All ETDs from UAB

Advisory Committee Chair

Kristen Triebel

Advisory Committee Members

Georg Deutsch

Richard Kennedy

Adrienne Lahti

Daniel C Marson

Document Type

Dissertation

Date of Award

2013

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Diagnostic criteria for amnestic mild cognitive impairment (aMCI) include subjective memory complaint, objective memory impairment, preserved general cognitive function, intact functional abilities, and absence of dementia diagnosis (Petersen, 2004). However, there is evidence to suggest that some aMCI patients show declines in complex instrumental activities of daily living. Under the conceptual model proposed in this study, neuropathological changes occurring in the brain of aMCI and Alzheimer's disease (AD) patients underlie specific forms of neurocognitive dysfunction, which in turn drive decline in everyday functional skills such as financial capacity. The current study examined the relationships between structural brain changes in aMCI, cognition, and financial skills. 19 aMCI participants were included with a subset of 11 aMCI patients with presumed AD etiology (aMCI-AD). Participants completed structural magnetic resonance imaging, neuropsychological testing, and the Financial Capacity Instrument (FCI). Exploratory whole brain analyses examining differences in cortical thickness between aMCI and matched controls were conducted. Partial correlations were performed between cortical thickness measures and cognitive measures and FCI scores in aMCI patients, controlling for previous number of visits. No significant clusters of cortical thinning were found across the cortex in aMCI relative to controls, although aMCI patients displayed cortical thinning of the bilateral entorhinal cortex and right parahippocampal gyrus regions compared to controls. Global cortical thinning was moderately associated with global cognitive status. Learning and memory impairment displayed robust correlations with cortical thinning of temporal regions in the aMCI-AD subset only, while both aMCI samples demonstrated moderate correlations between written arithmetic skills and cortical thickness of the inferior parietal cortex. Deficits on the FCI were strongly correlated with cortical thinning of the precunei and inferior parietal cortex, and additionally the superior frontal cortex in the aMCI-AD sample. Therefore, cortical thickness may be a useful tool to detect global and domain specific cognitive change in aMCI. Cortical thinning of parietal and frontal regions is implicated in deficits of everyday financial skills in aMCI patients. The current findings supplement our previous volumetric studies and suggest cortical thickness measures can be used to detect changes in parietal and frontal regions related to impaired financial abilities in aMCI.

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