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

Tatsuhiro Terada; Manabu Kubota; Jun Miyata; Tomokazu Obi; Hirotsugu Takashima; Takashi Matsudaira; Tomoyasu Bunai; Yasuomi Ouchi; Toshiya Murai

doi:10.1016/j.jns.2024.123327

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

J Neurol Sci. 2024 Nov 23:467:123327. doi: 10.1016/j.jns.2024.123327. Online ahead of print.

Authors

Tatsuhiro Terada¹, Manabu Kubota², Jun Miyata³, Tomokazu Obi⁴, Hirotsugu Takashima⁵, Takashi Matsudaira⁵, Tomoyasu Bunai⁶, Yasuomi Ouchi⁶, Toshiya Murai⁷

Affiliations

¹ Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan; Department of Biofunctional Imaging, Preeminent Bioimaging Research, Institute of Photonics Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu 431-3192, Japan. Electronic address: tatuhiro@hama-med.ac.jp.
² Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Brain Disorder Translational Research Group, Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
³ Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Psychiatry, Aichi Medical University, 1-1 Karimata, Yazako, Nagakute-shi, Aichi 480-1195, Japan.
⁴ Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan.
⁵ Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan; Department of Biofunctional Imaging, Preeminent Bioimaging Research, Institute of Photonics Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu 431-3192, Japan.
⁶ Department of Biofunctional Imaging, Preeminent Bioimaging Research, Institute of Photonics Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu 431-3192, Japan.
⁷ Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.

PMID: 39608296
DOI: 10.1016/j.jns.2024.123327

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.