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Aging and disease    2018, Vol. 9 Issue (6) : 1020-1030     DOI: 10.14336/AD.2018.0125
Orginal Article |
Relationship between Cortical Thickness and Neuropsychological Performance in Normal Older Adults and Those with Mild Cognitive Impairment
Cheng Calvin Pak-Wing1, Cheng Sheung-Tak2,*, Tam Cindy Woon-Chi3, Chan Wai-Chi4, Chu Winnie Chiu-Wing5, Lam Linda Chiu-Wa6
1Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong
2Department of Health and Physical Education, The Education University of Hong Kong and Norwich Medical School, University of East Anglia, UK
3Department of Psychiatry, North District Hospital, Hong Kong
4Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong
5Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong
6Department of Psychiatry, Tai Po Hospital, The Chinese University of Hong Kong, Hong Kong
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Abstract  

Mild cognitive impairment (MCI) has been extensively investigated in recent decades to identify groups with a high risk of dementia and to establish effective prevention methods during this period. Neuropsychological performance and cortical thickness are two important biomarkers used to predict progression from MCI to dementia. This study compares the cortical thickness and neuropsychological performance in people with MCI and cognitively healthy older adults. We further focus on the relationship between cortical thickness and neuropsychological performance in these two groups. Forty-nine participants with MCI and 40 cognitively healthy older adults were recruited. Cortical thickness was analysed with semiautomatic software, Freesurfer. The analysis reveals that the cortical thickness in the left caudal anterior cingulate (p=0.041), lateral occipital (p=0.009) and right superior temporal (p=0.047) areas were significantly thinner in the MCI group after adjustment for age and education. Almost all neuropsychological test results (with the exception of forward digit span) were significantly correlated to cortical thickness in the MCI group after adjustment for age, gender and education. In contrast, only the score on the Category Verbal Fluency Test and the forward digit span were found to have significant inverse correlations to cortical thickness in the control group of cognitively healthy older adults. The study results suggest that cortical thinning in the temporal region reflects the global change in cognition in subjects with MCI and may be useful to predict progression of MCI to Alzheimer’s disease. The different pattern in the correlation of cortical thickness to the neuropsychological performance of patients with MCI from the healthy control subjects may be explained by the hypothesis of MCI as a disconnection syndrome.

Keywords cortical thickness      dementia      mild cognitive impairment      neuropsychological performance      magnetic resonance imaging     
Corresponding Authors: Cheng Sheung-Tak   
About author:

These authors contributed equally to this work

Issue Date: 24 November 2017
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Cheng Calvin Pak-Wing
Cheng Sheung-Tak
Tam Cindy Woon-Chi
Chan Wai-Chi
Chu Winnie Chiu-Wing
Lam Linda Chiu-Wa
Cite this article:   
Cheng Calvin Pak-Wing,Cheng Sheung-Tak,Tam Cindy Woon-Chi, et al. Relationship between Cortical Thickness and Neuropsychological Performance in Normal Older Adults and Those with Mild Cognitive Impairment[J]. Aging and disease, 2018, 9(6): 1020-1030.
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http://www.aginganddisease.org/EN/10.14336/AD.2018.0125     OR     http://www.aginganddisease.org/EN/Y2018/V9/I6/1020
Healthy Controls (n=40)
Mean (SD)
MCI (n=49)
Mean (SD)
p-value
Age69.45 (4.56)75.92 (5.39)<0.001
Gender (Male: Female)15:2526:230.143
Education (years)8.00 (4.00)4.13 (4.04)<0.001
CMMSE27.68 (2.51)24.94 (2.85)<0.001
CDR - sum of boxes0.16 (0.43)1.02 (1.04)<0.001
ADAS-Cog6.46 (2.57)13.59 (3.61)<0.001
Delayed recall6.58 (1.47)2.29 (1.46)<0.001
CVFT40.10 (7.58)31.27 (8.03)<0.001
Digit span test (forward)7.50 (1.36)6.80 (1.44)0.021
Digit span test(backward)3.93 (1.65)2.59 (1.39)<0.01
Table 1  Participant demographics and neuropsychological performance.
Healthy ControlMCI

