Comparison of semantic and episodic memory BOLD fMRI activation in predicting cognitive decline in older adults.
Comparison of semantic and episodic memory BOLD fMRI activation in predicting cognitive decline in older adults.
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DOI：
10.1017/s1355617712000951
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发表时间：
2013-01
影响因子：
2.6
通讯作者：
Rao, Stephen M.
中科院分区：
文献类型：
--
作者：
Hantke, Nathan;Nielson, Kristy A.;Woodard, John L.;Breting, Leslie M. Guidotti;Butts, Alissa;Seidenberg, Michael;Smith, J. Carson;Durgerian, Sally;Lancaster, Melissa;Matthews, Monica;Sugarman, Michael A.;Rao, Stephen M.
关键词：
以前的研究表明，任务激活的fMRI可以预测健康老年人未来的认知能力下降。本研究采用功能磁共振成像（fMRI）研究了语义记忆（SM）和情景记忆（EM）激活任务对认知功能减退的相对敏感性。78名认知功能完好的老年人在入组时和18个月后接受了神经心理学测试，根据表现下降≥1.0 SD，将参与者分类为认知“稳定”或“下降”。基线fMRI扫描包括SM（著名的名字歧视）和EM（名称识别）任务。使用逻辑回归分析，SM和EM fMRI激活，沿着APOE ε4状态，作为认知结果的预测因子。27名（34.6%）参与者被归类为下降，51名（65.4%）被归类为稳定。APOE ε4状态单独显著预测认知能力下降（R2 = 0.106; C指数= 0.642）。添加SM激活显著提高了预测准确性（R2 = 0.285; C指数= 0.787），而添加EM则没有（R2 = 0.212; C指数= 0.711）。结合APOE状态，SM任务激活比EM激活更能预测未来的认知衰退。这些结果对fMRI在预防性临床试验中的应用具有一定的意义，这些临床试验涉及识别与年龄相关的记忆丧失和阿尔茨海默病的风险人群。
Previous studies suggest that task-activated fMRI can predict future cognitive decline among healthy older adults. The present fMRI study examined the relative sensitivity of semantic memory (SM) versus episodic memory (EM) activation tasks for predicting cognitive decline. Seventy-eight cognitively intact elders underwent neuropsychological testing at entry and after an 18-month interval, with participants classified as cognitively “Stable” or “Declining” based on ≥1.0 SD decline in performance. Baseline fMRI scanning involved SM (famous name discrimination) and EM (name recognition) tasks. SM and EM fMRI activation, along with APOE ε4 status, served as predictors of cognitive outcome using a logistic regression analysis. Twenty-seven (34.6%) participants were classified as Declining and 51 (65.4%) as Stable. APOE ε4 status alone significantly predicted cognitive decline (R2 = .106; C index = .642). Addition of SM activation significantly improved prediction accuracy (R2 = .285; C index = .787), whereas the addition of EM did not (R2 = .212; C index = .711). In combination with APOE status, SM task activation predicts future cognitive decline better than EM activation. These results have implications for use of fMRI in prevention clinical trials involving the identification of persons at-risk for age-associated memory loss and Alzheimer’s disease.