Poster Presentations: P3P512

Normal to AD as a single pattern-based score (Strother et al, OHBM, Que-

bec, 2011), and evaluated the relationship between CV scores, ROI rCMglc,

and MMSE, CDR-sb, and ADAS-11 performance. Results: AD subjects

worsened on average over 24 months by 4 points (SD¼5) on MMSE, 3

points (SD¼3) on CDR-sb and 8 points (SD¼7.6) on ADAS-11. Baseline

rCMglc CV score was significantly correlated with baseline MMSE

(P<0.011), CDR-sb (P<0.0004), and ADAS-11 (P<.0002) and predicted

24 month change (24mchg) in MMSE (P<.005), CDR-sb (P<.010), and

ADAS-11 (P<.001). Additionally, 12mchg in CV scores predicted

24mchg in MMSE (P<0.02), CDR-sb (P<0.004), and ADAS-11

(P<0.001). The 24mchg in CV scores was significantly correlated with

24mchg in MMSE (P<.005), CDR-sb (P<.010), and ADAS-11

(P<.0001). On a regional basis, significant correlations were found between

LTL andMMSE baseline and 24mchg scores (bothP<0.0001), and between

HIP and ADAS-11 baseline (P<0.010), ADAS-11 24mchg (P<0.072),

CDR-sb baseline (P<0.003), and CDR-sb 24mchg (P<0.051). Conclu-

sions: Measurement of glucose metabolism using a multivariate classifier

approach, and with ROI measures, provides a valuable biomarker to predict

cognitive status and subsequent longitudinal outcome.

Figure 1. Change in the CV1 pattern-based classifier score over 24 months

vs. change in ADAS-11 score over 24 months. Decreasing CV1 scores cor-

respond to increasing disease severity.

P3-172 SEVERITY OFAGE-RELATEDWHITE MATTER

HYPERINTENSITYASSOCIATEDWITH OBESITY,

HYPERTENSION AND EXECUTIVE

DYSFUNCTION

Deidre Devier1, Jessica Shields1, Katherine Smith2, Lynn Eckhardt3,

Anne Foundas1, 1Louisiana State University School of Medicine in New

Orleans, New Orleans, Louisiana, United States; 2Metropolitan Human

Services District of Louisiana, New Orleans, Louisiana, United States;3Ochsner Health Systems, New Orleans, Louisiana, United States.

Background:Aging is associated with decreased executive function and re-

duced frontal lobe volume. Increased numbers of white matter hyperinten-

sities (WMHs) in persons with mild cognitive impairment confer a greater

risk of conversion to Alzheimer’s disease. WMH formation is associated

with hypertension (HTN) and diabetes. We hypothesized that factors asso-

ciated with vascular risk andmetabolic syndromewould confer an increased

risk of WMHs and that the pattern of distribution (frontal) would be associ-

ated with increased executive dysfunction in a cohort of community-based

adults referred for a memory complaint in southeastern Louisiana.

Methods: The 1.5T MRI scans of 294 patients (Mean Age¼74.6,

Range¼55-97 years) were rated onWMH severity using the modified Faze-

kas rating scale (0¼no WMH; 3¼diffuse involvement). Of these, 80 partic-

ipants completed an extended mental status examination. Clinical

information included body mass index (BMI), HTN, diabetes, and hyperlip-

idemia. Results: Regression identified age as the largest predictor of whole

brainWMHs (R¼ .416, P< .001). In a stepwise regression model with clin-

ical factors, HTN and BMI remained predictors of totalWMHs (b¼.210 and

-.177, p<.01 respectively). A second model with cognitive variables re-

sulted in letter fluency predicting total WMHs (b¼-.242, P¼ .035) and clock

drawing predicting frontalWMHs (b¼-.099, P¼ .028). Agewas categorized

into approximate tertiles (<70, 70-79,�80). In the youngest group, no vari-

ables predicted total or frontal WMHs. In the middle age group, no comor-

bid variables predicted WMHs, but clock drawing predicted frontal WMHs

(b¼-.136, P¼ .042). In the oldest group, BMI predicted total WMHs

(b¼.223, P¼ .032) and HTN predicted frontal WMHs (b¼.89, P¼ .01).

Conclusions: Severity of WMHs was strongly related to age and BMI, hy-

pertension, letter fluency and clock drawing in a cohort of memory patients.

Results are consistent with the postulate that increased WHHs associated

with decline in executive functions are markers of preclinical pathology

in older adults. Results also support the hypothesis that t he interaction be-

tween vascular pathology and obesity may play an important role in execu-

tive dysfunction with increasing age. This potential increased burden on

brain pathology is likely more problematic in the southeastern United State

where HTN and obesity are common.

