Cortical Metabolic and Cognitive Correlates of Disorientation in Alzheimer's Disease

Gali H. Weissberger, Rebecca J. Melrose, Candace M. Fanale, Joseph V. Veliz, David L. Sultzer

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Orientation to time, date, and place is commonly utilized in clinical settings to aid in diagnosis, staging, and monitoring of Alzheimer's disease (AD). This study aimed to identify the cerebral metabolic correlates of orientation in patients with AD, and the degree to which regions associated with orientation overlap with memory-related structures. Eighty-five patients with a diagnosis of probable AD underwent fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological testing. Orientation items from the Dementia Rating Scale and recognition performance from the Consortium to Establish a Registry for AD (CERAD) Word List Learning test were correlated with cerebral glucose metabolism. Post-hoc analyses examined neuropsychological predictors of orientation. Better orientation performance related to greater cerebral metabolism in the bilateral middle-inferior temporal lobes, bilateral middle-posterior cingulate, left angular gyrus, and left middle occipital gyrus. In comparison, higher CERAD recognition discriminability score was associated with greater metabolic activity in left medial temporal lobe regions including the hippocampal and parahippocampal gyri, and the left fusiform gyrus. Post-hoc behavioral analyses revealed multiple cognitive functions to be related to orientation, including list learning, recognition memory, visuospatial functioning, attention, and language. Findings from the present study suggest that disorientation in AD results from dysfunction of a network of structures and cognitive abilities commonly found to be implicated in AD. The study supports the notion that memory is necessary but not sufficient for successful orientation.

Original languageEnglish
Pages (from-to)707-719
Number of pages13
JournalJournal of Alzheimer's Disease
Issue number2
StatePublished - 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 - IOS Press and the authors. All rights reserved.


Supported in part by the Department of Veterans Affairs (Merit Review award to Dr. Sultzer, Career Development and Merit Review awards to Dr. Mel-rose, Advanced Fellowship in Geriatrics award to Dr. Weissberger, and the Office of Academic Affiliations), and the NIMH (R01 MH-56031).

FundersFunder number
Office of Academic Affiliations
National Institute of Mental HealthR01 MH-56031
U.S. Department of Veterans AffairsI01CX000409


    • Alzheimer's disease
    • fluorodeoxyglucose F18
    • memory
    • neuropsychology
    • orientation


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