Diagnostic differentiation of mild cognitive impairment due to Alzheimer's disease using a hippocampus-dependent test of spatial memory
Diagnostic differentiation of mild cognitive impairment due to Alzheimer's disease using a hippocampus-dependent test of spatial memory
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DOI：
10.1002/hipo.22417
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发表时间：
2015-08-01
期刊：
影响因子：
3.5
通讯作者：
Chan, Dennis
中科院分区：
文献类型：
--
作者：
Moodley, Kuven;Minati, Ludovico;Chan, Dennis
海马是阿尔茨海默病（AD）最早受累的脑区之一，海马功能测试有可能在AD的最早阶段检测到AD。考虑到海马体在异中心空间记忆中起关键作用，本研究应用了一种简短的空间记忆测试，即4山测试（4 MT），以确定测试性能是否可以区分有和没有潜在AD的CSF生物标志物证据的轻度认知障碍（MCI）患者，以及该测试在不同文化背景下应用时是否可以区分MCI和轻度AD痴呆患者。从英国和意大利的研究中心招募健康对照（HC）、MCI和轻度AD痴呆患者。研究编号为：HC（英国20，意大利10）、MCI（英国21，意大利14）和AD（英国11，意大利9）。19例英国MCI患者分为CSF生物标志物阳性（MCI+，n = 10）和生物标志物阴性（MCI-，n = 9）亚组。行为数据与海马体积和楔前叶和后扣带回皮质厚度相关。英国和意大利MCI和AD患者的空间记忆均受损。MCI+和MCI-亚组之间的测试性能也存在差异（P = 0.001）。在英国人群中，4 MT评分8/15与检测早期AD（MCI+和轻度AD痴呆）的100%灵敏度和90%特异性相关，在意大利样本中，检测MCI和AD的灵敏度和特异性为100%和50%。4 MT表现与英国人群的海马体积和两个研究人群的楔前叶皮质厚度相关。总之，表现在一个校园敏感的空间记忆测试区分MCI由于AD具有较高的诊断灵敏度和特异性。在两个独立的研究人群中获得了类似的诊断灵敏度，与社区记忆诊所中测试的可扩展性和可用性相关联，这一观察结果支持4 MT在AD所致痴呆前期诊断中的未来应用。(c)2015年威利期刊公司
The hippocampus is one of the earliest brain regions affected in Alzheimer's disease (AD) and tests of hippocampal function have the potential to detect AD in its earliest stages. Given that the hippocampus is critically involved in allocentric spatial memory, this study applied a short test of spatial memory, the 4 Mountains Test (4MT), to determine whether test performance can differentiate mild cognitive impairment (MCI) patients with and without CSF biomarker evidence of underlying AD and whether the test can distinguish patients with MCI and mild AD dementia when applied in different cultural settings. Healthy controls (HC), patients with MCI, and mild AD dementia were recruited from study sites in UK and Italy. Study numbers were: HC (UK 20, Italy 10), MCI (UK 21, Italy 14), and AD (UK 11, Italy 9). Nineteen UK MCI patients were grouped into CSF biomarker-positive (MCI+, n = 10) and biomarker-negative (MCI-, n = 9) subgroups. Behavioral data were correlated with hippocampal volume and cortical thickness of the precuneus and posterior cingulate gyrus. Spatial memory was impaired in both UK and Italy MCI and AD patients. Test performance additionally differentiated between MCI+ and MCI- subgroups (P = 0.001). A 4MT score of 8/15 was associated with 100% sensitivity and 90% specificity for detection of early AD (MCI+ and mild AD dementia) in the UK population, and with 100% sensitivity and 50% specificity for detection of MCI and AD in the Italy sample. 4MT performance correlated with hippocampal volume in the UK population and cortical thickness of the precuneus in both study populations. In conclusion, performance on a hippocampus-sensitive test of spatial memory differentiates MCI due to AD with high diagnostic sensitivity and specificity. The observation that similar diagnostic sensitivity was obtained in two separate study populations, allied to the scalability and usability of the test in community memory clinics, supports future application of the 4MT in the diagnosis of pre-dementia due to AD. (c) 2015 Wiley Periodicals, Inc.