P3-173 EVIDENCE FOR DISSOCIABLE PATTERNS OF PIB

RETENTION DURING EARLY STAGES OF

AMYLOID ACCUMULATION

Elizabeth Mormino1, Aaron Schultz2, Alex Becker3,

Christopher Gidicsin3, Jacqueline Maye3, Lesley Pepin3, Dorene Rentz4,

Rebecca Amariglio3, Gad Marshall3, Keith Johnson5, Reisa Sperling4,1Massachusetts General Hospital, Boston, Massachusetts, United States;2Massachusetts General Hospital, Charlestown, Massachusetts, United

States; 3Massachusetts General Hospital, Boston, Massachusetts, United

States; 4Harvard Medical School, Boston, Massachusetts, United States;5Massachusetts General Hospital/Harvard Medical School, Boston,

Massachusetts, United States.

Background: Most studies have not demonstrated a clear relationship be-

tween regional amyloid burden and specific clinical symptomatology in

AD. Although group level analyses typically reveal diffuse elevation across

heteromodal cortices in high PiB subjects, it remains unclear whether any

spatial specificity exists in PiB retention during the early stages of amyloid

deposition.Methods:We explored 2 sets of PiB data that potentially reflect

early stages of amyloid deposition. Group 1 included cognitively normal el-

derly [CN, N¼116, mean age¼74(6)], from the Harvard Aging Brain Study,

whereas group 2 contained subjects across a range of cognitive impairment

(46 CN, 10 MCI, and 9 AD dementia) with global distribution volume ratio

(DVR) PiB values between 1.15 and 1.50 (i.e., the intermediate range of PiB

values presumably below plateau levels). Mean PiB DVR values across 33

cortical ROIs from the AAL atlas were subjected to exploratory maximum-

likelihood factor analysis in each group separately. Results: Factor analysis

of group 1 revealed 2 factors surpassing Kaiser criterion (accounting for

35% and 19% of the variance across PIB ROI values, see table,). Factor 1

was heavily influenced by frontal ROIs whereas factor 2 was influenced

by lateral parietal, precuneus and occipital ROIs. Group 2 analysis revealed

6 factors meeting criterion, with the first 2 factor loadings similar to the re-

sults from group 1 (accounting for 24% and 22% of the total variance, see

table). The remaining 4 factors were more focal and accounted for only

4-10% of the total variance (factor 3: superior lateral temporal; factor 4: me-

dial occipital; factor 5: inferior temporal; factor 6: temporal pole). Conclu-

sions: These analyses suggest that at least 2 dissociable spatial patterns of

PiB uptake may exist during early stages of amyloid accumulation-a frontal

predominant pattern, as well as a pattern encapsulating posterior regions of

Table

Factor loadings for each ROI from analyses performed on group 1 (cognitively normal subjects) and group 2 (intermediate PIB subjects). Loadings above 0.5 are

