Amyloid-PET Levels in the Precuneus and Posterior Cingulate Cortices Are Associated with Executive Function Scores in Preclinical Alzheimer's Disease Prior to Overt Global Amyloid Positivity

Background: Global amyloid-beta (A beta) deposition in the brain can be quantified by A beta-PET scans to support or refute a diagnosis of preclinical Alzheimer's disease (pAD). Yet, A beta-PET scans enable quantitative evaluation of regional A beta elevations in pAD, potentially allowing even earlier detection of pAD, long before global positivity is achieved. It remains unclear as to whether such regional changes are clinically meaningful. Objective: Test the hypothesis that early focal regional amyloid deposition in the brain is associated with cognitive performance in specific cognitive domain scores in pAD. Methods: Global and regional standardized uptake value ratios (SUVr) from F-18-florbetapir PET/CT scanning were determined using the Siemens Syngo.via (R) Neurology software package across a sample of 99 clinically normal participants with Montreal Cognitive Assessment (MoCA) scores >= 23. Relationships between regional SUVr and cognitive test scores were analyzed using linear regression models adjusted for age, sex, and education. Participants were divided into two groups based on SUVr in the posterior cingulate and precuneus gyri (SUVR >= 1.17). Between group differences in cognitive test scores were analyzed using ANCOVA models. Results: Executive function performance was associated with increased regional SUVr in the precuneus and posterior cingulate regions only (p < 0.05). There were no significant associations between memory and A beta-PET SUVr in any regions of the brain. Conclusion: These data demonstrate that increased A beta deposition in the precuneus and posterior cingulate (the earliest brain regions affected with A beta pathology) is associated with changes in executive function that may precede memory decline in pAD.

Automated summary

This study found that early focal regional amyloid deposition in the brain is associated with changes in executive function, but not memory, in preclinical Alzheimer's disease (pAD).