PREDICTION OF COGNITIVE DECLINE W/ MRI & MRS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 该项目的总体目标是确定大脑中纵向结构、灌注和代谢变化的模式，这是最好地预测未来因阿尔茨海默病(AD)而导致的认知衰退和痴呆的模式。具体地说，我们将确定MRI/MRS对认知测试的预测性“附加值”。我们将对130名65年前出现记忆障碍的非痴呆患者进行纵向临床评估、认知测试和MRI/MRS研究。在0、6、12、24个月由MRI/MRS获得自变量。以测量大脑结构、血流灌注和新陈代谢。因变量为记忆力下降和执行功能评分，每年评估一次。将临床痴呆评定量表和痴呆症转归作为次级因变量。总体假设是，MRI/MRSI可以预测认知功能下降/痴呆。假设：1.)初始内嗅皮层(ERC)容量预测认知功能下降/痴呆，并预测基线记忆功能的预测值。2.)除了基线记忆功能和ERC体积外，ERC萎缩的速度还可以提高对认知衰退的预测。3.)对记忆衰退最好的MRI预测指标是ERC和海马体体积随时间的变化，这些都增加了基线记忆功能的预测值。执行功能下降的最佳预测指标是额叶灰质的体积变化，这些变化增加了基线认知功能的预测价值。4.)除了基线记忆功能和ERC容量的变化外，海马区、颞叶和顶叶的灌流和代谢物(NAA，MI)随时间的变化进一步改善了对认知功能下降的预测。除了上述假设外，我们还将探索认知、遗传(APOE)和MRI/MRS测量的什么组合，以及扫描间隔是什么，最好地预测随后的认知功能下降/痴呆。该项目预计将改进预测AD引起的认知衰退/痴呆的方法；这些技术应该识别那些AD的高风险受试者，他们是一级预防的候选者。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall goal of this project is to determine the pattern of longitudinal structural, perfusion, and metabolic changes in the brain, which best predict future cognitive decline and dementia due to Alzheimer's disease (AD). Specifically we will determine the predictive "value added" of MRI/MRS to cognitive testing. We will perform longitudinal clinical evaluation, cognitive testing, and MRI/MRS studies on 130 completed non-demented subjects 65 yr, presenting with memory complaints. The independent variables will be obtained from MRI/MRS at 0, 6, 12,and 24 mo. to measure brain structure, perfusion, and metabolism. Dependent variables will be decline of memory and executive function scores, assessed annually. Clinical dementia rating scale and conversion to dementia will be used as secondary dependent variables. The overall hypothesis is that MRI/MRSI predicts cognitive decline/dementia. Hypotheses: 1.) Initial entorhinal cortex (ERC) volume predicts cognitive decline/dementia and ad ds to the predictive value of baseline memory function. 2.) In addition to baseline memory function and ERC volume, rate of ERC atrophy improves prediction of cognitive decline. 3.) The best MRI predictors for memory decline are volume change over time of ERC and hippocampus, and these add to the predictive value of baseline memory function. The best predictors of executive function decline are volume changes in frontal gray matter and these add to the predictive value of baseline cognitive function. 4.) In addition to baseline memory function and changes of ERC volume, perfusion and metabolite (NAA, mI) changes over time in hippocampus temporal and parietal lobe further improve prediction of cognitive decline. In addition to the above hypotheses, we will explore what combination of cognitive, genetic (APOE) and MRI/MRS measures, and what between-scan interval, best predicts subsequent cognitive decline/dementia. This project is expected to improve methods for predicting cognitive decl ine/dementia due to AD; these techniques should identify those subjects at high risk for AD, who are candidates for primary prevention.