti, Marco Pagani, Flavio Nobili
Journal of Nuclear Medicine Jun 2013, 54 (6) 894-902; DOI: 10.2967/jnumed.112.113928

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Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project
Silvia Morbelli, Robert Perneczky, Alexander Drzezga, Giovanni B. Frisoni, Anna Caroli, Bart N.M. van Berckel, Rik Ossenkoppele, Eric Guedj, Mira Didic, Andrea Brugnolo, Mehrdad Naseri, Gianmario Sambuceti, Marco Pagani, Flavio Nobili
Journal of Nuclear Medicine Jun 2013, 54 (6) 894-902; DOI: 10.2967/jnumed.112.113928
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  • Alzheimer’s disease
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