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  Vol. 47 No. 7, July 1990 TABLE OF CONTENTS
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Longitudinal Study of Cerebral Metabolic Asymmetries and Associated Neuropsychological Patterns in Early Dementia of the Alzheimer Type

James V. Haxby, PhD; Cheryl L. Grady, PhD; Elisabeth Koss, PhD; Barry Horwitz, PhD; Leonard Heston, MD; Mark Schapiro, MD; Robert P. Friedland, MD; Stanley I. Rapoport, MD

Arch Neurol. 1990;47(7):753-760.


Abstract



• Regional cerebral metabolic rates for glucose (rCMRglc), as measured with positron emission tomography, and neuropsychological function were studied longitudinally (range, 15 to 48 months) in 11 mildly impaired patients with dementia of the Alzheimer type (DAT) and compared with results from patients with moderate and severe DAT and from controls. At initial evaluation, association cortex metabolic asymmetries were greater in patients with DAT than in controls for all dementia severities and correlated significantly with neuropsychological discrepancies between visuospatial and language abilities in patients with moderate dementia. In mildly imparied patients, right-left metabolic asymmetries in the association cortices were directionally stable and became more pronounced over time. At initial evaluation, these patients had significant impairment, relative to controls, on tests of memory and attention to complex tasks but not on tests of language and visuospatial function. Memory, attention, language, and visuospatial impairments, however, all worsened significantly over time. In mildly impaired patients, correlations between right-left metabolic asymmetries and neuropsychological discrepancies were insignificant initially but were significant at last evaluation. These results demonstrate that heterogeneous nonmemory language and visuospatial impairments in early DAT are related to and predicted by the earlier-appearing distribution of metabolic reductions in the association neocortex.



Author Affiliations



From the Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Md (Drs Haxby, Grady, Koss, Horwitz, Schapiro, Friedland, and Rapoport), and the Department of Psychiatry, University of Minnesota, Minneapolis (Dr Heston).


Footnotes



Accepted for publication December 11, 1989.

Reprint requests to Laboratory of Neurosciences, National Institute on Aging, Bldg 10, Room 6C414, National Institutes of Health, Bethesda, MD 20892 (Dr Haxby).



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