Heading Disorientation in Amnestic Mild Cognitive Impairment is Correlated with Hypometabolism in the Posterior Cingulate Cortex

INTRODUCTION: A lesional study showed that three patients with right retrosplenial lesions had intact performance in the part A of the card-placing test (CPT) but impaired performance in the part B of the CPT. It was insisted that the part A of the CPT assesses egocentric disorientation whereas part B examines heading disorientation. However, the test has not yet been used in any larger population. In addition, neural substrates of the test have not yet been replicated in other studies. In our study, using statistical parametric mapping (SPM) analysis we aimed to investigate anatomical correlates of both part A and B of the CPT in FDG-PET studies of patients with amnestic mild cognitive impairment (aMCI). METHODS: A total of 15 aMCI patients were enrolled into the study. Patients underwent standardized neuropsychological tests and part A and part B of the CPT. The CPT scores and K-MMSE scores of 29 cognitively normal people were used for comparison. FDG-PET was performed in the same patients. We used the SPM correlation analysis to extract the regions whose changes in regional cerebral metabolism correlated significantly with part A and B of the CPT with adjustment of age and sex of patients. RESULTS: Controlling for age, sex, and education years, the K-MMSE score and CPT B score was significantly lower in the aMCI group (26.0±2.0 vs. 28.2±1.4, p<0.001, and 16.3±4.4 vs. 19.7±3.7, p=0.011). However, CPT A scores did not significantly differ between the two groups (25.5±3.5 vs. 27.7±2.7, p=0.055). The SPM analysis showed that decrease in scores of part A correlated with hypometabolism in bilateral precuneus, posterior cingulate gyri, right crus cerebelli, cerebellar vermis, right anterior and middle cingulate gyri, right superior and middle frontal gyri, left inferior parietal region, and the left angular gyrus. (uncorrected p<0.05). Decrease in scores of part B correlated with hypometabolism in bilateral precuneus, middle and posterior cingulate gyri (uncorrected p<0.005). CONCLUSION: The test scores of part B of the card placing test correlated well with hypometabolism of the posterior cingulate gyrus and its surrounding areas whereas part A correlated with hypometabolism in more various areas. Normal part A but impaired performance in the part B of the CPT may reflect dysfunction of the posterior cingulate gyrus and predict aMCI patients at risk of progression to Alzheimer’s disease.

Author dc:creator

• 이, 성준

Contributors dc:contributor

• 문, 소영
• 대학원 의학과
• 106853

• Heading disorientation
• topographical disorientation
• card placing test
• mild cognitive impairment
• Alzheimer disease
• posterior cingulate cortex

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013571
000000013571

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8633