Impaired Picture Arrangement subscores (WAIS-III) associated with decreased place orientation and frontal/occipital blood flow in Alzheimer's disease: Implications for social judgment dysfunction. The Osaki-Tajiri Project

Alzheimer's disease (AD) patients manifest not only memory impairment but also deficit of social judgment. However, contrary to frequently recognized deficit, only two neuropsychological tests have been established for assessing “judgment” : the Cognitive Abilities Screening Instrument domain Abstraction & judgment and the Picture Arrangement subscale of WAIS-III. For the former, we previously reported an association with decreased regional cerebral blood flow (rCBF) in the left parietal lobe. Herein, we analyzed the scores of the Picture Arrangement test. Forty-nine AD patients were classified into two groups, i.e., the high and low PA score groups. The ^99mTc-ECD SPECT investigation was performed with the voxel-based analysis using SPM5. The Mini-Mental State Examination subscores of “place orientation” showed a correlation with the PA scores. The low PA score group exhibited significantly decreased rCBFs in the Left Inferior Frontal Gyrus (LIFG), Left Superior Frontal Gyrus (LSFG) and Right Occipital Lobe (ROL), compared with the high PA score group. The ability of PA may be associated with the place orientation, which may be necessary to re-arrange the pictures. The ROL was related to visual recognition. The LSFG may be involved in executive function or “frontal reasoning.”