Department of Neurology, Konkuk University School of Medicine, Konkuk University Hospital, Seoul, Republic of Korea.
Dement Geriatr Cogn Disord. 2010;29(3):213-23. doi: 10.1159/000278422. Epub 2010 Mar 20.
Our purpose was to investigate differences in neuropsychological characteristics and glucose metabolism between early-onset mild cognitive impairment (EOMCI) and late onset MCI (LOMCI) patients and to determine if the baseline differences are predictive of conversion to dementia.
We enrolled 28 patients with MCI (12 EOMCI, 16 LOMCI) and 2 age-matched control groups. At the end of a 5-year follow-up, we compared the baseline neuropsychological and PET data between converters and nonconverters.
The EOMCI patients obtained significantly higher scores in verbal recall and word fluency tests than the LOMCI patients. The EOMCI group, compared to the young controls, demonstrated hypometabolism in brain regions vulnerable in mild Alzheimer's disease. Converters were significantly more impaired in the delayed verbal recall test than nonconverters (p = 0.028) and tended to be more impaired in the semantic word fluency test (p = 0.084). The baseline PET scan of the converters demonstrated severer hypometabolism in frontal areas than that of the nonconverters both in the EOMCI and LOMCI groups.
Our study suggests that EOMCI patients may differ from LOMCI in the patterns of cognitive deficits and glucose hypometabolism. In addition, baseline neuropsychological and FDG-PET findings suggest that MCI patients with poor memory or frontal dysfunction are at greater risk of conversion to dementia.
本研究旨在探究早发性轻度认知障碍(EOMCI)和晚发性轻度认知障碍(LOMCI)患者之间神经心理学特征和葡萄糖代谢的差异,并确定基线差异是否可预测向痴呆的转化。
我们纳入了 28 名 MCI 患者(12 名 EOMCI,16 名 LOMCI)和 2 个年龄匹配的对照组。在 5 年的随访结束时,我们比较了转化组和非转化组之间的基线神经心理学和 PET 数据。
EOMCI 患者在言语回忆和词汇流畅性测试中的得分明显高于 LOMCI 患者。与年轻对照组相比,EOMCI 组在轻度阿尔茨海默病易损脑区表现出代谢低下。与非转化组相比,转化组在延迟言语回忆测试中表现出更明显的损伤(p = 0.028),并且在语义词汇流畅性测试中也有损伤的趋势(p = 0.084)。转化组的基线 PET 扫描显示,与非转化组相比,额叶区域的代谢低下更为严重,无论是在 EOMCI 还是 LOMCI 组中。
我们的研究表明,EOMCI 患者在认知缺陷和葡萄糖代谢低下的模式上可能与 LOMCI 患者不同。此外,基线神经心理学和 FDG-PET 发现表明,记忆或额叶功能较差的 MCI 患者向痴呆转化的风险更高。