News | June 05, 2013

PET Finds Increased Cognitive Reserve Levels in Highly Educated Pre-Alzheimer’s Patients

Neural reserve and neural compensation were both shown to play a role in determining cognitive reserve

June 5, 2013 — Highly educated individuals with mild cognitive impairment that later progressed to Alzheimer’s disease cope better with the disease than individuals with a lower level of education in the same situation, according to research published in The Journal of Nuclear Medicine. In the study, “Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project,” neural reserve and neural compensation were both shown to play a role in determining cognitive reserve, as evidenced by positron emission tomography (PET).

Cognitive reserve refers to the hypothesized capacity of an adult brain to cope with brain damage in order to maintain a relatively preserved functional level. Understanding the brain adaptation mechanisms underlying this process remains a critical question, and researchers of this study sought to investigate the metabolic basis of cognitive reserve in individuals with higher (more than 12 years) and lower (less than 12 years) levels of education who had mild cognitive impairment that progressed to Alzheimer’s disease, also known as prodromal Alzheimer’s disease.

“This study provides new insight into the functional mechanisms that mediate the cognitive reserve phenomenon in the early stages of Alzheimer’s disease,” said Silvia Morbelli, M.D., lead author of the study.  “A crucial role of the dorso-lateral prefrontal cortex was highlighted by demonstrating that this region is involved in a wide fronto-temporal and limbic functional network in patients with Alzheimer’s disease and high education, but not in poorly educated Alzheimer’s disease patients.”

In the study, 64 patients with prodromal Alzheimer’s disease and 90 control subjects — coming from the brain PET project of the European Alzheimer Disease Consortium — underwent brain 18F-FDG PET scans. Individuals were divided into a subgroup with a low level of education (42 controls and 36 prodromal Alzheimer’s disease patients) and a highly educated subgroup (40 controls and 28 prodromal Alzheimer’s disease patients). Brain metabolism was compared between education-matched groups of patients and controls, and then between highly and poorly educated prodromal Alzheimer’s disease patients.

Higher metabolic activity was shown in the dorso-lateral prefrontal cortex for prodromal Alzheimer’s disease patients. More extended and significant correlations of metabolism within the right dorso-lateral prefrontal cortex and other brain regions were found with highly educated than less educated prodromal Alzheimer’s disease patients or even highly educated controls.

This result suggests that neural reserve and neural compensation are activated in highly educated prodromal Alzheimer’s disease patients. Researchers concluded that evaluation of the implication of metabolic connectivity in cognitive reserve further confirms that adding a comprehensive evaluation of resting 18F-FDG PET brain distribution to standard inspection may allow a more complete comprehension of Alzheimer’s disease pathophysiology and possibly may increase 18F-FDG PET diagnostic sensitivity.

“This work supports the notion that employing the brain in complex tasks and developing our own education may help in forming stronger ‘defenses’ against cognitive deterioration once Alzheimer’s knocks at our door,” said Morbelli. “It’s possible that, in the future, a combined approach evaluating resting metabolic connectivity and cognitive performance can be used on an individual basis to better predict cognitive decline or response to disease-modifying therapy.”

For more information: jnm.snmjournals.org

Related Content

PET Imaging Agent Predicts Brain Tau Pathology, Alzheimer's Diagnosis
News | PET Imaging | September 05, 2018
Eli Lilly and Co. and Avid Radiopharmaceuticals Inc. announced a Phase 3 study of positron emission tomography (PET)...
Abnormal Protein Concentrations Found in Brains of Military Personnel With Suspected CTE

Researchers are using the tracer, which is injected into a patient, then seen with a PET scan, to see if it is possible to diagnose chronic traumatic encephalopathy in living patients. In this image, warmer colors indicate a higher concentration of the tracer, which binds to abnormal proteins in the brain. Credit UCLA Health.

News | PET Imaging | August 24, 2018
August 24, 2018 — In a small study of
PET Tracer Identifies Estrogen Receptor Expression Differences in Breast Cancer Patients
News | PET Imaging | August 09, 2018
In metastatic breast cancer, prognosis and treatment is largely influenced by estrogen receptor (ER) expression of the...
Novel PET Imaging Method Could Track and Guide Type 1 Diabetes Therapy
News | PET Imaging | August 03, 2018
Researchers have discovered a new nuclear medicine test that could improve care of patients with type 1 diabetes. The...
Researchers Trace Parkinson’s Damage in the Heart
News | PET Imaging | July 17, 2018
A new way to examine stress and inflammation in the heart will help Parkinson’s researchers test new therapies and...
Siemens Healthineers Announces FDA Clearance of syngo.via VB30 Molecular Imaging Software
Technology | Nuclear Imaging | July 16, 2018
At the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), June 23-26 in Philadelphia...
SNMMI Image of the Year Highlights Theranostic Approach for Advanced Prostate Cancer

IMAGE OF THE YEAR: PSMA PET before and after lutetium-177 PSMA617 theranostics in 8 patients with metastatic prostate cancer who exhausted standard therapeutic options.

68Ga-PSMA11 PET maximum intensity projection (MIP) images at baseline and 3 months after 177Lu-PSMA617 in 8 patients with PSA decline ≥ 98 percent in a prospective phase II study. Any disease with SUV over 3 is in red. Credit: Michael Hofman, John Violet, Shahneen Sandhu, Justin Ferdinandus, Amir Iravani, Grace Kong, Aravind Ravi Kumar, Tim Akhurst, Sue Ping Thang, Price Jackson, Mark Scalzo, Scott Williams and Rodney Hicks, Peter MacCallum Cancer Centre, Melbourne, Australia.

News | PET Imaging | June 29, 2018
In the battle against metastatic castrate-resistant prostate cancer, studies have demonstrated a high response rate to...
MILabs Introduces Futuristic PET Capabilities on New VECTor6 System
Technology | PET Imaging | June 28, 2018
At the 2018 Society of Nuclear Medicine and Molecular Imaging (SNMMI) annual meeting, June 23-26, in Philadelphia,...
Philips North America and GE Healthcare Win IMV PET Imaging ServiceTrak Awards
News | PET Imaging | June 25, 2018
IMV, part of the Science and Medicine Group and a market research and business intelligence provider to the imaging...
FDA Clears New Imaging Functionalities for Biograph mCT PET/CT Systems
Technology | PET-CT | June 21, 2018
Siemens Healthineers will announce U.S. Food and Drug Administration (FDA) clearance of four new system features for...