Brain regionLeftRightLeftRight
Caudal anterior cingulate gyrus2.689 (0.315) *2.599 (0.296)2.502 (0.378)*2.512 (0.290)
Caudal middle frontal gyrus2.258 (0.168)2.262 (0.148)2.218 (0.131)2.243 (0.145)
Cuneus1.618 (0.125)1.619 (0.118)1.612 (0.125)1.606 (0.117)
Entorthinal area3.403 (0.392)3.605 (0.487)3.288 (0.340)3.522 (0.413)
Fusiform gyrus2.639 (0.148)2.603 (0.156)2.577 (0.158)2.554 (0.188)
Inferior parietal lobe2.164 (0.123)2.115 (0.113)2.142 (0.135)2.122 (0.148)
Inferior temporal gyrus2.695 (0.161)2.681 (0.154)2.613 (0.158)2.636 (0.184)
Isthmus cingulate gyrus2.416 (0.187)2.302 (0.225)2.267 (0.229)2.195 (0.206)
Lateral occipital gyrus1.902 (0.130)*1.879 (0.126)1.899 (0.152)*1.874 (0.147)
Lateral orbitofrontal gyrus2.522 (0.140)2.469 (0.153)2.510 (0.164)2.430 (0.166)
Lingual gyrus1.787 (0.118)1.810 (0.087)1.782 (0.144)1.779 (0.167)
Medial orbitofrontal gyrus2.283 (0.170)2.369 (0.164)2.289 (0.181)2.612 (0.165)
Middle temporal gyrus2.670 (0.172)2.746 (0.139)2.660 (0.142)2.715 (0.169)
Parahippocampal gyrus2.535 (0.230)2.557 (0.256)2.378 (0.303)2.489 (0.264)
Paracentral gyrus2.271 (0.179)2.270 (0.158)2.223 (0.179)2.222 (0.158)
Pars opercularis2.357 (0.173)2.366 (0.135)2.351 (0.120)2.352 (0.142)
Pars orbitalis2.539 (0.217)2.509 (0.235)2.471 (0.221)2.494 (0.247)
Pars triangularis2.245 (0.134)2.279 (0.148)2.202 (0.134)2.213 (0.162)
Periphery calcarine1.385 (0.878)1.427 (0.103)1.414 (0.123)1.446 (0.128)
Postcentral gyrus1.819 (0.132)1.765 (0.104)1.779 (0.123)1.787 (0.118)
Posterior cingulate gyrus2.440 (0.221)2.395 (0.198)2.345 (0.175)2.325 (0.177)
Precentral gyrus2.364 (0.151)2.343 (0.124)2.312 (0.136)2.284 (0.144)
Precuneus2.128 (0.141)2.064 (0.119)2.086 (0.161)2.047 (0.141)
Rostral anterior cingulate gyrus2.820 (0.199)2.882 (0.248)2.744 (0.223)2.802 (0.286)
Rostral middle frontal gyrus2.110 (0.137)2.154 (0.120)2.090 (0.141)2.139 (0.139)
Superior frontal gyrus2.518 (0.146)2.540 (0.142)2.475 (0.141)2.503 (0.137)
Superior parietal lobe1.884 (0.135)1.843 (0.122)1.863 (0.126)1.831 (0.121)
Superior temporal gyrus2.563 (0.146)2.596 (0.177)*2.491 (0.161)2.574 (0.155)*
Supramarginal gyrus2.298 (0.126)2.229 (0.149)2.219 (0.141)2.201 (0.135)
Frontal pole2.671 (0.263)2.634 (0.210)2.597 (0.256)2.593 (0.275)
Temporal pole3.638 (0.267)3.759 (0.301)3.513 (0.283)3.625 (0.293)
Transverse temporal gyrus2.148 (0.252)2.106 (0.254)2.070 (0.197)2.107 (0.203)
Insula2.891 (0.157)2.879 (0.175)2.861 (0.158)2.800 (0.165)
Table 2  Cortical thickness in healthy control and mild cognitive impairment (mean +/- S.D., mm, adjusted for age and education).
CMMSECDR-Sum of boxesADAS-CogCVFTForward
digit span
Backward
Digit span

