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Characteristic deterioration of ADAS-Jcog subscale scores and correlations with regional cerebral blood flow reductions in Alzheimer’s disease

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Abstract

The Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-Jcog) is composed of a number of subscale tasks. However, it is not clear which subscale tasks are most susceptible to impairment in Alzheimer’s disease (AD) or what is the relationship between reduction in regional cerebral blood flow (rCBF) and decreased ADAS-Jcog scores. Subjects were 32 AD patients, aged 52–86 years. We examined the relationship between subscale tasks that showed marked score changes and brain regions that showed reduced rCBF over a 2-year period. rCBF was measured by single-photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimer (99mTc-ECD), and the SPECT imaging data were analyzed with the easy Z-score imaging system (eZIS) and voxel-based stereotactic extraction estimation (vbSEE) methods. Total score of ADAS-Jcog deteriorated from 19.5 ± 7.0 to 35.7 ± 15.2 after 2 years. Subscale scores were significantly worse in all fields, particularly in orientation, word recall, remembering test instructions, commands, constructional praxis, and ideational praxis, in that order. Significant correlations were found between (1) word recall and commands and rCBF in the left middle temporal lobe, (2) naming objects/fingers and rCBF in the left temporal (middle, inferior) lobe, and (3) constructional and ideational praxis and rCBF in the right parietal (superior, inferior) lobe, temporal (superior, middle) lobe, angular gyrus, and cingulate gyrus. We identified the brain regions associated with specifically impaired subscales of ADAS-Jcog during progressive deterioration of AD over 2 years.

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Acknowledgements

We thank Mrs. Isa Yoshinari at the Department of Neurology, Saiseikai Shonan Hiratsuka Hospital, for her technical assistance.

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Authors and Affiliations

  1. Department of Neurology, Saiseikai Shonan Hiratsuka Hospital, 18-1 Miyamatsu-cho, Hiratsuka, 254-0036, Japan

    Fumihito Yoshii

  2. Department of Neurology, Tokai University Oiso Hospital, 21-1 Gakkyo, Naka-gun, 259-0198, Japan

    Fumihito Yoshii, Masafuchi Ryo & Wakoh Takahashi

  3. Department of Neurology, Seya Clinic, Seya, Yokohama, 246-0014, Japan

    Chikako Kawaguchi

  4. Department of Clinical Technology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Japan

    Saori Kohara, Mie Shimizu & Hiroe Onaka

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  1. Fumihito Yoshii
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  2. Chikako Kawaguchi
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  3. Saori Kohara
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  4. Mie Shimizu
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  5. Hiroe Onaka
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Correspondence to Fumihito Yoshii.

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The authors declare that they have no conflicts of interest.

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All procedures performed in our study were in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All authors hereby declare that submission of this manuscript for publication has been approved by Saiseikai Shonan Hiratsuka Hospital and Tokai University Oiso Hospital.

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Yoshii, F., Kawaguchi, C., Kohara, S. et al. Characteristic deterioration of ADAS-Jcog subscale scores and correlations with regional cerebral blood flow reductions in Alzheimer’s disease. Neurol Sci 39, 909–918 (2018). https://doi.org/10.1007/s10072-018-3277-6

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  • DOI: https://doi.org/10.1007/s10072-018-3277-6

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