IRCCS centro Neurolesi "Bonino-Pulejo", Messina, Italy.
J Alzheimers Dis. 2018;62(1):133-143. doi: 10.3233/JAD-170973.
Identifying the patients with mild cognitive impairment (MCI) who may develop dementia (MDC) is challenging. The study of peripersonal space (PPS) by using functional transcranial Doppler (fTCD) could be used for this purpose.
To identify changes in cerebral blood flow (CBF) during motor tasks targeting PPS, which can predict MDC.
We evaluated the changes in CBF in 22 patients with MCI and 23 with dementia [Alzheimer's disease (AD) and vascular dementia (VaD)] during a motor task (passive mobilization, motor imagery, and movement observation) in which the hand of the subject moved forward and backward the face.
CBF increased when the hand approached the face and decreased when the hand moved from the face in the healthy controls (HCs). CBF changed were detectable only in patients with MCI but not in those with the AD and those who were MDC after 8-month follow-up. On the other hand, the patients with VaD presented a paradoxical response to the motor task (i.e., a decrease of CBF rather than an increase, as observed in HCs and MCI). Therefore, we found a modulation of PPS-related CBF only in HCs and patients with stable MCI (at the 8-month follow-up).
fTCD may allow preliminarily differentiating and following-up the patients with MCI and MDC, thus allowing the physician to plan beforehand more individualized cognitive rehabilitative training.
识别可能发展为痴呆症(MDC)的轻度认知障碍(MCI)患者具有挑战性。使用功能经颅多普勒(fTCD)研究周边空间(PPS)可用于此目的。
确定针对 PPS 的运动任务中大脑血液流量(CBF)的变化,这些变化可以预测 MDC。
我们评估了 22 名 MCI 患者和 23 名痴呆症患者[阿尔茨海默病(AD)和血管性痴呆(VaD)]在运动任务(被动运动、运动想象和运动观察)期间的 CBF 变化,在此期间,受试者的手在面部前后移动。
健康对照组(HCs)中,当手靠近面部时 CBF 增加,当手从面部移动时 CBF 减少。仅在 MCI 患者中可检测到 CBF 的变化,而在 AD 患者和经过 8 个月随访后成为 MDC 的患者中则无法检测到。另一方面,VaD 患者对运动任务表现出矛盾的反应(即 CBF 减少而不是像 HCs 和 MCI 那样增加)。因此,我们仅在 HCs 和稳定的 MCI 患者(在 8 个月随访时)中发现了与 PPS 相关的 CBF 的调节。
fTCD 可能初步区分和随访 MCI 和 MDC 患者,从而使医生能够提前计划更个性化的认知康复训练。