Brain regionLeftRightLeftRightLeftRightLeftRightLeftRightLeftRight
Caudal anterior cingulate gyrus-.077.075-.005.042-.139-.047.041.075-.108-.213-.104.172
Caudal middle frontal gyrus-.202-.171.309.302-.061.142-.108-.152-.022-.184-.059.018
Cuneus-.050.032-.062-.051.062-.097.209.221-.151-.090.065.120
Entorthinal area.173.323-.262-.366*-.413-.259.349.335.101.246-.301-.228
Fusiform gyrus.213.239-.159-.337-.137-.204.106.178.156.162-.125-.016
Inferior parietal lobe.096.029.091.083.003.058.163.117-.109-.110-.059.074
Inferior temporal gyrus.191*.508-.023-.198-.216-.369.350.262.023.214-.102.101
Isthmus cingulate gyrus.336.201-.118-.116-.277-.193-.043-.032.115.134.120.246
Lateral occipital gyrus.075-.017-.133.005-.035-.040.085-.016.007.092.085.225
Lateral orbitofrontal gyrus-.028-.040.202.003-.053-.044.231.125.085-.038.176-.021
Lingual gyrus.108.185-.111-.060-.119-.226.172.209.048.125.165.191
Medial orbitofrontal gyrus.076.046-.023.033.030-.148.334.376.038.066.118.047
Middle temporal gyrus.212.359.084-.182-.025.048.131.137-.072-.083-.137.180
Parahippocampal gyrus.215.200*-.413-.317-.061-.193-.111-.012.004.131-.337-.190
Paracentral gyrus-.144.043.122.197-.073-.044.005.048-.244-.098.005.054
Pars opercularis.031.001.160.101-.031-.117.114.126-.117.131.028-.187
Pars orbitalis-.013.059.311.221.029.099-.175-.050.277.245.315*.408
Pars triangularis.045.051.058-.009-.124-.155.170.159.013.138.227.302
Pericalcarine-.029-.251.048.072-.069-.117.173.194.010.010.194.038
Postcentral gyrus-.170-.188.131.107-.013.035.049.247-.114-.146.042.081
Posterior cingulate gyrus.039.040-.012.096-.116.057.100-.036-.046-.120-.067.181
Precentral gyrus-.044-.165.011.093.012-.088-.040.003-.193-.066-.090-.044
Precuneus.102.134-.032.060-.151-.115.203.184-.021-.106.032.022
Rostral anterior cingulate gyrus-.028-.070.284.239.024.214.016-.148-.096-.090.087-.014
Rostral middle frontal gyrus-.267-.100.185.116.071-.006.260*.398.017-.103.053.023
Superior frontal gyrus-.196-.190.391.255.032-.002.008.048-.210-.098.007-.119
Superior parietal lobe.002.029-.024.020-.089-.028.151.188-.008-.004.128.260
Superior temporal gyrus.247.232-.142-.242-.089.036.324.235.086.084.127.050
Supramarginal gyrus.092.026.167-.027-.174-.039.175.112-.021.109.062.149
Frontal pole.104.176-.150-.089.042-.080.047.324.056-.049.323-.005
Temporal pole.115.256-.215-.175-.187-.209.356252.208.085.021-.041
Transverse temporal gyrus-.267-.188.198.089.131.251.029-.170-.173-.002.254.156
Insula.092.116.237-.012-.162-.299.276.322-.051.079.007-.078
Table 3  Correlation between neuropsychological performance and cortical thickness in mild cognitive impairment.
Figure 1.  Correlation between right temporal gyrus and Cantonese version of the Mini-Mental State Examination (CMMSE).
CMMSECDR-Sum of boxesADAS-CogCVFTForward
digit span
Backward
Digit span

