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Neural correlates of the components of the clock drawing test

Published online by Cambridge University Press:  16 May 2013

Teruyuki Matsuoka ,
Jin Narumoto ,
Aiko Okamura ,
Shogo Taniguchi ,
Yuka Kato ,
Keisuke Shibata ,
Kaeko Nakamura ,
Chio Okuyama ,
Kei Yamada  and
Kenji Fukui
Teruyuki Matsuoka*
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Jin Narumoto
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Aiko Okamura
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Shogo Taniguchi
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Yuka Kato
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Keisuke Shibata
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Kaeko Nakamura
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Chio Okuyama
Affiliation:
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Kei Yamada
Affiliation:
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Kenji Fukui
Affiliation:
Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
*
Correspondence should be addressed to: Dr. Teruyuki Matsuoka, Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. Phone: +81-75-2515612; Fax: +81-75-2515839. Email: tmms2004@koto.kpu-m.ac.jp.
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Abstract

Background: The aim of this study was to identify the neural correlates of each component of the clock drawing test (CDT) in drug-naïve patients with Alzheimer's disease (AD) using single photon emission computed tomography.

Methods: The participants were 95 drug-naïve patients with AD. The Rouleau CDT was used to score the clock drawings. The score for the Rouleau CDT (R total) is separated into three components: the scores for the clock face (R1), the numbers (R2), and the hands (R3). A multiple regression analysis was performed to examine the relationship of each score (i.e. R total, R1, R2, and R3) with regional cerebral blood flow (rCBF). Age, gender, and education were included as covariates. The statistical threshold was set to a family-wise error (FWE)-corrected p value of 0.05 at the voxel level.

Results: The R total score was positively correlated with rCBF in the bilateral parietal and posterior temporal lobes and the right middle frontal gyrus. R1 was not significantly positively correlated with rCBF, R2 was significantly positively correlated with rCBF in the right posterior temporal lobe and the left posterior middle temporal lobe, and R3 was significantly positively correlated with rCBF in the bilateral parietal lobes, the right posterior temporal lobe, the right middle frontal gyrus, and the right occipital lobe.

Conclusions: Various brain regions were associated with each component of the CDT. These results suggest that an assessment of these components is useful for the detection of localization of brain damage.

