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Alters of brain iron deposition in Alzheimer's disease patients after cognitive training: A prospective study1Department of Radiology, China-Japan Friendship Hospital, Beijing, China, 2Department of Anesthesiology, Peking University First Hospital, Beijing, China, 3GE Healthcare, Beijing, China
Synopsis
The increased iron deposition on brain quantitative susceptibility mapping (QSM) has been proved to be correlated with the decreased cognitive function of Alzheimer’s disease (AD) patients, while cognitive training seems an effective intervention for AD patients in clinic. This study quantifies the change of iron deposition of brain tissues before and after cognitive training and further explores the correlation between the change of iron deposition and the change of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores of mild AD patients. The results indicate that cognitive training can relieve iron deposition in right caudate nucleus (p<0.05), right hippocampus (p<0.01) and bilateral globus pallidus (p<0.05). However, there is no correlation between the change of iron deposition of brain tissues and the change of MMSE and MoCA scores, suggesting that cognitive training might be helpful to diminish disease progression of mild AD patients.
Introduction
Alzheimer's disease (AD) is a neurodegenerative disease and the iron deposition of brain tissues is associated with the disease severity.1 Cognitive training is an effective intervention for AD patients in clinic.2 However, the effect of cognitive training on the change of brain iron deposition remains unclear.Purpose
To investigate the change of iron deposition of brain tissues before and after cognitive training and explore the correlation between the change of iron deposition and the change of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores of mild AD patients.Methods
Twelve mild AD patients were randomly divided into the training group (n=5, mean age=75.4±4.51, 2 female) and the control group (n=7, mean age=75.4±4.24, 5 female). Cognitive training using a memory game on an iPad was given to the training group. All subjects were scanned with a 3 T GE Discovery MR750 scanner before and after 6 months, and the mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores were acquired at the meantime. The region of interest (ROI) was drawn in basal ganglia region (including caudate nucleus, putamen, globus pallidus) and hippocampus (Fig.1), and the magnetic susceptibility values were calculated. The correlation between the changes of brain iron deposition and the changes of MMSE and MoCA scores was analyzed using partial Spearman correlation analysis. Using paired t-test to analyze the difference of iron deposition of brain tissues before and after the treatment. Two-sample t-test was used to analyze the changes of brain iron deposition between the training group and the control group.Results
There was no linear correlation between the changes of MMSE and MoCA scores and the changes of magnetic susceptibility values. The increased susceptibility values in the control group was higher than that of the training group in right caudate nucleus (p<0.05), right hippocampus (p<0.01) and bilateral globus pallidus (p<0.05) (Fig.2).Conclusion
Cognitive training could slow down the brain iron deposition in mild AD patients.Acknowledgements
We are grateful to Dr. Kefeng Li from the University of California, San Diego for the helpful analysis software. The study is supported by the National Natural Science Foundation of China (NSFC) No. 81571641 and 81628008.References
[1] Du L, Zhao Z, Cui A, et al. Increased iron deposition on brain quantitative susceptibility mapping correlates with decreased cognitive function in Alzheimer’s disease. ACS Chemical Neuroscience, 2018, 9(7): 1849-1857.
[2] Savulich G, Piercy T, Fox C, et al. Cognitive training using a novel memory game on an iPad in patients with amnestic mild cognitive impairment (aMCI). International Journal of Neuropsychopharmacology, 2017, 20(8): 624-633.
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