Brain regionLeftRightLeftRightLeftRightLeftRightLeftRightLeftRight
Caudal anterior cingulate gyrus.010-.062-.159-.177.104.257.131-.166.110-.063-.076-.133
Caudal middle frontal gyrus-.066.116.220.164.182.106-.031-.043-.314-.253.116.072
Cuneus-.060.041.185.025.169.095.021.056-.230-.057.155.143
Entorthinal area-.252-.175.161.162.272.211-.229-.227-.091-.069-.096-.210
Fusiform gyrus-.015-.027.122.131.268.171-.081-.100-.183-.242-.053-.100
Inferior parietal lobe-.055.128.158-.012.145.176-.024.006-.156-.009.081.182
Inferior temporal gyrus-.006.239.002-.230.073-.154-.199-.090-.104-.008.228.013
Isthmus cingulate gyrus-.139-.137.377.249.271.342-.148-.232-.293-.130.058.247
Lateral occipital gyrus.229.277-.108-.105.018.088.124.197.028-.009.259.277
Lateral orbitofrontal gyrus-.278-.234.389.284.153.126-.300-.049-.396-.416.127.076
Lingual gyrus-.079.222.105.001.197.131.122.246-.405.017-.004.216
Medial orbitofrontal gyrus-.191-.068.263-.046.122.121-.227-.182-.393*-.456-.003.079
Middle temporal gyrus-.125.043.309.006.248.085*-.445-.306-.195-.133.205.174
Parahippocampal gyrus-.180-.151.076-.007.109-.029-.293-.201-.241-.235-.046-.131
Paracentral gyrus.096-.086.036.124.233.116.130.044-.139-.235.287.065
Pars opercularis-.211.117.303.193.340.153-.094.042*-.496-.258.043-.005
Pars orbitalis-.228-.187.261.040-.043.064.064-.045-.225-.355.075.011
Pars triangularis-.200-.038.333.207.261.041-.008-.031-.367-.116-.116-.080
Pericalcarine-.177-.109.249.097.187.091.036.020-.237-.331-.040-.093
Postcentral gyrus.144-.103-.017.057-.011.181-.004.039-.009-.093.145-.027
Posterior cingulate gyrus-.061-.046.000.064.306.379-.074-.039-.044-.144.125.095
Precentral gyrus-.049.016.145.220.110.183-.031-.015-.326-.183.217.132
Precuneus.059-.028-.060.179.199.170.077.001-.091-.143.323.204
Rostral anterior cingulate gyrus-.108-.117-.111-.086.068-.035-.142.023-.189-.201-.171-.090
Rostral middle frontal gyrus-.276.054.267.064.037-.003-.181-.092*-.422-.162-.183.247
Superior frontal gyrus.063-.001.023.158.137.196-.025-.117-.166-.295.092.088
Superior parietal lobe.092-.037.092.100.168.173.039.021-.074-.173.267.271
Superior temporal gyrus.136.213.093-.188.202.177.008-.029-.142.205.011.126
Supramarginal gyrus.093-.020.134-.105.187.045-.096-.103-.084-.092.056.038
Frontal pole-.051.030-.051-.074.037-.174-.238.074-.132-.086.231.259
Temporal pole-.007.131-.037-.069.080-.021-.198-.226.025.076.105.101
Transverse temporal gyrus-.033.232.051-.289.131.051.022.235-.118.214.026.260
Insula.057-.078.038.206-.060.132-.220-.274-.155-.229-.008-.083
Table 4  Correlation between neuropsychological performance and cortical thickness in healthy control.
Figure 2.  Correlation between left parahippocampal gyrus and Clinical Dementia Rating (CDR)- sum of boxes.
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