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预测遗忘型轻度认知障碍的进展:情节记忆损伤与灌注 SPECT 的整合。

Predicting progression of amnesic MCI: The integration of episodic memory impairment with perfusion SPECT.

机构信息

Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.

Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy; IRCCS Fondazione Santa Lucia, Department of Clinical and Behavioral Neurology, Rome, Italy.

出版信息

Psychiatry Res Neuroimaging. 2018 Jan 30;271:43-49. doi: 10.1016/j.pscychresns.2017.10.008. Epub 2017 Oct 24.

Abstract

The present study aimed at assessing if the ability to predict progression from amnesic Mild Cognitive Impairment (aMCI) to dementia is improved by considering the presence at the baseline of Single Photon Emission Computed Tomography (SPECT) perfusion abnormalities in addition to a defect of long term memory. The Episodic Memory Score (EMS), a global index which integrates results obtained in subtests of the Rey's Verbal Learning Test and the Rey-Osterrieth Figure recall, were taken into account to evaluate defects of long term memory. The study sample consisted of 42 subjects affected by aMCI, who were followed-up during a two-year period. At the final follow-up 15 subjects progressed to AD. The EMS predicted progression from aMCI to dementia with a high level of sensitivity and a lower level of specificity, but the association of neuropsychological (EMS) and SPECT data (hypoperfusion in the Posterior Cingulate Cortex) increased the accuracy in predicting conversion from aMCI to AD. The association of results obtained by aMCI patients on memory tests and perfusion SPECT may improve the accuracy in detecting subjects who will progress to dementia. The use of currently available and low-cost investigations could be advantageous in terms of public health policies.

摘要

本研究旨在评估在基线时除了长时记忆缺陷外,如果考虑到单光子发射计算机断层扫描 (SPECT) 灌注异常的存在,是否能提高预测遗忘型轻度认知障碍 (aMCI) 向痴呆进展的能力。采用情景记忆评分 (EMS) 作为整体指标,该指标整合了 Rey 听觉言语学习测验和 Rey-Osterrieth 图形回忆测验子测验的结果,用于评估长时记忆缺陷。研究样本包括 42 名患有 aMCI 的患者,对他们进行了为期两年的随访。在最终随访时,有 15 名患者进展为 AD。EMS 对从 aMCI 到痴呆的进展具有较高的敏感性和较低的特异性,但将神经心理学 (EMS) 和 SPECT 数据 (后扣带回皮质灌注不足) 相结合可以提高预测 aMCI 向 AD 转化的准确性。将 aMCI 患者在记忆测试和灌注 SPECT 上的结果结合起来,可以提高检测出将进展为痴呆的患者的准确性。使用当前可用的、成本较低的检查方法可能在公共卫生政策方面具有优势。

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