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使用电生理成像预测有主观症状的正常老年人的纵向认知衰退。

Prediction of longitudinal cognitive decline in normal elderly with subjective complaints using electrophysiological imaging.

作者信息

Prichep L S, John E R, Ferris S H, Rausch L, Fang Z, Cancro R, Torossian C, Reisberg B

机构信息

Brain Research Laboratories, Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.

出版信息

Neurobiol Aging. 2006 Mar;27(3):471-81. doi: 10.1016/j.neurobiolaging.2005.07.021. Epub 2005 Oct 6.

Abstract

An extensive literature reports changes in quantitative electroencephalogram (QEEG) with aging and a relationship between magnitude of changes and degree of clinical deterioration in progressive dementia. Longitudinal studies have demonstrated QEEG differences between mild cognitively impaired (MCI) elderly who go on to decline and those who do not. This study focuses on normal elderly with subjective cognitive complaints to assess the utility of QEEG in predicting future decline within 7 years. Forty-four normal elderly received extensive clinical, neurocognitive and QEEG examinations at baseline. All study subjects (N = 44) had only subjective complaints but no objective evidence of cognitive deficit (evaluated using the Global Deterioration Scale [GDS] score, GDS stage = 2) at baseline and were re-evaluated during 7-9 year follow-up. Baseline QEEGs of Decliners differed significantly (p < 0.0001, by MANOVA) from Non-Decliners, characterized by increases in theta power, slowing of mean frequency, and changes in covariance among regions, especially on the right hemisphere. Using logistic regression, an R2 of 0.93 (p < 0.001) was obtained between baseline QEEG features and probability of future decline, with an overall predictive accuracy of 90%. These data indicate high sensitivity and specificity for baseline QEEG as a differential predictor of future cognitive state in normal, subjectively impaired elderly.

摘要

大量文献报道了随着年龄增长定量脑电图(QEEG)的变化,以及在进行性痴呆中变化幅度与临床恶化程度之间的关系。纵向研究表明,轻度认知障碍(MCI)的老年人中,病情继续恶化者和未恶化者的QEEG存在差异。本研究聚焦于有主观认知主诉的正常老年人,以评估QEEG在预测7年内未来认知衰退方面的效用。44名正常老年人在基线时接受了全面的临床、神经认知和QEEG检查。所有研究对象(N = 44)在基线时仅有主观主诉,但无认知缺陷的客观证据(使用总体衰退量表[GDS]评分评估,GDS分期 = 2),并在7 - 9年的随访期间进行了重新评估。衰退者的基线QEEG与非衰退者有显著差异(多变量方差分析,p < 0.0001),其特征为θ波功率增加、平均频率减慢以及区域间协方差变化,尤其是在右半球。使用逻辑回归分析,基线QEEG特征与未来衰退概率之间的R2为0.93(p < 0.001),总体预测准确率为90%。这些数据表明,基线QEEG作为正常、有主观认知障碍老年人未来认知状态的鉴别预测指标,具有高敏感性和特异性。

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