Cognitive Reserve: A SPECT Study of 132 Alzheimer’s Disease Patients with an Education Range of 0

Vol. 20, No. 1, 2005

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Original Research Article

Cognitive Reserve: A SPECT Study of 132 Alzheimer's Disease Patients with an Education Range of 0-19 Years
Yi-Chu Liao^{a, c, f}, Ren-Shyan Liu^d, Evenly Lee Teng^h, Yi-Chung Lee^{a, b, g}, Pei-Ning Wang^{a, c}, Ker-Neng Lin^{c, e}, Chih-Ping Chung^{a, c}, Hsiu-Chih Liu^{a, c}

^aDepartment of Neurology and
^bInstitute of Clinical Medicine, National Yang-Ming University School of Medicine,
^cNeurological Institute and
^dDepartment of Nuclear Medicine, Taipei Veterans General Hospital, and
^eDepartment of Psychology, Fu Jen Catholic University, Taipei,
^fDepartment of Neurology, E-Da Hospital and I-Shou University, Kaohsiung, and
^gDepartment of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan;
^hDepartment of Neurology, University of Southern California Keck School of Medicine, Los Angeles, Calif., USA

Address of Corresponding Author

Dement Geriatr Cogn Disord 2005;20:8-14 (DOI: 10.1159/000085068)

Key Words

Alzheimer's disease
Cognitive reserve
Education
Single photon emission computed tomography
Statistical parametric mapping

Abstract

This study examines the associations between education, cerebral perfusion, and cognitive test performance among 132 patients with Alzheimer's disease. The participants had had between 0 and 19 years of formal schooling, and had either mild or moderate dementia according to the Clinical Dementia Rating Scale. Cerebral perfusion was evaluated by the ^99mTc-hexamethylpropylene amine oxime single photon emission computed tomography. The Mini-Mental State Examination and the Cognitive Abilities Screening Instrument were used to assess cognitive performance. For patients at each clinical dementia severity level, statistical parametric mapping was used to examine voxel by voxel the association between education and cerebral perfusion, and Pearson's correlation coefficients were calculated between education and cognitive test scores. Years of formal schooling had negative associations with cerebral perfusion and positive associations with cognitive test scores. The brain regions showing a significant education effect on perfusion involved bilateral posterior association areas in mild dementia, and bilateral parieto-temporo-frontal areas in moderate dementia. The present findings indicate that the cognitive reserve effect starts at the low end of the education range. They also suggest that the main effect of more education is a more facile use of alternative brain circuits instead of locally increased synaptic connections.

Author Contacts

Dr. Hsiu-Chih Liu
The Neurological Institute, Taipei Veterans General Hospital
201 Sec. 2, Shih-pai Road, Shih-pai
Taipei 11217 (Taiwan)
Tel. +886 2 2875 7492, Fax +886 2 2873 8696, E-Mail hcliu@vghtpe.gov.tw

Article Information

Accepted: November 24, 2004
Published online: April 12, 2005
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 2, Number of References : 37

Medline Abstract (ID 15832030)

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