Elifcan ALADAĞ, Elif BULUT, Pınar DEMİRAYAK, Bilge Volkan SALANCI, Kader Karlı OĞUZ, Belkıs ERBAŞ, Eser Lay ERGÜN, Burcu Balam DOĞU, Mustafa CANKURTARAN, Meltem Gülhan HALİL

Comparison of Visual Rating Scale Based on Brain 18F-FDG-PET and Montreal Cognitive Assessment Test in Probable Alzheimer’s Disease

Objecives: Recently, imaging biomarkers like flouro-deoxi-glucose positron emission tomography (FDG-PET) become even more important for evaluation probable AD. The aim of this study was to evaluate the possible correlation between Montreal Cognitive Assessment Test (MoCA) and metabolic function of brain regions determined by FDGPET in patients with probable AD. Materials and methods: Thirty seven (37) patients who had diagnosis of probable AD were included. MoCA test and metabolic measurements of brain regions by FDG-PET were performed in all patients. A visual scoring was performed to obtain the rates of hypometabolism in brain regions. Results: Median age of the patients was 77 (minimum 65-maximum 83) years. On the right hemisphere, MOCA test score decreased according to visual FDG-PET score of parietal lobe (15±5.1, 11.8±8.4 and 8.5±5.9; p=0.032). MOCA test score was 16±5.8, 13.1±7.6 and 9.1±6.1 in patients with left temporal lobe and 15.2±5.2, 11.8±7.8 and 8.5±5.9 in patients with left parietal lobe according to visual FDG-PET scores respectively (p=0.035; p=0.02). The comparison of the other right and left hemisphere regions and MOCA test scores were not significant. Conclusion: The present study is emphasized that the MoCA test which is easily applied in outpatient clinics can be demonstrated the hypometabolism of bilateral parietal and left temporal brain regions related with pathophysiology of AD.

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[1] Scheltens P, De Strooper B, Kivipelto M, et al. Alzheimer’s disease. Lancet 2021; 397(10284):1577-1590.
[2] Dubois B, Villain N, Frisoni GB, et al. Clinical diagnosis of Alzheimer’s disease: recommendations of the International Working Group. Lancet Neurol 2021; 20(6):484-496.
[3] Chandra A, Dervenoulas G, Politis M, et al. Magnetic resonance imaging in Alzheimer’s disease and mild cognitive impairment. J Neurol 2019; 266(6):1293-1302.
[4] Chetelat G, Arbizu J, Barthel H, et al. Amyloid-PET and (18) F-FDG-PET in the diagnostic investigation of Alzheimer’s disease and other dementias. Lancet Neurol 2020; 19(11):951-962.
[5] Marcus C, Mena E, Subramaniam RM. Brain PET in the diagnosis of Alzheimer’s disease. Clin Nucl Med 2014; 39(10):e413-422; quiz e423-416.
[6] Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4):695-699.
[7] Nousia A, Siokas V, Aretouli E, et al. Beneficial Effect of Multidomain Cognitive Training on the Neuropsychological Performance of Patients with Early-Stage Alzheimer’s Disease. Neural Plast 2018; 2018:2845176.
[8] Woodford HJ, George J. Cognitive assessment in the elderly: a review of clinical methods. QJM 2007; 100(8):469- 484.
[9] Carson N, Leach L, Murphy KJ. A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores. Int J Geriatr Psychiatry 2018; 33(2):379-388.
[10] Bloudek LM, Spackman DE, Blankenburg M, et al. Review and meta-analysis of biomarkers and diagnostic imaging in Alzheimer’s disease. J Alzheimers Dis 2011; 26(4):627- 645.
[11] Shivamurthy VK, Tahari AK, Marcus C, et al. Brain FDG PET and the diagnosis of dementia. AJR Am J Roentgenol 2015; 204(1):W76-85.
[12] Bohnen NI, Djang DS, Herholz K, et al. Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. J Nucl Med 2012; 53(1):59- 71.
[13] Zukotynski K, Gaudet V, Kuo PH, et al. The Use of Random Forests to Identify Brain Regions on Amyloid and FDG PET Associated With MoCA Score. Clin Nucl Med 2020; 45(6):427-433.
[14] Jing J, Zhang F, Zhao L, et al. Correlation Between Brain 18F-AV45 and 18F-FDG PET Distribution Characteristics and Cognitive Function in Patients with Mild and Moderate Alzheimer’s Disease. J Alzheimers Dis 2021; 79(3):1317- 1325.
[15] Lee DY, Seo EH, Choo IH, et al. Neural correlates of the Clock Drawing Test performance in Alzheimer’s disease: a FDG-PET study. Dement Geriatr Cogn Disord 2008; 26(4):306-313.
[16] Woo BK, Harwood DG, Melrose RJ, et al. Executive deficits and regional brain metabolism in Alzheimer’s disease. Int J Geriatr Psychiatry 2010; 25(11):1150-1158.