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Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects
Ewers M, Brendel M, Rizk-Jackson A, Rominger A, Bartenstein P, Schuff N, Weiner MW, Alzheimer's Disease Neuroimaging Initiative (ADNI).. NeuroImage. Clinical, 2013-11-04
Topic: Brain proteins, microglia and lab models
Brain changes reminiscent of Alzheimer disease (AD) have been previously reported in a substantial portion of elderly cognitive healthy (HC) subjects. The major aim was to evaluate the accuracy of MRI assessed regional gray matter (GM) volume, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and neuropsychological test scores to identify those HC subjects who subsequently convert to mild cognitive impairment (MCI) or AD dementia. We obtained in 54 healthy control (HC) subjects a priori defined region of interest (ROI) values of medial temporal and parietal FDG-PET and medial temporal GM volume. In logistic regression analyses, these ROI values were tested together with neuropsychological test scores (free recall, trail making test B (TMT-B)) as predictors of HC conversion during a clinical follow-up between 3 and 4 years. In voxel-based analyses, FDG-PET and MRI GM maps were compared between HC converters and HC non-converters. Out of the 54 HC subjects, 11 subjects converted to MCI or AD dementia. Lower FDG-PET ROI values were associated with higher likelihood of conversion (p = 0.004), with the area under the curve (AUC) yielding 82.0% (95% CI = (95.5%, 68.5%)). The GM volume ROI was not a significant predictor (p = 0.07). TMT-B but not the free recall tests were a significant predictor (AUC = 71% (95% CI = 50.4%, 91.7%)). For the combination of FDG-PET and TMT-B, the AUC was 93.4% (sensitivity = 82%, specificity = 93%). Voxel-based group comparison showed reduced FDG-PET metabolism within the temporo-parietal and prefrontal cortex in HC converters. In conclusion, medial temporal and-parietal FDG-PET and executive function show a clinically acceptable accuracy for predicting clinical progression in elderly HC subjects.
Key findings
- Lower FDG-PET ROI values were associated with higher likelihood of conversion (p = 0.004), with the area under the curve (AUC) yielding 82.0% (95% CI = (95.5%, 68.5%)).
- The GM volume ROI was not a significant predictor (p = 0.07).
- TMT-B but not the free recall tests were a significant predictor (AUC = 71% (95% CI = 50.4%, 91.7%)).
- In conclusion, medial temporal and-parietal FDG-PET and executive function show a clinically acceptable accuracy for predicting clinical progression in elderly HC subjects.
Why it matters
In 54 cognitively healthy elderly people followed for 3 to 4 years, lower FDG-PET values in medial temporal and parietal regions and worse executive function predicted conversion to mild cognitive impairment or Alzheimer's dementia, while gray matter volume did not. This concerns predicting progression and does not show that any treatment, cure or prevention works.
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Study details
- Effect size82.0%; 95.5%; 68.5%
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (NeuroImage. Clinical) |
| Journal's citation record | 1 / 4 | NeuroImage Clinical: journal h-index 133 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 111 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.9 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 3 / 6 | Cited 5.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Michael Walter Weiner: h-index 171 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24286024) |
| Free to read | 2 / 2 | Free to read |
| Total | 47 / 100 | — |
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Read the original
- DOI: 10.1016/j.nicl.2013.10.018
- PubMed: 24286024
- Original source →
- Free full text: NeuroImage Clinical →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Ewers, M., Brendel, M., Rizk-Jackson, A., Rominger, A., Bartenstein, P., Schuff, N., et al. (2014). Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects. NeuroImage. Clinical. https://doi.org/10.1016/j.nicl.2013.10.018
Vancouver
Ewers M, Brendel M, Rizk-Jackson A, Rominger A, Bartenstein P, Schuff N, et al. Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects. NeuroImage. Clinical. 2014. doi:10.1016/j.nicl.2013.10.018. PMID: 24286024.
BibTeX
@article{ewers2014-24286024,
author = {Ewers, M. and Brendel, M. and Rizk-Jackson, A. and Rominger, A. and Bartenstein, P. and Schuff, N. and Weiner, M. W.},
title = {{Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects}},
journal = {NeuroImage. Clinical},
year = {2014},
doi = {10.1016/j.nicl.2013.10.018},
pmid = {24286024},
url = {https://doi.org/10.1016/j.nicl.2013.10.018}
}
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