Prediction of cognitive decline in healthy older adults using fMRI

John L. Woodard, Michael Seidenberg, Kristy A. Nielson, J. Carson Smith, Piero Antuono, Sally Durgerian, Leslie Guidotti, Qi Zhang, Alissa Butts, Nathan Hantke, Melissa Lancaster, Stephen M. Rao

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Few studies have examined the extent to which structural and functional MRI, alone and in combination with genetic biomarkers, can predict future cognitive decline in asymptomatic elders. This prospective study evaluated individual and combined contributions of demographic information, genetic risk, hippocampal volume, and fMRI activation for predicting cognitive decline after an 18-month retest interval. Standardized neuropsychological testing, an fMRI semantic memory task (famous name discrimination), and structural MRI (sM I) were performed on 78 healthy elders (73% female; mean age = 73 years, range = 65 to 88 years). Positive family history of dementia and presence of one or both apolipoprotein E (APOE) ε4 alleles occurred in 51.3% and 33.3% of the sample, respectively. Hippocampal volumes were traced from sMRI scans. At follow-up, all participants underwent a repeat neuropsychological examination. At 18 months, 27 participants (34.6%) declined by at least 1 SD on one of three neuropsychological measures. Using logistic regression, demographic variables (age, years of education, gender) and family history of dementia did not predict future cognitive decline. Greater fMRI activity, absence of an APOE ε4 allele, and larger hippocampal volume were associated with reduced likelihood of cognitive decline. The most effective combination of predictors involved fMRI brain activity and APOE ε4 status. Brain activity measured from task-activated fMRI, in combination with APOE ε4 status, was successful in identifying cognitively intact individuals at greatest risk for developing cognitive decline over a relatively brief time period. These results have implications for enriching prevention clinical trials designed to slow AD progression.

Original languageEnglish (US)
Pages (from-to)871-885
Number of pages15
JournalJournal of Alzheimer's Disease
Volume21
Issue number3
DOIs
Publication statusPublished - Jan 1 2010
Externally publishedYes

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Keywords

  • Aging
  • apolipoprotein E
  • cognitive decline
  • fMRI
  • hippocampal volume
  • memory
  • neuroimaging

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Woodard, J. L., Seidenberg, M., Nielson, K. A., Smith, J. C., Antuono, P., Durgerian, S., ... Rao, S. M. (2010). Prediction of cognitive decline in healthy older adults using fMRI. Journal of Alzheimer's Disease, 21(3), 871-885. https://doi.org/10.3233/JAD-2010-091693