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Brain Advance Access published online on June 23, 2003

Brain, doi:10.1093/brain/awg196
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© 2003 The Guarantors of Brain

Article

Dissociating atrophy and hypometabolism impact on episodic memory in mild cognitive impairment

Gaël Chételat 1, Béatrice Desgranges 1, Vincent de la Sayette 2*, Fausto Viader 2, Karim Berkouk 3, Brigitte Landeau 1, Catherine Lalevée 2, François Le Doze 4, Benoît Dupuy 5, Didier Hannequin 6, Jean-Claude Baron 7, and Francis Eustache 8

1 INSERM E0218-Université de Caen, GIP Cyceron, CHU Côte de Nacre, France
2 INSERM E0218-Université de Caen, GIP Cyceron, CHU Côte de Nacre; Services de Neurologie, CHU de Caen, France
3 INSERM E0218-Université de Caen, GIP Cyceron, CHU Côte de Nacre; PVE-OUT EC project, France
4 Services de Neurologie, CHU de Caen, France
5 CH de Cherbourg, France
6 CHU de Rouen, France
7 Services de Neurologie, CHU de Caen, France; Department of Neurology, University of Cambridge, Cambridge, UK
8 INSERM E0218-Université de Caen, GIP Cyceron, CHU Côte de Nacre; Ecole Pratique des Hautes Etudes, CNRS 8581, Université René Descartes, Paris 5, France

* Corresponding author. E-mail: neuropsycho{at}chu-caen.fr.

Received 5 August 2002 ; revised 9 February 2003 ; accepted 11 April 2003

Abstract

The present study aims to unravel, in the same study, both morphological and functional specific substrates of encoding versus retrieval deficits in patients with amnestic mild cognitive impairment (MCI). For this purpose, 21 highly screened MCI patients with isolated memory impairment, who attended a memory clinic and fulfilled operational criteria for MCI, underwent (i) two episodic memory subtests designed to assess preferentially either incidental encoding or retrieval capacity; (ii) a high-resolution T1-weighted volume MRI scan; and (iii) a resting state [18F]fluoro-2-deoxy-D-glucose PET study. Using statistical parametic mapping, positive correlations between memory scores on one hand, and grey matter density and normalized partial volume effect-corrected brain glucose utilization (ncCMRglc) on the other hand, were computed. Deficits in both encoding and retrieval were correlated with declines in hippocampal region grey matter density. The encoding subtest also correlated with hippocampal ncCMRglc, whereas the retrieval subtest correlated with the posterior cingulate area ncCMRglc only. The present findings highlight a distinction in the neural substrates of encoding and retrieval deficits in MCI. Furthermore, they unravel a partial dissociation between metabolic and structural correlates, suggesting distinct interpretations. Hippocampal atrophy was related to both encoding and retrieval deficits, possibly reflecting a direct effect on hippocampal functioning, as well as an indirect effect, through remote functional disruption, on posterior cingulate region synaptic function, respectively.

Keywords: Alzheimer's disease; resting cerebral glucose metabolism; MRI; statistical parametric mapping; episodic memory
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