Cognitive impairment no dementia neuropsychological and neuroimaging characterization of an amnestic subgroup
Cognitive impairment no dementia neuropsychological and neuroimaging characterization of an amnestic subgroup
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DOI：
10.1159/000115848
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发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
Feldman, Howard H.
中科院分区：
文献类型：
--
作者：
Jacova, Claudia;Peters, Kevin R.;Feldman, Howard H.
背景/目的：认知障碍无痴呆（CIND）是指认知功能低于正常但不符合痴呆标准的个体。CIND的一个重要目标是确定可预测进展为阿尔茨海默病的亚群。伴有遗忘缺陷的CIND与阿尔茨海默病的高风险有关，但迄今为止一直是在回顾性的基础上进行调查。在这项研究中，通过详细的神经心理测试和结构磁共振成像（MRI）测量，对前瞻性定义的健忘CIND组进行了表征。方法：遗忘性CIND定义为满足至少1项但不是全部DSM-IV-TR痴呆标准，Rey听觉言语学习测试延迟回忆得分低于标准6.1 SD，临床痴呆评分为0.5，迷你精神状态考试得分>= 24。这项横断面研究将符合这些标准的受试者（n = 25）与年龄和教育程度匹配的对照组（n = 26）进行了比较。神经心理学测试包括记忆和非记忆测量，作为连续变量进行分析，并将其分为受损（>= 1 SD低于对照组）和未受损。MRI扫描采用全脑容量测量[脑分数比（BFR）]和基于视觉的内侧颞叶萎缩（MTA）评分进行评估。结果：健忘症患儿在情景记忆领域和非记忆领域均存在神经心理障碍。80%的CIND受试者存在多域损伤。最明显的非记忆障碍是在语言能力领域，有64%的受试者受到影响，效应大小适中（d = 0.7）。MRI显示，与对照组相比，CIND患者的BFR较低（74.5 +/- 4.6 vs. 75.5 +/- 4.4）， MTA较高（72 vs. 38%, MTA >= 1）。BFR与MTA相关（r = -0.45），与综合记忆评分相关（r = 0.296）。结论：前瞻性遗忘性CIND分组似乎可以识别具有多域神经心理损伤模式和内侧颞叶和整体脑萎缩的个体。版权所有(c) 2008 S. Karger AG，巴塞尔。
Background/Aims: Cognitive impairment no dementia (CIND) describes individuals whose cognitive functioning falls below normal but who do not meet dementia criteria. An important goal within CIND is to identify subgroups that will predictably progress to Alzheimer disease. CIND with amnestic deficits has been associated with high risk of Alzheimer disease but has until now been investigated on a retrospective basis. In this study a prospectively defined amnestic CIND group was characterized on a detailed neuropsychological test battery and on structural magnetic resonance imaging (MRI) measures. Methods: Amnestic CIND was defined as meeting at least 1 but not all DSM-IV-TR criteria for dementia, scoring 6 1 SD below norms on Rey Auditory Verbal Learning Test delayed recall, having a Clinical Dementia Rating score of 0.5 and a Mini-Mental State Exam score >= 24. This cross-sectional study compared subjects meeting these criteria (n = 25) to age- and education-matched controls (n = 26). The neuropsychological battery included memory and nonmemory measures that were analyzed as continuous variables and dichotomized into impaired (>= 1 SD below controls) versus nonimpaired. MRI scans were evaluated with a global-brain volumetric measure [brain fractional ratio (BFR)] and with visually based medial temporal lobe atrophy (MTA) ratings. Results: Amnestic CIND had neuropsychological impairment in the episodic memory domain and also in nonmemory domains. There were 80% of CIND subjects with multidomain impairment. The most clear-cut nonmemory impairment was in the verbal ability domain, with 64% of subjects affected and a moderate effect size (d = 0.7). On MRI, BFR was lower (74.5 +/- 4.6 vs. 75.5 +/- 4.4) and MTA higher (72 vs. 38% with MTA >= 1) in CIND than in control subjects. BFR correlated with MTA (r = -0.45) and with a composite memory score (r = 0.296). Conclusion: A prospective amnestic CIND grouping appears to identify individuals with a multidomain pattern of neuropsychological impairment and with both medial temporal lobe and global brain atrophy. Copyright (c) 2008 S. Karger AG, Basel.