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Effects of a 6-month cognitive intervention on brain metabolism in patients with amnestic MCI and mild Alzheimer’s disease

Authors

Förster, Stefan, Buschert, Verena C., Teipel, Stefan J., Friese, Uwe, Buchholz, Hans-Georg, Drzezga, Alexander, Hampel, Harald, Bartenstein, Peter, Buerger, Katharina

Journal

Journal Of Alzheimer's Disease: JAD, Volume: 26 Suppl 3, Pages.: 337-348

Year of Publication

2011

Abstract

The effect of cognitive intervention on brain metabolism in AD is largely unexplored. Therefore, we aimed to investigate cognitive parameters and 18FDG PET to test for effects of a cognitive intervention in patients with aMCI or mild AD. Patients with aMCI (N = 24) or mild AD (N = 15) were randomly assigned either to cognitive intervention groups (IGs), receiving weekly sessions of group-based multicomponent cognitive intervention, or active control groups (CGs), receiving pencil-paper exercises for self-study. We obtained resting-state FDG-PET scans and neuropsychological testing at baseline and after six-months. Normalized FDG-PET images were analyzed using voxel-based SPM5 approaches to determine longitudinal changes, group-by-time interactions and correlations with neuropsychological outcome parameters. Primary global cognitive outcome was determined by analyses of covariance with MMSE and ADAS-cog scores as dependent measures. Both, aMCI and AD subgroups of CGs showed widespread bilateral cortical declines in FDG uptake, while the AD subgroup of IGs showed discrete decline or rather no decline in case of the aMCI subgroup. Group by time analyses revealed strongest attenuation of metabolic decline in the aMCI subgroup of the IGs, involving left anterior temporal pole and anterior cingulate gyrus. However, correlation analyses revealed only weak non-significant associations between increased FDG uptake and improvement in primary or secondary outcome parameters. Concurrently, there was significant improvement in global cognitive status in the aMCI subgroup of the IGs. A six-month cognitive intervention imparted cognitive benefits in patients with aMCI, which were concurrent with an attenuated decline of glucose metabolism in cortical regions affected by neurodegenerative AD.;

Keywords

aged, aged, 80 and over, alzheimer disease, amnesia, brain mapping, cerebral cortex, cognitive therapy, complications, diagnostic use, etiology, female, fluorodeoxyglucose f18, humans, male, metabolism, methods, middle aged, mild cognitive impairment, neuropsychological tests, pathology, radionuclide imaging, rehabilitation, treatment outcome

Countries of Study

Germany

Types of Dementia

Alzheimer’s Disease, Mild Cognitive Impairment (MCI)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Cognition

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Adult safeguarding and abuse detection/prevention