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Neuroimaging correlates of subjective memory deficits in a community population

From King’s College London (Institute of Psychiatry) (R.S.), UK; Inserm U708 "Neuroepidemiology" (C.D., O.G., C.T.), Paris; Université Pierre et Marie Curie–Paris 6 (C.D., O.G., C.T.); Inserm U888 (K.R.), Montpellier; and Groupe d’Imagerie Neurofonctionnelle (P.M., N.D., F.C., B.M.), UMR 6194, CNRS-CEA-Universités de Caen et Paris 5, Caen, France.

Address correspondence and reprint requests to Dr. Carole Dufouil, INSERM Unit 708, Hôpital La Salpêtrière, 75651 Paris Cédex 13, France carole.dufouil{at}chups.jussieu.fr

Background: Subjective memory deficit (SMD) is one of few potential presenting symptoms for people with early cognitive impairment. However, associations with underlying brain changes are unclear.

Methods: In a community sample of 1,779 people without dementia, and with neuroimaging (MRI) data, associations were investigated for SMD with white matter lesion volume and with the following volumetric measures: gray and white matter, CSF, hippocampal, parahippocampal, and amygdalar. Covariates included depressive symptoms (Center for Epidemiologic Studies Depression Scale), a battery of cognitive tests, physical health, and social activity.

Results: SMD was present in 26.4% of the sample. Of the neuroimaging measures analyzed, SMD was most strongly associated with temporal WML (OR for highest quintile compared to the remainder 1.44, 95% CI 1.12–1.85), and lower hippocampal volume (OR per decreasing quintile 1.22, 1.11–1.35). These associations were independent of all other covariates, including cognitive function.

Conclusions: Subjective memory deficit (SMD) was associated with neuroimaging characteristics in the temporal and hippocampal regions, suggesting that SMD may, at least in some cases, represent a realistic appraisal of underlying brain function independent of measured cognition. However, further research is required for volumetric measures and SMD to establish whether the association reflects lifelong structure or neurodegenerative changes.

GLOSSARY: CES-D = Center for Epidemiologic Studies Depression Scale; GM = gray matter; MMSE = Mini-Mental State Examination; ROI = regions of interest; SMD = subjective memory deficit; TIV = total intracranial volume; VBM = voxel-based morphometry; WM = white matter; WML = white matter lesions.

Supplemental data at www.neurology.org

The Three-City Study is conducted under a partnership agreement among the Institut National de la Santé et de la Recherche Médicale (INSERM), the Victor Segalen–Bordeaux II University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme "Cohortes et collections de données biologiques."

Disclosure: The authors report no conflicts of interest.

Received October 10, 2007. Accepted in final form January 8, 2008.

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