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Diffusion Tensor Imaging Predictors of Episodic Memory Decline in Healthy Elders at Genetic Risk for Alzheimer’s Disease

Published online by Cambridge University Press:  01 December 2016

Melissa A. Lancaster
Affiliation:
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
Michael Seidenberg
Affiliation:
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
J. Carson Smith
Affiliation:
Department of Kinesiology, University of Maryland, College Park, Maryland
Kristy A. Nielson
Affiliation:
Department of Psychology, Marquette University, Milwaukee, Wisconsin Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
John L. Woodard
Affiliation:
Department of Psychology, Wayne State University, Detroit, Wisconsin
Sally Durgerian
Affiliation:
Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
Stephen M. Rao*
Affiliation:
Neurological Institute, Cleveland Clinic, Cleveland, Ohio
*
Correspondence and reprint requests to: Stephen M. Rao, Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue / U10, Cleveland, OH 44195. E-mail: raos2@ccf.org

Abstract

Objectives: White matter (WM) integrity within the mesial temporal lobe (MTL) is important for episodic memory (EM) functioning. The current study investigated the ability of diffusion tensor imaging (DTI) in MTL WM tracts to predict 3-year changes in EM performance in healthy elders at disproportionately higher genetic risk for Alzheimer’s disease (AD). Methods: Fifty-one cognitively intact elders (52% with family history (FH) of dementia and 33% possessing an Apolipoprotein E ε4 allelle) were administered the Rey Auditory Verbal Learning Test (RAVLT) at study entry and at 3-year follow-up. DTI scanning, conducted at study entry, examined fractional anisotropy and mean, radial and axial diffusion within three MTL WM tracts: uncinate fasciculus (UNC), cingulate-hippocampal (CHG), and fornix-stria terminalis (FxS). Correlations were performed between residualized change scores computed from RAVLT trials 1–5, immediate recall, and delayed recall scores and baseline DTI measures; MTL gray matter (GM) and WM volumes; demographics; and AD genetic and metabolic risk factors. Results: Higher MTL mean and axial diffusivity at baseline significantly predicted 3-year changes in EM, whereas baseline MTL GM and WM volumes, FH, and metabolic risk factors did not. Both ε4 status and DTI correlated with change in immediate recall. Conclusions: Longitudinal EM changes in cognitively intact, healthy elders can be predicted by disruption of the MTL WM microstructure. These results are derived from a sample with a disproportionately higher genetic risk for AD, suggesting that the observed WM disruption in MTL pathways may be related to early neuropathological changes associated with the preclinical stage of AD. (JINS, 2016, 22, 1005–1015)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2016 

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