KMID : 0311120190600100935
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Yonsei Medical Journal 2019 Volume.60 No. 10 p.935 ~ p.943
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Distinct Neural Correlates of Executive Function by Amyloid Positivity and Associations with Clinical Progression in Mild Cognitive Impairment
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Yoon Hyung-Jun
Kim Seung-Gon Kim Sang-Hoon Choo Il-Han Park Sang-Hag Seo Eun-Hyun
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Abstract
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Purpose: This study aimed to identify the neural basis of executive function (EF) in amnestic mild cognitive impairment (aMCI) according to beta-amyloid (A¥â) positivity. Furthermore, we explored if the identified brain areas could serve as predictors for clinical progression.
Materials and Methods: We included individuals with aMCI using data from [18F]-florbetapir-positron emission tomography (PET), fluorodeoxyglucose-PET, and EF scores, as well as follow-up clinical severity scores at 1 and 5 years from baseline from the Alzheimer's Disease Neuroimaging Initiative database. The correlations between EF score and regional cerebral glucose metabolism (rCMglc) were analyzed separately for aMCI with low A¥â burden (aMCI A¥â?, n=230) and aMCI with high A¥â burden (aMCI A¥â+, n=268). Multiple linear regression analysis was conducted to investigate the associations between rCMglc and clinical progression.
Results: Longitudinal courses differed between aMCI A¥â? and aMCI A¥â+ groups. On average, aMCI A¥â? subjects maintained their level of clinical severity, whereas aMCI A¥â+ subjects showed progression. EF impairment in aMCI A¥â? was related to the anterior cingulate cortex (ACC), whereas that in aMCI A¥â+ was related to Alzheimer's Disease-vulnerable brain regions. ACC and the posterior cingulate cortex were associated with clinical progression in aMCI A¥â? and aMCI A¥â+, respectively.
Conclusion: Our findings suggest that although MCI subjects showed similar behavioral phenotypes at the time of diagnosis, EF and further progression were associated with different brain regions according to A¥â burden. Clarification of the etiologies and nature of EF impairment in aMCI are critical for disease prognosis and management.
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KEYWORD
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Mild cognitive impairment, amyloid, cognitive function, anterior cingulate cortex, posterior cingulate cortex, positron emission tomography
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