Devanand D P, Liu Xinhua, Brown Patrick J, Huey Edward D, Stern Yaakov, Pelton Gregory H
Division of Geriatric Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 126, New York, NY 10032, USA.
Int J Alzheimers Dis. 2012;2012:483469. doi: 10.1155/2012/483469. Epub 2012 Feb 1.
A published predictor model in a single-site cohort study (questionable dementia, QD) that contained episodic verbal memory (SRT total recall), informant report of function (FAQ), and MRI measures was tested using logistic regression and ROC analyses with comparable measures in a second multisite cohort study (Alzheimer's Disease Neuroimaging Initiative, ADNI). There were 126 patients in QD and 282 patients in ADNI with MCI followed for 3 years. Within each sample, the differences in AUCs between the statistical models were very similar. Adding hippocampal and entorhinal cortex volumes to the model containing AVLT/SRT, FAQ, age and MMSE increased the area under the curve (AUC) in ADNI but not QD, with sensitivity increasing by 2% in ADNI and 2% in QD for a fixed specificity of 80%. Conversely, adding episodic verbal memory (SRT/AVLT) and FAQ to the model containing age, Mini Mental State Exam (MMSE), hippocampal and entorhinal cortex volumes increased the AUC in ADNI and QD, with sensitivity increasing by 17% in ADNI and 10% in QD for 80% specificity. The predictor models showed similar differences from each other in both studies, supporting independent validation. MRI hippocampal and entorhinal cortex volumes showed limited added predictive utility to memory and function measures.
在一项单中心队列研究（可疑痴呆，QD）中发表的预测模型，该模型包含情景性言语记忆（SRT总回忆）、功能的知情者报告（FAQ）和MRI测量指标，在第二项多中心队列研究（阿尔茨海默病神经影像学倡议，ADNI）中使用逻辑回归和ROC分析，并采用可比指标进行了测试。QD组有126例患者，ADNI组有282例MCI患者，随访3年。在每个样本中，统计模型之间的AUC差异非常相似。在包含AVLT/SRT、FAQ、年龄和MMSE的模型中加入海马体和内嗅皮质体积，ADNI组的曲线下面积（AUC）增加，但QD组未增加，在固定特异性为80%时，ADNI组和QD组的敏感性分别增加2%。相反，在包含年龄、简易精神状态检查（MMSE）、海马体和内嗅皮质体积的模型中加入情景性言语记忆（SRT/AVLT）和FAQ，ADNI组和QD组的AUC均增加，在特异性为80%时，ADNI组和QD组的敏感性分别增加17%和10%。在两项研究中，预测模型彼此之间显示出相似的差异，支持独立验证。MRI海马体和内嗅皮质体积对记忆和功能测量指标的额外预测效用有限。
