- Executive function
- Non-amnestic mild cognitive impairment
- Dysexecutive mild cognitive impairment
Background/Aims: There are few studies that evaluate the clinical outcomes of individuals with non-amnestic mild cognitive impairment (MCI). The purpose of this study was to evaluate baseline predictors of clinical progression after 2 years for patients with dysexecutive MCI (dMCI), a single-domain non-amnestic MCI subgroup. Methods:We evaluated clinical progression in a sample of 31 older adults with dMCI. Clinical progression was defined as a worsening on the Clinical Dementia Rating sum of boxes at the 2-year visit, whereas patients were classified as stable if the score did not worsen over 2 years. We compared baseline brain MRI, neuropsychological tests, and health risk factors. Results: Twelve individuals with dMCI progressed clinically, and 19 individuals remained stable over 2 years. Compared to the stable dMCI patients, the dMCI patients who progressed showed brain atrophy in the bilateral insula and left lateral temporal lobe on MRI. dMCI patients who progressed were also older, had lower baseline performance on category fluency and a spatial location task, and reported fewer dysexecutive symptoms. Health risk factors, except hypertension, did not differ between groups. Conclusion: The results suggest that dMCI patients who progress relatively quickly over 2 years may have unique clinical and brain MRI features.
Copyright © 2010 S. Karger AG, Basel
- Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Duijn C, Visser P, Petersen RC: Mild cognitive impairment – Beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240–246.
- Busse A, Hensel A, Guhne U, Angermeyer MC, Riedel-Heller SG: Mild cognitive impairment: long-term course of four clinical subtypes. Neurology 2006;67:2176–2185.
- Palmer K, Backman L, Winblad B, Fratiglioni L: Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. Am J Geriatr Psychiatry 2008;16:603–611.
- Busse A, Bischkopf J, Riedel-Heller SG, Angermeyer MC: Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). Br J Psychiatry 2003;182:449–454.
- Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E, Krampla W, Tragl KH: Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology 2007;68:288–291.
- Yaffe K, Petersen RC, Lindquist K, Kramer J, Miller B: Subtype of mild cognitive impairment and progression to dementia and death. Dement Geriatr Cogn Disord 2006;22:312–319.
- Pa J, Boxer A, Chao LL, Gazzaley A, Freeman K, Kramer J, Miller BL, Weiner MW, Neuhaus J, Johnson JK: Clinical-neuroimaging characteristics of dysexecutive mild cognitive impairment. Ann Neurol 2009;65:414–423.
- Petersen RC: Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194.
- Kramer JH, Jurik J, Sha SJ, Rankin KP, Rosen HJ, Johnson JK, Miller BL: Distinctive neuropsychological patterns in frontotemporal dementia, semantic dementia, and Alzheimer disease. Cogn Behav Neurol 2003;16:211–218.
- Berg L: Clinical Dementia Rating Scale (CDR). Psychopharmacol Bull 1988;24:637–639.
- Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
- Yesavage JA, Brink TL, Rolse TL, Lum O, Huang V, Adey M, Leiter VO: Development and validity of a Geriatric Depression Scale: a preliminary report. J Psychiatr Res 1983;17:37–49.
- Delis DC, Kramer JH, Kaplan E, Ober BA: California Verbal Learning Test. San Antonio, The Psychological Corporation, 2000.
- Warrington EK, James M: The Visual Object and Space Perception Battery. Bury St Edmunds, Thames Valley Test Company, 1991.
- Wechsler D: Wechsler Adult Intelligence Scale. San Antonio, The Psychological Corporation, 1997.
- Jak AJ, Bangen KJ, Wierenga CE, Delano-Wood L, Corey-Bloom J, Bondi MW: Contributions of neuropsychology and neuroimaging to understanding clinical subtypes of mild cognitive impairment. Int Rev Neurobiol 2009;84:81–103.
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
- Longstreth WT Jr, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, Enright PL, O’Leary D, Fried L: Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 1996;27:1274–1282.
