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Eur J Nucl Med Mol Imaging. 2019 Aug;46(9):1787-1795. doi: 10.1007/s00259-019-04342-3. Epub 2019 Jun 10.

Level of education mitigates the impact of tau pathology on neuronal function.

Author information

1
Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany. merle.hoenig@uk-koeln.de.
2
Molecular Organization of the Brain, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany. merle.hoenig@uk-koeln.de.
3
Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany.
4
Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany.
5
Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.
6
Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.
7
Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany.
8
Department of Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.
9
German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany.
10
Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
11
Nuclear Chemistry, Institute of Neuroscience and Medicine (INM-5), Research Center Jülich, Jülich, Germany.
12
Institute of Radiochemistry and Experimental Molecular Imaging, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.
13
Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.
14
Molecular Organization of the Brain, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany.

Abstract

PURPOSE:

Using PET imaging in a group of patients with Alzheimer's disease (AD), we investigated whether level of education, a proxy for resilience, mitigates the harmful impact of tau pathology on neuronal function.

METHODS:

We included 38 patients with mild-to-moderate AD (mean age 67 ± 7 years, mean MMSE score 24 ± 4, mean years of education 14 ± 4; 20 men, 18 women) in whom a [18F]AV-1451 scan (a measure of tau pathology) and an [18F]FDG scan (a measure of neuronal function) were available. The preprocessed PET scans were z-transformed using templates for [18F]AV-1451 and [18F]FDG from healthy controls, and subsequently thresholded at a z-score of ≥3.0, representing an one-tailed p value of 0.001. Next, three volumes were computed in each patient: the tau-specific volume (tau pathology without neuronal dysfunction), the FDG-specific volume (neuronal dysfunction without tau pathology), and the overlap volume (tau pathology and neuronal dysfunction). Mean z-scores and volumes were extracted and used as dependent variables in regression analysis with years of education as predictor, and age and MMSE score as covariates.

RESULTS:

Years of education were positively associated with tau-specific volume (β = 0.362, p = 0.022), suggesting a lower impact of tau pathology on neuronal function in patients with higher levels of education. Concomitantly, level of education was positively related to tau burden in the overlap volume (β = 0.303, p = 0.036) implying that with higher levels of education more tau pathology is necessary to induce neuronal dysfunction.

CONCLUSION:

In patients with higher levels of education, tau pathology is less paralleled by regional and remote neuronal dysfunction. The data suggest that early life-time factors such as level of education support resilience mechanisms, which ameliorate AD-related effects later in life.

KEYWORDS:

Brain maintenance; Brain reserve; Glucose metabolism; Resilience; [18F]AV-1451; [18F]FDG

PMID:
31183635
DOI:
10.1007/s00259-019-04342-3

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