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Am J Psychiatry 1997; 154:18-24
Copyright © 1997 by American Psychiatric Association
Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer's disease
E Mori, N Hirono, H Yamashita, T Imamura, Y Ikejiri, M Ikeda, H Kitagaki, T Shimomura and Y Yoneda
Division of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders, Japan. mori@hiabcd.go.jp
OBJECTIVE: Both the magnitude of brain atrophy and premorbid brain size
determine the volume of the brain affected by Alzheimer's disease. To
examine the possibility that premorbid brain volume is a determinant of
cognitive reserve in patients with Alzheimer's disease, the relation
between diffuse brain atrophy and cognitive decline and the impact of
premorbid brain size on cognitive decline were studied in patients with
Alzheimer's disease. METHOD: By measuring whole brain volume and
intracranial volume in 60 patients with probable Alzheimer's disease, mild
to moderate in severity, with the use of high-resolution magnetic resonance
imaging and image processing, the authors studied the impact of premorbid
brain volume and magnitude of diffuse brain atrophy on cognitive functions.
On the basis of the normative brain-calvarium relationship derived from
data an 28 healthy adults and the total intracranial volume measure of each
patient, the magnitude of brain atrophy and premorbid brain volume were
estimated. RESULTS: After control for the effects of age, sex, and
education as confounding factors, it was found that the Alzheimer's disease
patients' intelligence was correlated both positively with premorbid brain
volume and negatively with magnitude of brain atrophy, while impairments in
language and memory were correlated with magnitude of brain atrophy but not
with premorbid brain volume. CONCLUSIONS: These findings partially support
the hypothesis that premorbid brain volume is a determinant of reserves
against intellectual decline in Alzheimer's disease.
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