Frontal neurodegeneration associated with Frontal Assessment Battery in early Alzheimer's disease

J Neurol Sci. 2024 Dec 15:467:123327. doi: 10.1016/j.jns.2024.123327. Epub 2024 Nov 23.

Abstract

Background: The Frontal Assessment Battery (FAB) is widely used to assess executive dysfunction in patients with amnestic mild cognitive impairments due to Alzheimer's disease (aMCI-AD), but its neurobiological meaning is unclear. To elucidate this, we examined the relationship between the FAB score and three key imaging biomarkers: gray matter volume, amyloid-beta (Aβ) deposition, and glucose metabolism.

Methods: Twenty Aβ- and tau-positive aMCI-AD patients and age-matched controls underwent structural magnetic resonance imaging and positron emission tomography with [11C]PiB and [18F]FDG. Voxel-based morphometry and statistical parametric mapping analyses were performed to elucidate the relationships between FAB scores and regional gray matter volume, [11C]PiB uptake for Aβ deposition, and [18F]FDG uptake for glucose metabolism.

Results: FAB scores were significantly lower in aMCI-AD than in controls (p < 0.001). In aMCI-AD, FAB was significantly correlated with right inferior frontal gray matter volume and right medial and left middle frontal glucose metabolism (family-wise error p < 0.05). However, there was no correlation between Aβ deposition and FAB (family-wise error p < 0.05).

Conclusions: The decreased FAB score is linked more with frontal-lobe neurodegeneration than with Aβ pathology in aMCI-AD. The FAB could be an early marker for neurodegeneration related to frontal-lobe executive dysfunction.

Keywords: Alzheimer's disease (AD); Amnestic mild cognitive impairments (aMCI); Frontal Assessment Battery (FAB); Voxel-based morphometry (VBM); [(11)C]PiB; [(18)F]FDG.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / pathology
  • Amyloid beta-Peptides / metabolism
  • Cognitive Dysfunction* / diagnostic imaging
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / pathology
  • Executive Function / physiology
  • Female
  • Fluorodeoxyglucose F18
  • Frontal Lobe* / diagnostic imaging
  • Frontal Lobe* / pathology
  • Glucose / metabolism
  • Gray Matter / diagnostic imaging
  • Gray Matter / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Positron-Emission Tomography*

Substances

  • Fluorodeoxyglucose F18
  • Amyloid beta-Peptides
  • Glucose