Institute for Neurodegenerative Diseases, Clinical Branch, University and University Hospital of Bordeaux, Bordeaux, France.
Department of Psychology, University of Cincinnati, OH, USA.
J Alzheimers Dis. 2018;65(4):1209-1223. doi: 10.3233/JAD-180082.
Saccade alterations are potential early signs of Alzheimer's disease. However, uncertainty persists in how early and reliably automated saccade recording systems detect impairments. This multicenter pathophysiological case-control transversal study explored saccade execution in carefully diagnosed amnestic mild cognitive impairment patients fulfilling research criteria for prodromal Alzheimer's disease (n = 29), as compared to both aged-matched mild Alzheimer's disease patients (n = 23) and controls (n = 27). Auto-coded saccades from horizontal (gap) vertical (step) stimulus elicited pro-saccades, and anti-saccade (gap) tasks were compared across the 3 groups. Mild cognitive impairment patients committed significantly more anti-saccade errors compared to controls (46.9 versus 24.3%, p < 0.001). Conventional analyses of the auto-coded stimulus elicited saccades parameters did not distinguish the amnestic mild cognitive impairment from controls or the mild Alzheimer's disease group. However, an offline analysis of manually coded saccade latencies, using resampling statistics did reveal subtle differences among the groups. Analysis of the manually coded data revealed that the mild Alzheimer's disease group had a reliably larger self-corrected error-rate than in amnestic mild cognitive impairment and controls (p = 0.003). Analysis of the manually coded saccade latencies, using more sensitive lognormal bootstrap analysis revealed a continuum, from amnestic mild cognitive impairment to mild Alzheimer's disease, of an increased severity of impaired inhibition of stimulus elicited saccades and correct voluntary saccade initiation. Anti-saccade error rates and psychometric measures of executive and several other cognitive functions were moderately and negatively correlated. Overall, inhibitory impairments in stimulus elicited saccades, characteristic of Alzheimer's disease, may be detected early in presumed prodromal patients using a simple, automated anti-saccade task.
扫视改变是阿尔茨海默病的潜在早期迹象。然而，自动化扫视记录系统如何早期且可靠地检测到损伤仍存在不确定性。这项多中心病理生理学病例对照横断面研究探索了在满足前驱性阿尔茨海默病研究标准的精心诊断为遗忘型轻度认知障碍患者（n=29）、年龄匹配的轻度阿尔茨海默病患者（n=23）和对照组（n=27）中，扫视执行情况。自动编码水平（间隙）和垂直（步）刺激引发的前瞻性扫视和反扫视（间隙）任务在 3 组中进行比较。轻度认知障碍患者的反扫视错误明显多于对照组（46.9%比 24.3%，p<0.001）。自动编码刺激引发的扫视参数的常规分析不能区分遗忘型轻度认知障碍与对照组或轻度阿尔茨海默病组。然而，使用重采样统计对手动编码扫视潜伏期的离线分析确实揭示了组间的细微差异。手动编码数据的分析表明，轻度阿尔茨海默病组的自我校正错误率明显高于遗忘型轻度认知障碍和对照组（p=0.003）。使用更敏感的对数正态bootstrap 分析对手动编码的扫视潜伏期进行分析，显示出从遗忘型轻度认知障碍到轻度阿尔茨海默病的连续体，刺激引发的扫视抑制和正确的自愿扫视启动的受损抑制程度增加。反扫视错误率和执行以及其他几种认知功能的心理测量指标呈中度负相关。总体而言，使用简单的自动化反扫视任务，可能会在疑似前驱患者中早期检测到刺激引发扫视的抑制损伤，这是阿尔茨海默病的特征。
