1. Fluoro-Deoxy-Glucose Positron Emission Tomography Correlates of Impaired Activities of Daily Living in Dementia With Lewy Bodies: Implications for Cognitive Reserve
- Author
-
Robert Perneczky, Henning Boecker, Hans Förstl, Alexander Drzezga, Peter Haussermann, Alexander Kurz, Regina Feurer, and Oliver Granert
- Subjects
Blood Glucose ,Lewy Body Disease ,Male ,medicine.medical_specialty ,Activities of daily living ,Neural substrate ,Brain damage ,Neuropsychological Tests ,Audiology ,Cognition ,Fluorodeoxyglucose F18 ,Activities of Daily Living ,Image Processing, Computer-Assisted ,medicine ,Humans ,Dementia ,Aged ,Cognitive reserve ,Aged, 80 and over ,Dementia with Lewy bodies ,Brain ,Middle Aged ,medicine.disease ,Brodmann area 19 ,Psychiatry and Mental health ,Positron-Emission Tomography ,Educational Status ,Regression Analysis ,Female ,Radiopharmaceuticals ,Geriatrics and Gerontology ,medicine.symptom ,Psychology ,Neuroscience - Abstract
Objectives 1) To investigate the neural substrate of impaired activities of daily living (ADL) in dementia with Lewy bodies (DLB) and 2) to explore, in the context of cognitive reserve, if hypometabolism was more pronounced in well-educated patients at the same level of everyday impairment. Methods Twenty-one patients with DLB underwent an extensive clinical evaluation including cerebral positron emission tomography with 18 F-fluoro-2-deoxy-glucose scanning. First, brain areas were identified, where ADL performance and glucose metabolism were significantly correlated, controlling for individual differences in cognitive and motor dysfunction. Second, it was tested if there was a significant negative association between metabolism and years of education in brain regions associated with ADL performance. Again, a correction for cognitive and motor impairment was deployed. Results There was a significant association between glucose hypometabolism and impaired ADL performance in an extensive brain cluster located in the right temporoparietal cortex. Furthermore, schooling and metabolic rate were inversely associated in the right Brodmann area 19, controlling for ADL performance. Conclusions The study suggests that 1) certain brain metabolic alterations are specifically associated with the loss of everyday competence, even if differences in cognition and motor function are taken into consideration and 2) well-educated patients can offset more brain damage until reaching the same degree of ADL impairment as their less educated counterparts. These results extend the literature on cognitive reserve to a region-specific effect on ADL performance.
- Published
- 2009
- Full Text
- View/download PDF