bolded for emphasis

AAL ROI

Group 1 Group 2

Factor1 Factor2 Factor1 Factor2 Factor3 Factor4 Factor5 Factor6

Rectus 0.8 0.305 0.872 0.299 0.08 0.082 0.116 0.146

Olfactory 0.701 0.344 0.726 0.156 0.223 0.27 �0.096 �0.016

Cingulate Ant 0.778 0.295 0.67 0.317 0.342 0.111 �0.118 0.006

Cingulate Mid 0.696 0.407 0.442 0.556 0.255 0.234 �0.033 �0.126

Frontal Sup 0.675 0.48 0.422 0.65 0.094 �0.069 0.038 0.054

Frontal Sup Medial 0.762 0.364 0.547 0.537 0.205 0.133 �0.202 0.041

Frontal Sup Orb 0.797 0.289 0.923 0.237 0.1 0.067 0.117 0.182

Frontal Inf Oper 0.655 0.371 0.624 0.29 0.382 0.016 0.224 0.104

Frontal Inf Orb 0.779 0.309 0.872 0.194 0.186 0.087 0.206 0.023

Frontal Inf Tri 0.703 0.401 0.727 0.416 0.269 �0.009 0.111 0.011

Frontal Mid 0.703 0.458 0.495 0.651 0.128 0.014 0.059 0.063

Frontal Mid Orb 0.786 0.282 0.919 0.228 0.122 0.07 0.101 0.099

Insula 0.68 0.304 0.67 0.114 0.505 0.172 0.212 0.001

Parietal Inf 0.538 0.614 0.197 0.921 0.159 0.124 0.007 0.023

Parietal Sup 0.488 0.656 0.138 0.853 0.171 0.243 0.2 �0.015

SupraMarginal 0.551 0.473 0.262 0.669 0.46 0.041 0.247 0.077

Angular 0.582 0.564 0.27 0.891 �0.016 0.033 0.063 0.146

Cingulate Post 0.49 0.357 0.052 0.158 0.061 0.124 0.081 0.11

Precuneus 0.599 0.544 0.322 0.845 0.061 0.232 0.012 0

Rolandic Oper 0.472 0.303 0.444 0.024 0.703 0.145 0.176 0.057

Temporal Pole Mid 0.421 0.312 0.198 0.133 0.07 0.039 0.222 0.895

Temporal Pole Sup 0.531 0.24 0.542 0.001 0.385 0.062 0.101 0.425

Heschl 0.417 0.352 0.211 0.115 0.901 0.165 0.02 0.004

Temporal Sup 0.492 0.439 0.244 0.351 0.784 0.233 0.155 0.145

Temporal Mid 0.561 0.479 0.382 0.604 0.255 0.18 0.399 0.261

Temporal Inf 0.505 0.422 0.476 0.319 0.068 0.104 0.647 0.31

Fusiform 0.407 0.372 0.298 0.003 0.141 0.398 0.728 0.243

Occipital Inf 0.362 0.457 0.01 0.118 0.142 0.405 0.856 0.022

Occipital Mid 0.418 0.639 0.09 0.603 0.025 0.326 0.516 0.155

Occipital Sup 0.364 0.699 �0.024 0.566 �0.068 0.454 0.352 0.1

Cuneus 0.405 0.581 0.207 0.513 0.076 0.703 0.148 0.099

Lingual 0.341 0.307 0.047 0.056 0.174 0.844 0.343 0.021

Calcarine 0.41 0.43 0.149 0.234 0.252 0.818 0.233 �0.023

Poster Presentations: P3 P513

the default mode network. Longitudinal PiB imaging will reveal whether

these spatial patterns reflect different points along a continuum of deposition

or intersubject differences in deposition patterns. The presence of dissocia-

ble patterns during early stages of amyloid accumulation has important im-

plications for regional amyloid-behavioral relationships as well as for the

use of global PIB measures in defining PiB positivity.

P3-174 CAN WE FURTHER DIVIDE AMNESTIC MILD

COGNITIVE IMPAIRMENT BASED ON THE

PATTERN OF MEMORY DEFICIT?

Eun Hye Jeong1, Heeyoung Kim2, Jae-Hong Lee2, 1Asan Medical Center,

Seoul, South Korea; 2Asan Medical Center, University of Ulsan College of

Medicine, Seoul, South Korea.

Background: Mild cognitive impairment (MCI) is considered as a transi-

tional state between normal aging and dementia and can be subdivided

into amnestic vs. nonamnestic and single vs. multiple domains types. It is

suggested that these clinical subtypes may have different underlying etiolo-

gies and outcomes. The amnestic MCI differs in the performance profile on

memory testing: retention vs. retrieval deficit. Generally, the retention def-

icit is attributed to the medial temporal dysfunction and the retrieval deficit

to the frontal dysfunction. We tried to determine whether there could be dis-

tinctive subtypes available even in the amnestic MCI. Methods: Sixty-two

patients with amnestic MCI-single domain were included in this retrospec-

tive study. They were divided into the retention- vs. the retrieval-deficit

groups according to the results of Seoul Verbal Learning Test (SVLT). We

compared baseline characteristics including vascular risk factors and neuro-

psychological profiles. We also measured the medial temporal atrophy

(MTA) using a visual rating scale and assessed lacunar infarcts and white

matter hyperintensities (WMH). Results: Of 62 patients, 41 had retention

deficit and 21 had retrieval deficit on SVLT. Among baseline clinical and de-

mographic variables, only the frequency of hypertension was higher in the

retrieval-deficit group (P ¼0.005). There were no differences in neuropsy-

chological profiles between the two groups other than a lower immediate re-

call score in the retention-deficit group (P¼0.012) and a higher recognition

score in the retrieval-deficit group (P¼0.001). Severities ofWMHandMTA

were not different between the two groups, nor were the number of lacunar

infarcts and microbleeds. Conclusions: We could not find any significant

difference except for the frequency of hypertension between the two sub-

groups of amnesticMCI, suggesting that there may be no further gain in sub-

dividing a single domain amnestic MCI.