- Burgess PW, Alderman N, Evans J, Emslie H, Wilson BA: The ecological validity of tests of executive function. J Int Neuropsychol Soc 1998;4:547–558.
- Pfeffer RI, Kurosaki TT, Harrah CH Jr, Chance JM, Filos S: Measurement of functional activities in older adults in the community. J Gerontol 1982;37:323–329.
- Beekly DL, Ramos EM, Lee WW, Deitrich WD, Jacka ME, Wu J, Hubbard JL, Koepsell TD, Morris JC, Kukull WA: The National Alzheimer’s Coordinating Center (NACC) database: the Uniform Data Set. Alzheimer Dis Assoc Disord 2007;21:249–258.
- Rosen WG, Terry RD, Fuld PA, Katzman R, Peck A: Pathological verification of ischaemic score in differentiation of the dementias. Ann Neurol 1980;7:486–488.
- Torralva T, Roca M, Gleichgerrcht E, Lopez P, Manes F: INECO Frontal Screening (IFS): a brief, sensitive, and specific tool to assess executive functions in dementia. J Int Neuropsychol Soc 2009;15:777–786.
- Morris JC: The Clinical Dementia Rating (CDR): current version and scoring rules [see comments]. Neurology 1993;43:2412–2414.
- Ashburner J, Friston KJ: Unified segmentation. Neuroimage 2005;26:839–851.
- Rusch N, Spoletini I, Wilke M, Bria P, Di Paola M, Di Iulio F, Martinotti G, Caltagirone C, Spalletta G: Prefrontal-thalamic-cerebellar gray matter networks and executive functioning in schizophrenia. Schizophr Res 2007;93:79–89.
- Salmond CH, Ashburner J, Vargha-Khadem F, Connelly A, Gadian DG, Friston KJ: Distributional assumptions in voxel-based morphometry. Neuroimage 2002;17:1027–1030.
- McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, Cummings J, Duda JE, Lippa C, Perry EK, Aarsland D, Arai H, Ballard CG, Boeve B, Burn DJ, Costa D, Del Ser T, Dubois B, Galasko D, Gauthier S, Goetz CG, Gomez-Tortosa E, Halliday G, Hansen LA, Hardy J, Iwatsubo T, Kalaria RN, Kaufer D, Kenny RA, Korczyn A, Kosaka K, Lee VM, Lees A, Litvan I, Londos E, Lopez OL, Minoshima S, Mizuno Y, Molina JA, Mukaetova-Ladinska EB, Pasquier F, Perry RH, Schulz JB, Trojanowski JQ, Yamada M: Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 2005;65:1863–1872.
- Burton EJ, Karas G, Paling SM, Barber R, Williams ED, Ballard CG, McKeith IG, Scheltens P, Barkhof F, O’Brien JT: Patterns of cerebral atrophy in dementia with Lewy bodies using voxel-based morphometry. Neuroimage 2002;17:618–630.
- Risacher SL, Saykin AJ, West JD, Shen L, Firpi HA, McDonald BC: Baseline MRI predictors of conversion from MCI to probable AD in the ADNI cohort. Curr Alzheimer Res 2009;6:347–361.
- Burton EJ, Barber R, Mukaetova-Ladinska EB, Robson J, Perry RH, Jaros E, Kalaria RN, O’Brien JT: Medial temporal lobe atrophy on MRI differentiates Alzheimer’s disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis. Brain 2009;132:195–203.
- Karas G, Sluimer J, Goekoop R, van der Flier W, Rombouts SA, Vrenken H, Scheltens P, Fox N, Barkhof F: Amnestic mild cognitive impairment: structural MR imaging findings predictive of conversion to Alzheimer disease. AJNR Am J Neuroradiol 2008;29:944–949.
- Hamalainen A, Tervo S, Grau-Olivares M, Niskanen E, Pennanen C, Huuskonen J, Kivipelto M, Hanninen T, Tapiola M, Vanhanen M, Hallikainen M, Helkala EL, Nissinen A, Vanninen R, Soininen H: Voxel-based morphometry to detect brain atrophy in progressive mild cognitive impairment. Neuroimage 2007;37:1122–1131.
