Brain Metabolic Correlates of Decision Making in Amnestic Mild Cognitive Impairment

Persons with amnestic mild cognitive impairment (MCI) have subtle impairments in medical decision-making capacity (MDC). We examined the relationship between proton magnetic resonance spectroscopy (MRS) and MDC in MCI. Twenty-nine MCI patients and 42 controls underwent MRS to obtain ratios of N-acet...

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Bibliographic Details
Published in:Aging, Neuropsychology, and Cognition Neuropsychology, and Cognition, 2010-01, Vol.17 (4), p.492-504
Main Authors: Griffith, H. Randall, Okonkwo, Ozioma C., den Hollander, Jan A., Belue, Katherine, Copeland, Jacqueline, Harrell, Lindy E., Brockington, John C., Clark, David G., Marson, Daniel C.
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Amnesia - metabolism
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Biological and medical sciences
Brain - metabolism
Choline - metabolism
Cognition Disorders - metabolism
Creatine - metabolism
Decision making
Decision Making - physiology
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Female
Geriatrics
Health Behavior
Hippocampus
Humans
Inositol - metabolism
Magnetic Resonance Spectroscopy
Male
Medical sciences
Middle Aged
Mild cognitive impairment
Nervous system (semeiology, syndromes)
Neurology
Neuropsychological Tests
Organic mental disorders. Neuropsychology
Posterior cingulate gyrus
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
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Summary:Persons with amnestic mild cognitive impairment (MCI) have subtle impairments in medical decision-making capacity (MDC). We examined the relationship between proton magnetic resonance spectroscopy (MRS) and MDC in MCI. Twenty-nine MCI patients and 42 controls underwent MRS to obtain ratios of N-acetylaspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, and myo-Inositol (mI)/Cr of the posterior cingulate. They also completed the Capacity to Consent to Treatment Instrument (CCTI), a vignette-based instrument measuring decisional standards of expressing choice, appreciating consequences of choice, providing rational reasons for choice, and understanding treatment choices. Patients showed abnormal MRS ratios of mI/Cr and Cho/Cr compared to controls, and impairments on the CCTI understanding and reasoning Standards. Performance on the reasoning standard of the CCTI was correlated with NAA/Cr (r = .46, p < .05). The relationship of NAA/Cr with decision-making suggests a role for posterior cortical neuronal functioning in performance of complex IADLs in MCI.
ISSN:1382-5585
1744-4128
DOI:10.1080/13825581003646135