Cerebral metabolic correlates of the clinical dementia rating scale in mild cognitive impairment

Mild cognitive impairment (MCI) is often a prodromal state of Alzheimer's disease (AD). Imaging studies have shown that metabolic deficits in cerebral regions known to be affected early by AD pathology are predictive of progression to AD. In the present article, the authors examine associations between clinical impairment (Clinical Dementia Rating scale sum of boxes CDR-SB]) and regional deficits in glucose utilization in a sample of 41 patients with MCI, who underwent cerebral 18F-FDG PET for the measurement of regional glucose metabolism. A linear regression analysis with CDR-SB score as the independent variable and glucose metabolism as the dependent variable, adjusted for age, gender, and years of school education, was conducted in voxel-by-voxel fashion in SPM2. The regression analysis revealed a significant negative association between CDR-SB score and glucose metabolism in the right posterior cingulate gyrus (P < .001, uncorrected for multiple comparisons), which was independent from demographical variables. The authors conclude that clinical severity of impairments is already correlated with deficits in glucose metabolism in the stage of MCI.