fMRI and SAGE Test Evaluation of pre-Mild Cognitive Impairment (pre-MCI)

Stoicea Nicoleta¹, Scharre D¹, Abduljalil AM², Knopp M², Schmalbrock Petra², Gusti Simona³, Gusti Alice⁴, Narayanan A⁵

1 Department of Neurology, The Ohio State University, Columbus, OH, USA
2 Department of Radiology, Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
3 Department of Physiology, University of Medicine and Pharmacy, Craiova, Romania
4 Faculty of Exercise Science and Sport, Craiova, Romania
5 Interdisciplinary Graduate Studies Program, The Ohio State University, Columbus, OH, USA

Introduction: Mild Cognitive Impairment (MCI) is characterized by impaired memory and preserved activities of daily living. fMRI shows increased medial temporal lobe (MTL) activation during memory tasks in MCI patients as compared to lower activation in normal and dementia controls. Recent research has investigated patients with cognitive decline that is insufficient for MCI criteria, but who also appear to be at increased risk for developing MCI and dementia, known as pre-MCI. We compared pre-MCI subjects with matched normal controls using fMRI memory, visual, verbal, and problem solving tasks in an attempt to improve early identification of pre-MCI subjects.
Methods: Right-handed, English speaking pre-MCI patients were age and education matched with normal controls. Each subject completed the National Adult Reading Test (NART) and the Self-Administered Georcognitive Examination (SAGE). fMRI scanning was performed on a 3 T Achieva Philips scanner using an Invivo IFIS-SA fMRI System. Four cognitive tasks were performed during and after fMRI imaging testing: [1] Attention, [2] Verbal fluency, [3] Visuospatial problem solving (VPS), and [4] Memory. Single subject and group functional analysis was performed.
Results: Sixteen subjects (8 pre-MCI, ages 66–82y, and 8 matched normal controls) participated. Pre-MCI subjects showed numerically worse cognitive performance on the verbal fluency, problem solving and attention tasks than controls. While performing these tasks, pre-MCI subjects had reduced activation in the visual cortex during the attention task and in the frontal cortex during the verbal fluency task.
Conclusions: While more research is needed, specific fMRI activation tasks appear to differentiate pre-MCI from normals and may aid both in the initial identification of pre-MCI and possibly in follow-up evaluations looking for progression to dementia.