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Computerized paired associate learning performance and imaging biomarkers in older adults without dementia

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Abstract

This cross-sectional study examined whether performance on the computerized Paired Associate Learning (PAL) task from the Cambridge Neuropsychological Test Automated Battery is associated with amyloid positivity as measured by Positron Emission Tomography, regional volume composites as measured by Magnetic Resonance Imaging, and cognitive impairment. Participants from the BIOCARD Study (N = 73, including 62 cognitively normal and 11 with mild cognitive impairment; M age = 70 years) completed the PAL task, a comprehensive clinical and neuropsychological assessment, and neuroimaging as part of their annual study visit. In linear regressions covarying age, sex, years of education and diagnosis, higher PAL error scores were associated with amyloid positivity but not with medial temporal or cortical volume composites. By comparison, standard neuropsychological measures of episodic memory and global cognition were unrelated to amyloid positivity, but better performance on the verbal episodic memory measures was associated with larger cortical volume composites. Participants with mild cognitive impairment demonstrated worse cognitive performance on all of the cognitive measures, including the PAL task. These findings suggest that this computerized visual paired associate learning task may be more sensitive to amyloid positivity than standard neuropsychological tests, and may therefore be a promising tool for detecting amyloid positivity in non-demented participants.

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Data availability

Anonymized data used in the analyses presented in this report are available on request from qualified investigators (biocard-se.org).

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Acknowledgements

This work was supported by the National Institutes of Health (grant numbers U19-AG033655, P30-AG066507), and in part by the Intramural Research Program of the National Institute on Aging, NIH. The BIOCARD Study consists of 7 Cores and two Projects with the following members: (1) the Administrative Core (Marilyn Albert, Rostislav Brichko); (2) the Clinical Core (Marilyn Albert, Anja Soldan, Corinne Pettigrew, Rebecca Gottesman, Greg Pontone, Leonie Farrington, Jules Gilles, Nicole Johnson, Maura Grega, Gay Rudow, Scott Rudow); (3) the Imaging Core (Michael Miller, Susumu Mori, Tilak Ratnanather, Andrea Faria, Anthony Kolasny, Kenichi Oishi, Laurent Younes); (4) the Biospecimen Core (Abhay Moghekar, Jacqueline Darrow, Alexandria Lewis); (5) the Informatics Core (Ann Ervin, Roberta Scherer, David Shade, Jennifer Jones, Hamadou Coulibaly, Kathy Moser); (6) the Biostatistics Core (Mei-Cheng Wang, Yuxin (Daisy) Zhu, Jiangxia Wang); (7) the Neuropathology Core (Juan Troncoso, Javier Redding, Karen Fisher); (8) Project 1 (Paul Worley, Jeremy Walston), and (9) Project 2 (Mei-Cheng Wang, Yifei Sun). The authors are grateful to the members of the BIOCARD Scientific Advisory Board who provide continued oversight and guidance regarding the conduct of the study including: Drs. David Holtzman, William Jagust, David Knopman, Walter Kukull, and Kevin Grimm, and Drs. John Hsiao and Laurie Ryan, who provide oversight on behalf of the National Institute on Aging. The authors thank the members of the BIOCARD Resource Allocation Committee who provide ongoing guidance regarding the use of the biospecimens collected as part of the study, including: Drs. Constantine Lyketsos, Carlos Pardo, Gerard Schellenberg, Leslie Shaw, Madhav Thambisetty, and John Trojanowski.

The authors acknowledge the contributions of the Geriatric Psychiatry Branch of the intramural program of NIMH who initiated the study (Principal investigator: Dr. Trey Sunderland). The authors are indebted to Dr. Karen Putnam, who provided documentation of the Geriatric Psychiatry Branch study procedures and the data files received from NIMH.

Funding

This work was supported by grants from the National Institute on Aging (U19-AG033655, P30-AG066507).

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Authors and Affiliations

  1. Department of Neurology, Division of Cognitive Neuroscience, Johns Hopkins University School of Medicine, 1620 McElderry Street, Reed Hall West - 1, Baltimore, MD, 21205, USA

    Corinne Pettigrew

  2. Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Anja Soldan, Rostislav Brichko & Marilyn Albert

  3. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21287, USA

    Yuxin Zhu & Mei-Cheng Wang

  4. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA

    Kwame Kutten & Michael I. Miller

  5. Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute On Aging, Baltimore, MD, 21224, USA

    Murat Bilgel

  6. Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Susumu Mori

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  1. Corinne Pettigrew
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the BIOCARD Research Team

Contributions

Author contributions included conception and study design (CP, AS, MA), data collection and image processing (RB, KK, MB, BIOCARD Research Team), statistical analysis (YZ, MCW), interpretation of results (CP, AS, MA), drafting the manuscript or revising it critically for important intellectual content (CP, AS, MA) and approval of final version to be published and agreement to be accountable for the integrity and accuracy of all aspects of the work (all authors).

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Correspondence to Corinne Pettigrew.

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CP, AS, RB, YZ, MCW, KK and MB report no disclosures. Michael I. Miller owns Anatomy Works, with Susumu Mori serving as its CEO. This arrangement is being managed by Johns Hopkins University in accordance with its conflict of interest policies. Marilyn Albert is an advisor to Eli Lily.

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Pettigrew, C., Soldan, A., Brichko, R. et al. Computerized paired associate learning performance and imaging biomarkers in older adults without dementia. Brain Imaging and Behavior 16, 921–929 (2022). https://doi.org/10.1007/s11682-021-00583-9

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