Cortical signatures of cognition and their relationship to Alzheimer's disease.

Cortical signatures of cognition and their relationship to Alzheimer's disease.
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DOI:
10.1007/s11682-012-9180-5
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发表时间:
2012-12
影响因子:
3.2
通讯作者:
McLaren, Donald G.
McLaren, Donald G.
中科院分区:
医学3区
文献类型:
--
作者:
Gross, Alden L.;Manly, Jennifer J.;Pa, Judy;Johnson, Julene K.;Park, Lovingly Quitania;Mitchell, Meghan B.;Melrose, Rebecca J.;Inouye, Sharon K.;McLaren, Donald G.

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最近阿尔茨海默病(AD)诊断标准的变化表明,生物标志物可以提高AD诊断的确定性。在本研究中,我们将认知功能和脑形态学(一种潜在的成像生物标志物)结合起来,预测从轻度认知障碍到AD的转化。在阿尔茨海默病神经影像学倡议(ADNI)的参与者中,我们从皮层厚度对代表记忆、执行功能/处理速度、语言和视觉空间功能的神经心理因素的回归中确定了四种生物标志物或认知皮层特征(CSC)。神经心理因素评分是根据先前验证的ADNI神经心理电池的多维因素结构创建的。基线研究访问时每个CSC的平均厚度用于评估轻度认知障碍(MCI)参与者转化为临床AD的风险和临床痴呆评定量表(CDR-SB)评分的下降率。在307名MCI参与者中,119人转化为AD。对于所有特定领域的CSC,一个标准偏差的皮质厚度越薄,转换风险增加约50%,CDR-SB每年增加约0.30点。在结合领域特异性CSC和神经心理因素评分的模型中,CSC和因素评分都预测了AD的转化和临床严重程度的增加。随着结构磁共振成像在临床上比神经心理学测试更加常规和有效,这些特征可以用作阿尔茨海默病转化和临床严重程度增加的生物标志物。
Recent changes in diagnostic criteria for Alzheimer’s disease (AD) state that biomarkers can enhance certainty in a diagnosis of AD. In the present study, we combined cognitive function and brain morphology, a potential imaging biomarker, to predict conversion from mild cognitive impairment to AD. We identified four biomarkers, or cortical signatures of cognition (CSC), from regressions of cortical thickness on neuropsychological factors representing memory, executive function/processing speed, language, and visuospatial function among participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Neuropsychological factor scores were created from a previously validated multidimensional factor structure of the neuropsychological battery in ADNI. Mean thickness of each CSC at the baseline study visit was used to evaluate risk of conversion to clinical AD among participants with mild cognitive impairment (MCI) and rate of decline on the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score. Of 307 MCI participants, 119 converted to AD. For all domain-specific CSC, a one standard deviation thinner cortical thickness was associated with an approximately 50% higher hazard of conversion and an increase of approximately 0.30 points annually on the CDR-SB. In combined models with a domain-specific CSC and neuropsychological factor score, both CSC and factor scores predicted conversion to AD and increasing clinical severity. As structural magnetic resonance imaging becomes more clinically routine and time-effective than neuropsychological testing, these signatures can be used as biomarkers of conversion to AD andincreasing clinical severity.
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