Anatomical Correlates of Interlocking Pentagon Drawing

Eek-Sung Lee; Yun Jeong Hong; Bora Yoon; Sung-Chul Lim; Yong S. Shim; Kook Jin Ahn; A-Hyun Cho; Dong-Won Yang

doi:10.12779/dnd.2012.11.4.141

Journal List > Dement Neurocogn Disord > v.11(4) > 1120795

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Lee, Hong, Yoon, Lim, Shim, Ahn, Cho, and Yang: Anatomical Correlates of Interlocking Pentagon Drawing

Original Article

Dementia and Neurocognitive Disorders

Dementia and Neurocognitive Disorders 2012; 11(4): 141-145.

Published online: 31 December 2012

DOI: https://doi.org/10.12779/dnd.2012.11.4.141

Anatomical Correlates of Interlocking Pentagon Drawing

Eek-Sung Lee, M.D., Yun Jeong Hong, M.D.^*, Bora Yoon, M.D.^†, Sung-Chul Lim, M.D.^‡, Yong S. Shim, M.D.^‡, Kook Jin Ahn, M.D.^§, A-Hyun Cho, M.D.^‡, Dong-Won Yang, M.D.^‡

Graduate School of Medical Science and Engineering, KAIST, Daejeon, Korea.

^*Hyoja Geriatric Hospital, Yongin, Korea.

^†Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.

^‡Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

^§Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address for correspondence: Dong-Won Yang, M.D. Department of Neurology, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6077, Fax: +82-2-599-9686, neuroman@catholic.ac.kr

Received 17 November 2012 Revised 12 December 2012 Accepted 17 December 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The interlocking pentagon drawing test, a part of the Mini-Mental State Examination (MMSE), is a widely used clinical practice to measure visuoconstructional ability of dementia patients. We investigated the anatomical structures of brain associated with pentagon drawing in subjects with mild to moderate Alzheimer's disease (AD) by using voxel-based morphometry (VBM).

Methods

Medical records of forty-four AD patients were reviewed and a 1.5 T SPGR 3D image data were used for VBM analysis. A voxel-based multiple regression analysis was used to investigate correlation between gray matter loss and pentagon drawing performance of AD patients. The correlations between pentagon drawing score and MMSE score were evaluated by Spearman correlation analysis.

Results

There was a positive correlation between the interlocking pentagon copying scores and the MMSE scores (r=0.448, p=0.002). The lower the scores of interlocking pentagon copying were, the more severe the atrophy of right inferior frontal gyrus became ([x, y, z]=[52, 39, 3], Broadmann area 45, and z score=3.86).

Conclusions

The performance of interlocking pentagon drawing is associated with a general cognitive function in patients with mild-to-moderate Alzheimer's disease. It is also associated with the atrophy of the right inferior frontal gyrus.

Keywords: Interlocking pentagon drawing, Right inferior frontal gyrus, Voxel-based morphometry, Alzheimer's disease

Figures and Tables

Fig. 1

The result of voxel-based regression analysis. A pentagon drawing score was positively correlated with cortical atrophy in the right inferior temporal gyrus (p<0.001, uncorrected for multiple comparisons, extent threshold=100 voxels).

Table 1

Intersecting pentagons scoring system

Table 2

Baseline dermographics

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