- Chetelat G, Landeau B, Eustache F, Mezenge F, Viader F, de la Sayette V, Desgranges B, Baron JC: Using voxel-based morphometry to map the structural changes associated with rapid conversion in MCI: a longitudinal MRI study. Neuroimage 2005;27:934–946.
- Albert MS, Moss MB, Tanzi R, Jones K: Preclinical prediction of AD using neuropsychological tests. J Int Neuropsychol Soc 2001;7:631–639.
- Backman L, Jones S, Berger AK, Laukka EJ, Small BJ: Cognitive impairment in preclinical Alzheimer’s disease: a meta-analysis. Neuropsychology 2005;19:520–531.
- Lambon Ralph MA, Powell J, Howard D, Whitworth AB, Garrard P, Hodges JR: Semantic memory is impaired in both dementia with Lewy bodies and dementia of Alzheimer’s type: a comparative neuropsychological study and literature review. J Neurol Neurosurg Psychiatry 2001;70:149–156.
- Rascovsky K, Salmon DP, Ho GJ, Galasko D, Peavy GM, Hansen LA, Thal LJ: Cognitive profiles differ in autopsy-confirmed frontotemporal dementia and AD. Neurology 2002;58:1801–1808.
- Bak TH, Crawford LM, Hearn VC, Mathuranath PS, Hodges JR: Subcortical dementia revisited: similarities and differences in cognitive function between progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy (MSA). Neurocase 2005;11:268–273.
- Molano J, Boeve B, Ferman T, Smith G, Parisi J, Dickson D, Knopman D, Graff-Radford N, Geda Y, Lucas J, Kantarci K, Shiung M, Jack C, Silber M, Pankratz VS, Petersen R: Mild cognitive impairment associated with limbic and neocortical Lewy body disease: a clinicopathological study. Brain, 133:540–556.
- Ries ML, Jabbar BM, Schmitz TW, Trivedi MA, Gleason CE, Carlsson CM, Rowley HA, Asthana S, Johnson SC: Anosognosia in mild cognitive impairment: relationship to activation of cortical midline structures involved in self-appraisal. J Int Neuropsychol Soc 2007;13:450–461.
- Vogel A, Hasselbalch SG, Gade A, Ziebell M, Waldemar G: Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer’s disease. Int J Geriatr Psychiatry 2005;20:238–246.
- Mitchell AJ, Shiri-Feshki M: Rate of progression of mild cognitive impairment to dementia – Meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand 2009;119:252–265.
- Johnson JK: Mild cognitive impairment subgroups; in Miller BL, Boeve BF (eds): The Behavioral Neurology of Dementia. Cambridge, Cambridge University Press, 2009.
- Whitwell JL, Petersen RC, Negash S, Weigand SD, Kantarci K, Ivnik RJ, Knopman DS, Boeve BF, Smith GE, Jack CR Jr.: Patterns of atrophy differ among specific subtypes of mild cognitive impairment. Arch Neurol 2007;64:1130–1138.
- Johnson JK, Vogt BA, Kim R, Cotman CW, Head E: Isolated executive impairment and associated frontal neuropathology. Dement Geriatr Cogn Disord 2004;17:360–367.
- Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Pantieri G, Mariani E: Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors. Dement Geriatr Cogn Disord 2006;21:51–58.
- Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M: Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke 2002;33:1981–1985.
Julene K. Johnson, PhD
UCSF Institute for Health and Aging
3333 California St., Suite 340
San Francisco, CA 94148 (USA)
Tel. +1 415 476 1106, Fax +1 415 502 5208, E-Mail Julene.Johnson@ucsf.edu
Published online: October 12, 2010
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 4, Number of References : 48
Dementia and Geriatric Cognitive Disorders
Vol. 30, No. 4, Year 2010 (Cover Date: October 2010)
Journal Editor: Chan-Palay V. (New York, N.Y.)
ISSN: 1420-8008 (Print), eISSN: 1421-9824 (Online)
For additional information: http://www.karger.com/DEM
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