Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, C/Marquès de Sentmenat 35-37, Barcelona, Spain.
J Alzheimers Dis. 2012;30(1):109-20. doi: 10.3233/JAD-2012-111850.
The 15-Objects Test (15-OT) provides useful gradation of visuoperceptual impairment from normal aging through Alzheimer's disease (AD) and correlates with temporo-parietal perfusion. The objectives of this study were to analyze progression of 15-OT performance in mild cognitive impairment (MCI) and AD, and its correlates with cognition and single photon emission computerized tomography (SPECT), as well as to examine neuropsychological and SPECT differences between the MCI patients who developed AD and those who did not. From the initial 126 participants (42/group), 38 AD, 39 MCI, and 38 elderly controls (EC) were reassessed (SPECT: 35 AD, 33 MCI, 35 EC) after two years. The progression of cognitive and SPECT scores during this period was compared between groups, and baseline data between converters and non-converters. The 15-OT was the only measure of progression that differed between the three groups; worsening scores on 15-OT were associated with worsening in verbal and visual retention, and decreased perfusion on left postsubicular area. In the MCI patients, cerebral perfusion fell over the two years in medial-posterior cingulate and fronto-temporo-parietal regions; AD showed extensive changes involving almost all cerebral regions. No SPECT changes were detected in controls. At baseline, the MCI patients who developed AD differed from non-converters in verbal recognition memory, but not in SPECT perfusion. In conclusion, SPECT and 15-OT appear to provide a potential measure to differentiate between normal aging, MCI, and AD. Worsening on 15-OT was related to decreased perfusion in postsubicular area; but further longitudinal studies are needed to determine the contribution of 15-OT as a predictor of AD from MCI.
15- 项测验（15-OT）可对正常衰老、阿尔茨海默病（AD）患者的视知觉障碍进行有用的分级，并与颞顶叶灌注相关。本研究的目的是分析轻度认知障碍（MCI）和 AD 患者的 15-OT 表现进展及其与认知和单光子发射计算机断层扫描（SPECT）的相关性，并检查发展为 AD 和未发展为 AD 的 MCI 患者的神经心理学和 SPECT 差异。从最初的 126 名参与者（42 名/组）中，有 38 名 AD、39 名 MCI 和 38 名老年对照组（EC）在两年后重新评估（SPECT：35 名 AD、33 名 MCI、35 名 EC）。比较了各组在此期间认知和 SPECT 评分的进展情况，并比较了转化者和非转化者的基线数据。15-OT 是三组之间唯一有差异的进展指标；15-OT 评分恶化与言语和视觉保留恶化以及左后下托区灌注减少相关。在 MCI 患者中，内侧后扣带回和额颞顶叶区域的脑灌注在两年内下降；AD 显示出广泛的变化，几乎涉及所有大脑区域。对照组未检测到 SPECT 变化。在基线时，发展为 AD 的 MCI 患者在言语识别记忆方面与非转化者不同，但 SPECT 灌注无差异。总之，SPECT 和 15-OT 似乎提供了一种潜在的方法来区分正常衰老、MCI 和 AD。15-OT 恶化与后下托区灌注减少有关；但需要进一步的纵向研究来确定 15-OT 作为从 MCI 预测 AD 的指标的贡献。