Keywords

clock drawing testAlzheimer's diseasesingle photon emission computed tomographystatistical parametric mapping 8drug-naïve patients
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 8: Elder abuse an international perspective , August 2013 , pp. 1317 - 1323
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Blair, M., Kertesz, A., Mcmonagle, P., Davidson, W. and Bodi, N. (2006). Quantitative and qualitative analyses of clock drawing in frontotemporal dementia and Alzheimer's disease. Journal of the International Neuropsychological Society, 12, 159–165.CrossRefGoogle ScholarPubMed
Bonelli, R. M. and Cummings, J. L. (2007). Frontal-subcortical circuitry and behavior. Dialogues in Clinical Neuroscience, 9, 141–151.CrossRefGoogle ScholarPubMed
Brodaty, H. and Moore, C. M. (1997). The clock drawing test for dementia of the Alzheimer's type: a comparison of three scoring methods in a memory disorders clinic. International Journal of Geriatric Psychiatry, 12, 619–627.3.0.CO;2-H>CrossRefGoogle Scholar
Brugnolo, A.et al. (2010). The reversed clock drawing test phenomenon in Alzheimer's disease: a perfusion SPECT study. Dementia and Geriatric Cognitive Disorders, 29, 1–10.CrossRefGoogle ScholarPubMed
Chen, Q., Marshall, J. C., Weidner, R. and Fink, G. R. (2009). Zooming in and zooming out of the attentional focus: an FMRI study. Cerebral Cortex, 19, 805–819.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and Mchugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Freedman, M., Leach, L., Kaplan, E., Winocur, G., Shulman, K. I. and Delis, D. C. (1994). Clock Drawing: A Neuropsychological Analysis. New York: Oxford University Press.Google Scholar
Ino, T., Asada, T., Ito, J., Kimura, T. and Fukuyama, H. (2003). Parieto-frontal networks for clock drawing revealed with fMRI. Neuroscience Research, 45, 71–77.CrossRefGoogle ScholarPubMed
Jouk, A. and Tuokko, H. (2012). A reduced scoring system for the clock drawing test using a population-based sample. International Psychogeriatrics, 24, 1738–1748.CrossRefGoogle ScholarPubMed
Kellenbach, M. L., Brett, M. and Patterson, K. (2001). Large, colorful, or noisy? Attribute- and modality-specific activations during retrieval of perceptual attribute knowledge. Cognitive, Affective, and Behavioral Neuroscience, 1, 207–221.CrossRefGoogle ScholarPubMed
Kitabayashi, Y., Ueda, H., Narumoto, J., Nakamura, K., Kita, H. and Fukui, K. (2001). Qualitative analyses of clock drawings in Alzheimer's disease and vascular dementia. Psychiatry and Clinical Neurosciences, 55, 485–491.CrossRefGoogle ScholarPubMed
Lee, D. Y.et al. (2008a). Neural correlates of the clock drawing test performance in Alzheimer's disease: a FDG-PET study. Dementia and Geriatric Cognitive Disorders, 26, 306–313.CrossRefGoogle ScholarPubMed
Lee, K. S., Kim, E. A., Hong, C. H., Lee, D. W., Oh, B. H. and Cheong, H. K. (2008b). Clock drawing test in mild cognitive impairment: quantitative analysis of four scoring methods and qualitative analysis. Dementia and Geriatric Cognitive Disorders, 26, 483–489.CrossRefGoogle ScholarPubMed
Leyhe, T.et al. (2009). Changes in cortical activation during retrieval of clock time representations in patients with mild cognitive impairment and early Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 27, 117–132.CrossRefGoogle ScholarPubMed
Matsuoka, T.et al. (2011). Neural correlates of performance on the different scoring systems of the clock drawing test. Neuroscience Letters, 487, 421–425.CrossRefGoogle ScholarPubMed
Mckhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Neufang, S.et al. (2011). Disconnection of frontal and parietal areas contributes to impaired attention in very early Alzheimer's disease. Journal of Alzheimer's Disease, 25, 309–321.CrossRefGoogle ScholarPubMed
Owen, A. M., Milner, B., Petrides, M. and Evans, A. C. (1996). Memory for object features versus memory for object location: a positron-emission tomography study of encoding and retrieval processes. Proceedings of the National Academy of Sciences of the United States of America, 93, 9212–9217.CrossRefGoogle ScholarPubMed
Rouleau, I., Salmon, D. P., Butters, N., Kennedy, C. and Mcguire, K. (1992). Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease. Brain and Cognition, 18, 70–87.CrossRefGoogle ScholarPubMed
Royall, D. R., Cordes, J. A. and Polk, M. (1998). CLOX: an executive clock drawing task. Journal of Neurology, Neurosurgery, and Psychiatry, 64, 588–594.CrossRefGoogle ScholarPubMed
Schramm, U., Berger, G., Muller, R., Kratzsch, T., Peters, J. and Frolich, L. (2002). Psychometric properties of clock drawing test and MMSE or Short Performance Test (SKT) in dementia screening in a memory clinic population. International Journal of Geriatric Psychiatry, 17, 254–260.CrossRefGoogle ScholarPubMed
Seidl, U.et al. (2012). Subcortical morphological correlates of impaired clock drawing performance. Neuroscience Letters, 512, 28–32.CrossRefGoogle ScholarPubMed
Shulman, K. I. (2000). Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Storey, J. E., Rowland, J. T., Basic, D. and Conforti, D. A. (2001). A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis. International Journal of Geriatric Psychiatry, 16, 394–399.CrossRefGoogle ScholarPubMed
Suhr, J., Grace, J., Allen, J., Nadler, J. and Mckenna, M. (1998). Quantitative and qualitative performance of stroke versus normal elderly on six clock drawing systems. Archives of Clinical Neuropsychology, 13, 495–502.CrossRefGoogle ScholarPubMed
Takahashi, M.et al. (2008). Poor performance in clock-drawing test associated with visual memory deficit and reduced bilateral hippocampal and left temporoparietal regional blood flows in Alzheimer's disease patients. Psychiatry and Clinical Neurosciences, 62, 167–173.CrossRefGoogle ScholarPubMed
Tranel, D., Rudrauf, D., Vianna, E. P. and Damasio, H. (2008). Does the clock drawing test have focal neuroanatomical correlates? Neuropsychology, 22, 553–562.CrossRefGoogle ScholarPubMed
Ueda, H.et al. (2002). Relationship between clock drawing test performance and regional cerebral blood flow in Alzheimer's disease: a single photon emission computed tomography study. Psychiatry and Clinical Neurosciences, 56, 25–29.CrossRefGoogle ScholarPubMed
Ventre-Dominey, J.et al. (2005). Double dissociation in neural correlates of visual working memory: a PET study. Brain Research. Cognitive Brain Research, 25, 747–759.CrossRefGoogle ScholarPubMed
Wise, S. P., Boussaoud, D., Johnson, P. B. and Caminiti, R. (1997). Premotor and parietal cortex: corticocortical connectivity and combinatorial computations. Annual Review of Neuroscience, 20, 25–42.CrossRefGoogle ScholarPubMed